title: To operate or not?: A literature review of surgical outcomes in 95 patients with Parkinson's disease undergoing spine surgery.
abstract: BACKGROUND
  Degenerative spondylosis and kyphoscoliosis are increasingly recognized entities in patients with Parkinson's disease. Surgical treatment with spinal fusion can be complicated due to poor bone quality and muscular dysfunction in this patient population. The goal of this paper is to investigate surgical outcomes in Parkinson's patients undergoing spine surgery.
  
  
  METHODS
  We performed a literature review using the PubMed and Google Scholar search engines investigating "Parkinson's disease and spinal fusion surgery" from the period of 2000 to 2013. The inclusion criteria included only English articles with Parkinson's patients that underwent spinal surgery. We identified and reviewed all six articles that included ninety-five patients with Parkinson's disease who underwent spinal surgery.
  
  
  RESULTS
  A total of 95 patients with Parkinson's disease who underwent spinal fusion surgery were reviewed with average patient age of 69 and a 3:4 male to female ratio. With an average follow up of 40 months, 46 out of 73 patients (63%) were judged to have satisfactory outcomes with poor outcomes noted in the remaining 37%. These included but were not limited to pseudoarthrosis, hardware failure/pullout, development of adjacent level disease, persistent kyphosis or sagittal imbalance, and no improvement or worsening in their postoperative visual analog pain scale. There was a 45% (29/65) revision rate and a 59% (30/51) complication rate following the index procedure.
  
  
  CONCLUSIONS
  It remains unclear whether Parkinson's patients benefit from spinal fusion surgery. Further prospective research is warranted to investigate surgical outcomes in this subset of patients.
authors.affiliation: Icahn School of Medicine at Mount Sinai, Department of Neurosurgery, New York, USA. Electronic address: Christopher.sarkiss@mountsinai.org.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Sarkiss
authors.affiliation: Saba University School of Medicine, Saba, Bonaire, Sint Eustatius and Saba.
authors.forename: Guy A
authors.initials: GA
authors.lastname: Fogg
authors.affiliation: Icahn School of Medicine at Mount Sinai, Department of Neurosurgery, New York, USA.
authors.forename: Branko
authors.initials: B
authors.lastname: Skovrlj
authors.affiliation: Icahn School of Medicine at Mount Sinai, Department of Orthopedic Surgery, New York, USA.
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Cho
authors.affiliation: Icahn School of Medicine at Mount Sinai, Department of Neurosurgery, New York, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Caridi
mesh_terms: D005260:Female; D006801:Humans; D007738:Kyphosis / Q000150:complications / Q000601:surgery*; D008297:Male; D019635:Neurosurgical Procedures; D010147:Pain Measurement; D010300:Parkinson Disease / Q000150:complications*; D011183:Postoperative Complications / Q000453:epidemiology*; D011542:Pseudarthrosis / Q000453:epidemiology; D012086:Reoperation; D012600:Scoliosis / Q000150:complications / Q000601:surgery*; D013123:Spinal Fusion; D013131:Spine / Q000601:surgery*; D055009:Spondylosis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome
keywords: Degenerative spondylosis; Kyphoscoliosis; Parkinson's disease; Spinal decompression; Spinal fusion