title: Evolution and complications after surgery for spine deformation in patients with Parkinson's disease.
abstract: Surgical treatment of spinal deformity is high risk in patients suffering from Parkinson's disease (PD). Several series have already reported a high rate of complications. However, none of these studies included more than 40 patients and none of the risk factors of complications were described. The aim of this study was to describe the rate and risk factors of revision surgery as well as the clinical outcome at the last visit in a large multicenter study of PD patients operated for spinal deformities.
  
  
  
  A multicenter retrospective study included arthrodesis for spinal deformity in patients with PD. Clinical and surgical data including revision surgeries were collected. Assessment of functional outcomes at last follow-up was classified in 3 grades and spinal balance was assessed on anteroposterior and lateral plain X-rays of the entire spine.
  
  
  
  Forty-eight patients were included. Median age was 67 years old (range 41-80). Median follow-up was 27 months. The rate of surgical revision was 42%. Eighty per cent of revisions were performed for chronic mechanical complication. Global results were considered to be good in 17 patients (35%), doubtful in 17 patients (35%) and a failure in 14 patients (30%), for the whole series.
  
  
  
  The results of surgery for spinal deformities in patients with Parkinson disease vary with a high rate of complications and revisions. Nevertheless, these results should be seen in relation to the natural progression of these spinal deformities once spinal imbalance has developed. The association between preoperative clinical balance and final outcome suggests that early surgery can probably play a role in treatment.
  
  
  
  Level IV (e.g. case series).
authors.affiliation: Study Group on Scoliosis (GES), Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France(1).
authors.forename: B
authors.initials: B
authors.lastname: Bouyer
authors.affiliation: Study Group on Scoliosis (GES), Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France(1).
authors.forename: C
authors.initials: C
authors.lastname: Scemama
authors.affiliation: Study Group on Scoliosis (GES), Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France(1).
authors.forename: P
authors.initials: P
authors.lastname: Roussouly
authors.affiliation: Study Group on Scoliosis (GES), Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France(1).
authors.forename: F
authors.initials: F
authors.lastname: Laouissat
authors.affiliation: Study Group on Scoliosis (GES), Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France(1).
authors.forename: I
authors.initials: I
authors.lastname: Obeid
authors.affiliation: Study Group on Scoliosis (GES), Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France(1).
authors.forename: L
authors.initials: L
authors.lastname: Boissière
authors.affiliation: Study Group on Scoliosis (GES), Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France(1).
authors.forename: F-H
authors.initials: FH
authors.lastname: Parent
authors.affiliation: Study Group on Scoliosis (GES), Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France(1).
authors.forename: S
authors.initials: S
authors.lastname: Schuller
authors.affiliation: Study Group on Scoliosis (GES), Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France(1).
authors.forename: J-P
authors.initials: JP
authors.lastname: Steib
authors.affiliation: Study Group on Scoliosis (GES), Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France(1).
authors.forename: H
authors.initials: H
authors.lastname: Pascal-Moussellard
authors.affiliation: Study Group on Scoliosis (GES), Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France(1).
authors.forename: P
authors.initials: P
authors.lastname: Guigui
authors.affiliation: Study Group on Scoliosis (GES), Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France(1).
authors.forename: S
authors.initials: S
authors.lastname: Wolff
authors.affiliation: Study Group on Scoliosis (GES), Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France(1). Electronic address: griouallon@hpsj.fr.
authors.forename: G
authors.initials: G
authors.lastname: Riouallon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease; D011183:Postoperative Complications; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion; D016896:Treatment Outcome
keywords: Complications; Parkinson's disease; Revision rate; Sagittal balance; Spinal deformity