title: Impact of Movement Disorders on Management of Spinal Deformity in the Elderly.
abstract: Spinal deformities are frequent and disabling complications of movement disorders such as Parkinson disease and multiple system atrophy. The most distinct spinal deformities include camptocormia, antecollis, Pisa syndrome, and scoliosis. Spinal surgery has become lower risk and more efficacious for complex spinal deformities, and thus more appealing to patients, particularly those for whom conservative treatment is inappropriate or ineffective. Recent innovations and advances in spinal surgery have revolutionized the management of spinal deformities in elderly patients. However, spinal deformity surgeries in patients with Parkinson disease remain challenging. High rates of mechanical complications can necessitate revision surgery. The success of spinal surgery in patients with Parkinson disease depends on an interdisciplinary approach, including both surgeons and movement disorder specialists, to select appropriate surgical patients and manage postoperative movement in order to decrease mechanical failures. Achieving appropriate correction of sagittal alignment with strong biomechanical instrumentation and bone fusion is the key determinant of satisfactory results.
authors.affiliation: ‡Department of Neurosurgery, Spine and Spinal Cord Research Institute, College of Medicine, Yonsei University, Seoul, Korea; §Department of Neurosurgery, Spine Center, Hallym University Sacred Heart Hospital, Anyang, Korea; ¶Department of Neurosurgery, University of Virginia, Charlottesville, Virginia; ‖Department of Surgery, University of Toronto, Toronto, Canada; #Department of Neurosurgery, University of California San Francisco, San Francisco, California.
authors.forename: Yoon
authors.initials: Y
authors.lastname: Ha
authors.forename: Jae Keun
authors.initials: JK
authors.lastname: Oh
authors.forename: Justin S
authors.initials: JS
authors.lastname: Smith
authors.forename: Tamir
authors.initials: T
authors.lastname: Ailon
authors.forename: Michael G
authors.initials: MG
authors.lastname: Fehlings
authors.forename: Christopher I
authors.initials: CI
authors.lastname: Shaffrey
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Ames
mesh_terms: D000368:Aged; D019468:Disease Management; D006801:Humans; D009069:Movement Disorders / Q000150:complications; D009134:Muscular Atrophy, Spinal / Q000209:etiology / Q000601:surgery*; D010300:Parkinson Disease / Q000150:complications*; D011183:Postoperative Complications; D012086:Reoperation; D012600:Scoliosis / Q000209:etiology / Q000601:surgery; D013121:Spinal Curvatures / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome