title: Surgical outcome of lumbar fusion surgery in patients with Parkinson disease.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To investigate the overall surgical outcome of lumbar fusion surgery in patients with Parkinson disease (PD). SUMMARY OF BACK GROUND DATA: Poor bone quality and muscular dysfunction are important clinical manifestations connected with musculoskeletal diseases in PD patients. These secondary changes caused by PD often result in spinal pathology, indicating spine operations for some patients with scoliosis, kyphosis, osteoporotic fracture, or degenerative spondylosis. However, little is known about the surgical outcome or prognosis of spine surgery in PD patients.
  
  
  METHODS
  Lumbar fusion surgery was performed on 20 patients who had PD and degenerative spinal diseases. At the time of lumbar fusion surgery, the mean duration of PD, age, sex, the preoperative visual analog pain scale (VAS, 0 to 100 mm) for low back pain, Hoehn and Yahr staging, and other comorbidities were evaluated. Patients' postoperative clinical outcome was measured using the criteria of Kim and Kim and VAS for back pain. Radiographic assessment was made using plain films and a dynamogram.
  
  
  RESULTS
  At the time of the spine surgery, Hoehn and Yahr staging of PD was from 1 to 2 in all patients. Only 1 patient had a satisfactory outcome; a good result according to Kim and Kim's criteria. The average postoperative VAS (mm) was 55.2, whereas the mean preoperative VAS (mm) was 53.9. Radiological assessment showed fusion status in 15 patients and probably no solid fusion mass in 5 patients.
  
  
  CONCLUSIONS
  A poor surgical outcome would be inevitable because of the worsening of symptoms owing to the natural history of PD. Therefore, our current study suggested surgical indication should be exercised cautiously in the patients with PD and spinal stenosis.
authors.affiliation: Department of Orthopaedic Surgery, Yonsei University College of Medicine,Yonse Sarang Hospital, Seoul, Korea.
authors.forename: Seong-Hwan
authors.initials: SH
authors.lastname: Moon
authors.forename: Hwan-Mo
authors.initials: HM
authors.lastname: Lee
authors.forename: Heoung-Jae
authors.initials: HJ
authors.lastname: Chun
authors.forename: Kyoung-Tak
authors.initials: KT
authors.lastname: Kang
authors.forename: Hak-Sun
authors.initials: HS
authors.lastname: Kim
authors.forename: Jin-Oh
authors.initials: JO
authors.lastname: Park
authors.forename: Eun-Su
authors.initials: ES
authors.lastname: Moon
authors.forename: Hyon-Su
authors.initials: HS
authors.lastname: Chong
authors.forename: Joon-Seok
authors.initials: JS
authors.lastname: Sohn
authors.forename: Ho-Joong
authors.initials: HJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010300:Parkinson Disease / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome