Article

Surgical treatment of spinal deformity is high risk in patients
suffering from Parkinson's disease (PD). Several series have already reported a
high rate of complications. However, none of these studies included more than 40
patients and none of the risk factors of complications were described. The aim of
this study was to describe the rate and risk factors of revision surgery as well
as the clinical outcome at the last visit in a large multicenter study of PD patients operated for spinal deformities. METHODS: A multicenter retrospective
study included arthrodesis for spinal deformity in patients with PD. Clinical and
surgical data including revision surgeries were collected. Assessment of
functional outcomes at last follow-up was classified in 3 grades and spinal
balance was assessed on anteroposterior and lateral plain X-rays of the entire
spine. RESULTS: Forty-eight patients were included. Median age was 67 years old
(range 41-80). Median follow-up was 27 months. The rate of surgical revision was
42%. Eighty per cent of revisions were performed for chronic mechanical
complication. Global results were considered to be good in 17 patients (35%),
doubtful in 17 patients (35%) and a failure in 14 patients (30%), for the whole
series. CONCLUSIONS: The results of surgery for spinal deformities in patients
with Parkinson disease vary with a high rate of complications and revisions.
Nevertheless, these results should be seen in relation to the natural progression
of these spinal deformities once spinal imbalance has developed. The association
between preoperative clinical balance and final outcome suggests that early
surgery can probably play a role in treatment.
LEVEL OF EVIDENCE: Level IV (e.g. case series).
CI - Copyright (c) 2017 Elsevier Masson SAS. All rights reserved.

Langue : FRANCAIS