title: Deep brain stimulation significantly decreases disability from low back pain in patients with advanced Parkinson's disease.
abstract: BACKGROUND
  Up to 60% of Parkinson's disease (PD) patients suffer from low back pain (LBP) during the course of their disease. How LBP affects daily functional status and how to manage this aspect of PD has not been adequately explored.
  
  
  METHODS
  We examined 16 patients undergoing bilateral subthalamic nucleus deep brain stimulation (STN DBS) who met the inclusion criteria for moderate disability from LBP, as classified by the Oswestry Low Back Pain Disability Index (OLBPD).
  
  
  RESULTS
  Thirteen of 16 patients had attempted additional treatments for LBP, including medical management, massage, chiropractic, epidural steroid injections and/or surgery, with minimal relief. Following DBS, there was a significant improvement in the OLBPD at both the 6-month and 1-year time points (p < 0.02, p < 0.005, respectively). A mean improvement of 31.7% on the OLBPD score was noted. The Visual Analogue Scale (VAS) similarly decreased significantly at 1 year (p = 0.015). There was no correlation between the OLBPD score and other measures, including the Unified Parkinson's Disease Rating Scale (UPDRS), age and other nonmotor symptoms.
  
  
  CONCLUSIONS
  Given the prevalent yet undertreated disability associated with LBP in PD, these results are novel in that they show that STN DBS has a significant positive effect on disability associated with LBP.
authors.affiliation: Department of Neurosurgery, Albany Medical College, Albany, N.Y., USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Smith
authors.forename: Lucy
authors.initials: L
authors.lastname: Gee
authors.forename: Vignessh
authors.initials: V
authors.lastname: Kumar
authors.forename: Adolfo
authors.initials: A
authors.lastname: Ramirez-Zamora
authors.forename: Jennifer
authors.initials: J
authors.lastname: Durphy
authors.forename: Era
authors.initials: E
authors.lastname: Hanspal
authors.forename: Anne
authors.initials: A
authors.lastname: Barba
authors.forename: Eric
authors.initials: E
authors.lastname: Molho
authors.forename: Damian
authors.initials: D
authors.lastname: Shin
authors.forename: Julie G
authors.initials: JG
authors.lastname: Pilitsis
mesh_terms: D000328:Adult; D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods*; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010300:Parkinson Disease / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome