論文

2021年10月15日

Spinal Surgery after Bilateral Subthalamic Stimulation for Patients with Parkinson's Disease: A Retrospective Outcome Analysis of Pain and Functional Control.

Neurologia medico-chirurgica
  • Michiari Umakoshi
  • ,
  • Takao Yasuhara
  • ,
  • Jun Morimoto
  • ,
  • Satoshi Murai
  • ,
  • Tatsuya Sasaki
  • ,
  • Masahiro Kameda
  • ,
  • Kyohei Kin
  • ,
  • Yasuyuki Miyoshi
  • ,
  • Isao Date

61
10
開始ページ
607
終了ページ
618
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.2176/nmc.oa.2021-0094

Parkinson's disease (PD) patients often suffer from spinal diseases requiring surgeries, although the risk of complications is high. There are few reports on outcomes after spinal surgery for PD patients with deep brain stimulation (DBS). The objective of this study was to explore the data on spinal surgery for PD patients with precedent DBS. We evaluated 24 consecutive PD patients with 28 spinal surgeries from 2007 to 2017 who received at least a 2-year follow-up. The characteristics and outcomes of PD patients after spinal surgery were compared to those of 156 non-PD patients with degenerative spinal diseases treated in 2013-2017. Then, the characteristics, outcomes, and spinal alignment of PD patients receiving DBS were analyzed in degenerative spinal/lumbar diseases. The mean age at the time of spinal surgery was 68 years. The Hoehn and Yahr score regarding PD was stage 1 for 8 patients, stage 2 for 2 patients, stage 3 for 8 patients, stage 4 for 10 patients, and stage 5 for 0 patient. The median preoperative L-DOPA equivalent daily dose was 410 mg. Thirteen patients (46%) received precedent subthalamic nucleus (STN) DBS. Lumbar lesions with pain were common, and operation and anesthesia times were long in PD patients. Pain and functional improvement of PD patients persisted for 2 years after surgery with a higher complication rate than for non-PD patients. PD patients with STN DBS maintained better lumbar lordosis for 2 years after spinal surgery. STN DBS significantly maintained spinal alignment with subsequent pain and functional amelioration 2 years after surgery. The outcomes of spinal surgery for PD patients might be favorably affected by thorough treatment for PD including DBS.

リンク情報
DOI
https://doi.org/10.2176/nmc.oa.2021-0094
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/34408107
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8531877
ID情報
  • DOI : 10.2176/nmc.oa.2021-0094
  • PubMed ID : 34408107
  • PubMed Central 記事ID : PMC8531877

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