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Posterior Spinal Fusion from T2 to the Sacrum for the Management of Major Deformities in Patients with Parkinson's Disease. A Retrospective Review with Analysis of Complications: E‐Poster #212

Bourghli, Anouar MD; Obeid, Ibrahim; Aurouer, Nicolas MD; Gille, Olivier; Pointillart, Vincent MD, PhD; Vital, Jean M.

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Spine Journal Meeting Abstracts: 2010 - Volume - Issue - p 132–133
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Summary: T2‐sacrum fusion is an option for the management of major deformities in patients with Parkinson's disease. Despite several complications, clinical and radiological results were acceptable with improvement of sagittal and coronal alignment after surgery. These results were maintained even in patients who required revision surgery

Introduction: Spine deformity surgery in Parkinson disease is challenging and complicated. The aim of the study is to evaluate the efficiency of the long posterior construct and the incidence and types of perioperative complications, and also to assess patient satisfaction following surgery

Methods: A retrospective review was performed on 12 consecutive Parkinson's disease patients undergoing a posterior spinal fusion from T2 to the sacrum for major deformities in a 2 year span at a single institution. 6 were first surgeries and 6 revision surgeries. The aim of the surgery was to correct the coronal and sagittal imbalance, pedicle substraction osteotomy was used in 6 cases. All patients had a circumferential fusion at L5S1 using TLIF. Pre‐operative, 3 months post‐operative and latest follow‐up full spine EOS low dose radiographs were evaluated by an independant spine surgeon, complications were analyzed. Assessment of the functional outcome was made using the SRS‐30 questionnaire

Results: The mean age at index procedure was 68 years. The mean duration of Parkinson disease was 10 years. Mean follow up was 32.8 months. Sagittal and coronal alignments were improved after surgery with statistical significance, the SVA improved from 15.2 cm to 0.5 cm at the latest follow‐up. 5 patients were revised 1 time, 3 for instrumentation failure, 1 for an adjacent level instability at T1 T2 and 1 for an epidural hematoma. 1 patient was revised 3 times after adjacent level instability at T1T2. Patients were pleased with their clinical outcome based on the SRS‐30 questionnaire and most of them would have the same procedure again

Conclusion: This is the first series of Parkinson's disease patients undergoing posterior spinal fusion from T2 to the sacrum for management of major deformities. This study indicates that good correction of sagittal and frontal balance enables good clinical and radiological results that remain stable over time even when complications occur

Significance: T2‐sacrum fusion is a good option for the treatment of spine deformities in Parkinson disease. The instrumentation failures occurred during the first 6 months postoperatively in patients without sagittal imbalance, and were probably due to rod weakness (5.5 mm rod) and overbending

© 2010 Lippincott Williams & Wilkins, Inc.