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Surgical outcomes of spinal fusion for osteoporotic thoracolumbar vertebral fractures in patients with Parkinson's disease: what is the impact of Parkinson's disease on surgical outcome?

ABSTRACT: BACKGROUND:To date, there have been little published data on surgical outcomes for patients with PD with thoracolumbar OVF. We conducted a retrospective multicenter study of registry data to investigate the outcomes of fusion surgery for patients with Parkinson's disease (PD) with osteoporotic vertebral fracture (OVF) in the thoracolumbar junction. METHODS:Retrospectively registered data were collected from 27 universities and their affiliated hospitals in Japan. In total, 26 patients with PD (mean age, 76?years; 3 men and 23 women) with thoracolumbar OVF who underwent spinal fusion with a minimum of 2?years of follow-up were included (PD group). Surgical invasion, perioperative complications, radiographic sagittal alignment, mechanical failure (MF) related to instrumentation, and clinical outcomes were evaluated. A control group of 296 non-PD patients (non-PD group) matched for age, sex, distribution of surgical procedures, number of fused segments, and follow-up period were used for comparison. RESULTS:The PD group showed higher rates of perioperative complications (p?

SUBMITTER: Watanabe K

PROVIDER: S-EPMC6408814 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Surgical outcomes of spinal fusion for osteoporotic thoracolumbar vertebral fractures in patients with Parkinson's disease: what is the impact of Parkinson's disease on surgical outcome?

Watanabe Kei K Katsumi Keiichi K Ohashi Masayuki M Shibuya Yohei Y Izumi Tomohiro T Hirano Toru T Endo Naoto N Kaito Takashi T Yamashita Tomoya T Fujiwara Hiroyasu H Nagamoto Yukitaka Y Matsuoka Yuji Y Suzuki Hidekazu H Nishimura Hirosuke H Terai Hidetomi H Tamai Koji K Tagami Atsushi A Yamada Syuta S Adachi Shinji S Yoshii Toshitaka T Ushio Shuta S Harimaya Katsumi K Kawaguchi Kenichi K Yokoyama Nobuhiko N Oishi Hidekazu H Doi Toshiro T Kimura Atsushi A Inoue Hirokazu H Inoue Gen G Miyagi Masayuki M Saito Wataru W Nakano Atsushi A Sakai Daisuke D Nukaga Tadashi T Ikegami Shota S Shimizu Masayuki M Futatsugi Toshimasa T Ohtori Seiji S Furuya Takeo T Orita Sumihisa S Imagama Shiro S Ando Kei K Kobayashi Kazuyoshi K Kiyasu Katsuhito K Murakami Hideki H Yoshioka Katsuhito K Seki Shoji S Hongo Michio M Kakutani Kenichiro K Yurube Takashi T Aoki Yasuchika Y Oshima Masashi M Takahata Masahiko M Iwata Akira A Endo Hirooki H Abe Tetsuya T Tsukanishi Toshinori T Nakanishi Kazuyoshi K Watanabe Kota K Hikata Tomohiro T Suzuki Satoshi S Isogai Norihiro N Okada Eijiro E Funao Haruki H Ueda Seiji S Shiono Yuta Y Nojiri Kenya K Hosogane Naobumi N Ishii Ken K

BMC musculoskeletal disorders 20190309 1

<h4>Background</h4>To date, there have been little published data on surgical outcomes for patients with PD with thoracolumbar OVF. We conducted a retrospective multicenter study of registry data to investigate the outcomes of fusion surgery for patients with Parkinson's disease (PD) with osteoporotic vertebral fracture (OVF) in the thoracolumbar junction.<h4>Methods</h4>Retrospectively registered data were collected from 27 universities and their affiliated hospitals in Japan. In total, 26 pati ...[more]

PMID: 30851739

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Project description:BACKGROUND:Vitamin D deficiency has long been studied as a risk factor for osteoporosis. However, the association between serum vitamin D status, bone mineral density (BMD) and the incidence of vertebral fractures (OVFs) remain controversial. It is believed that free portion of the circulating vitamin D carries the metabolic activities of vitamin D. Therefore, the aim of the present study is to analyse if free vitamin D correlates with BMD and osteoporotic fragile vertebral fractures in the elderly population. METHODS:A total of 90 consecutive patients, including 81 female and 9 male patients, aged >?48?years, were included in this cross sectional study between March and July of 2018. Total vitamin D (total 25(OH)D), free vitamin D (free 25(OH)D), calcium and phosphorus were measured. BMD was measured using dual energy X-ray absorptiometry (DEXA) and osteoporotic vertebral fracture was assessed using plain radiograph. Multiple linear regression was performed to find out the association between total vitamin D, free vitamin D and BMD at various sites. To evaluate the association with osteoporotic vertebral multivariate logistic regression model was used. RESULTS:The mean total vitamin D and free vitamin D were 25.1?±?10.2 and 6.1?±?1.7 respectively. Free vitamin D had a linear correlation with total vitamin D (R2?=?0.69). While free vitamin D had a positive correlation with lumbar BMD roles (p?<?0.05), total vitamin D didn't have any association with BMD at any site. Of the total patients, 62 patients (68.9%) had thoracolumbar junction OVFs. Free vitamin D level correlated with the prevalence of OVFs as well as lumbar osteoporosis (p?<?0.05). However, there was no statistical correlation between serum vitamin D status and the OVFs. CONCLUSIONS:Free vitamin D was significantly related to the occurrence of thoracolumbar junction OVFs and lumbar BMD, which assumed to be a positive predictor for fracture and osteoporosis prevention. However, total serum vitamin D levels did not have any association with BMD at different sites as well as fragile vertebral fracture. TRIAL REGISTRATION:The study is registered at clinicaltrials.gov NCT03605173.

Project description:BACKGROUND:Osteoporotic vertebral compression fractures (OVCFs) often cause local kyphosis. Percutaneous kyphoplasty (PKP) is a common method for the treatment of local kyphosis. However, the influence of kyphoplasty on spino-pelvic alignment and global sagittal balance when performed at specific treatment sites in the spine remains unclear. The purpose of the study is to investigate the influence of different fracture sites and PKP treatment on the spino-pelvic alignment and global sagittal balance in patients with OVCFs. METHODS:90 patients with OVCF who underwent PKP were included in the retrospective study. According to the site of the fractured vertebrae, all the cases were divided into 3 groups: Main thoracic (MT) group (T1 to T9), Thoracolumbar (TL) group (T10 to L2) and Lumbar (LU) group (L3 to L5). 26 healthy elderly volunteers (aged over 59) were enrolled as the control group. Sagittal spino-pelvic parameters were measured on the full-spine radiographs preoperatively and postoperatively. Information of sagittal spino-pelvic parameters and global sagittal balance was gathered. RESULTS:Compared with the Control group, TL group showed significant differences in almost all parameters, except pelvic incidence (PI) and lumbar lordosis (LL). While only local sagittal parameters (Thoracic kyphosis (TK), Thoracolumbar kyphosis (TLK), LL) were significantly different in MT group. There was no significant difference in almost all of the parameters except for PT and TPA in LU group. Correspondingly, the sagittal parameters of TL group improved best after PKP, except for thoracic kyphosis (TK) and sagittal vertical axis (SVA). In MT group, only TLK was significantly decreased, while in LU group, only local kyphosis Cobb angle and SSA were improved. CONCLUSIONS:OVCF mainly occurs in the thoracolumbar region. Compared with MT group and LU group, OVCF occurred in the thoracolumbar region had greater influence on the spino-pelvic alignment and global sagittal balance. When PKP was performed, the improvement of sagittal balance parameters of TL group was the best in the three groups.

Dataset Information

Surgical outcomes of spinal fusion for osteoporotic thoracolumbar vertebral fractures in patients with Parkinson's disease: what is the impact of Parkinson's disease on surgical outcome?

Publications

Surgical outcomes of spinal fusion for osteoporotic thoracolumbar vertebral fractures in patients with Parkinson's disease: what is the impact of Parkinson's disease on surgical outcome?

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