title: Characteristics of spinopelvic alignment in Parkinson's disease: Comparison with adult spinal deformity.
abstract: OBJECTIVE
  The characteristics and pathogenesis of spinopelvic alignment in Parkinsons's disease (PD) patients-including differences compared to non-PD subjects and their relationships with the severity of PD-have not been clarified. The aim of this study was to investigate the characteristics of spinopelvic alignment in patients with PD.
  
  
  METHODS
  Forty-eight PD patients complaining of chronic low back pain were included (PD group). The PD condition, determined using the Hoehn and Yahr (H&Y) stage and Unified Parkinson Disease Rating Scale (UPDRS) score; radiographic spinopelvic alignment; lumbar range of motion (ROM); and low back pain-related quality of life assessments were evaluated. Fifty age- and sex-matched patients with adult spinal deformities were included as controls (ASD group).
  
  
  RESULTS
  The spinopelvic alignments of the PD/ASD groups demonstrated sagittal vertical axes of 120.9/106.3 mm and pelvic incidences of 49.7/52.9°, with no significant differences. Conversely, there were significant differences in the thoracic kyphosis (TK; 27.6/16.7°), lumbar lordosis (-22.7/-7.9°), and pelvic tilt (25.3/34.4°) (all, p < 0.05). With regard to correlations with the PD condition, the H&Y stage demonstrated significant correlations with the sagittal vertical axis, thoracolumbar kyphosis, and lumbar ROM (all, p < 0.05), and the UPDRS score tended to correlate with the TK and thoracolumbar kyphosis (both, p < 0.01).
  
  
  CONCLUSIONS
  Characteristic spinal conditions in PD exist, with progressed PD condition causing stooped posture with increased thoracic or thoracolumbar kyphosis and decreased lumbar ROM; moreover, global sagittal malalignment progresses without sufficient compensatory mechanisms such as loss of TK and pelvic retroversion.
authors.affiliation: Division of Orthopedic Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan. Electronic address: keiwatanabe_39jp@live.jp.
authors.forename: Kei
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Division of Orthopedic Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Hirano
authors.affiliation: Division of Orthopedic Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Katsumi
authors.affiliation: Division of Orthopedic Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohashi
authors.affiliation: Division of Orthopedic Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Shoji
authors.affiliation: Niigata Spine Surgery Center, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hasegawa
authors.affiliation: Department of Orthopedic Surgery, Spine Center, Niigata Central Hospital, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Yamazaki
authors.affiliation: Department of Neurology, Brain Disease Center Agano Hospital, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ishikawa
authors.affiliation: Department of Neurology, Nishi-Niigata Chuo National Hospital, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Koike
authors.affiliation: Division of Orthopedic Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Endo
authors.affiliation: Department of Neurology, Brain Research Institute, Niigata University, Niigata City, Niigata, Japan.
authors.forename: Masatoyo
authors.initials: M
authors.lastname: Nishizawa
authors.affiliation: Department of Neurology, Brain Research Institute, Niigata University, Niigata City, Niigata, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Shimohata
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017760:Bone Malalignment / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D008141:Lordosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D017116:Low Back Pain / Q000209:etiology / Q000503:physiopathology*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology / Q000503:physiopathology*; D010388:Pelvis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D013122:Spinal Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018709:Statistics, Nonparametric