gms | German Medical Science

62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

07. - 11. Mai 2011, Hamburg

Spinal instrumentation in patients with Parkinson's disease: A series of 13 cases

Meeting Abstract

Suche in Medline nach

  • A. Reinke - Department of Neurosurgery, Technical University of Munich
  • A. Preuss - Department of Neurosurgery, Technical University of Munich
  • B. Meyer - Department of Neurosurgery, Technical University of Munich
  • F. Ringel - Department of Neurosurgery, Technical University of Munich

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocP 054

DOI: 10.3205/11dgnc275, URN: urn:nbn:de:0183-11dgnc2750

Veröffentlicht: 28. April 2011

© 2011 Reinke et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Spinal instrumentation in patients with Parkinson’s disease is supposedly associated with a higher rate of hardware failure as well as other complications. The reason for this is believed to originate from the severe neuromuscular disorder and associated poor bone quality. The present study aimed to assess the single-center results of spinal instrumentation in patients with Parkinson´s syndrome.

Methods: Patients with the necessity for spinal instrumentation and the presence of Parkinson´s disease were included in this study. 13 consecutive patients, treated between March 2006 and November 2010, were identified and analyzed regarding complications and reoperation rates. Additionally, radiographic data were collected as well as the clinical status. A supplementary follow-up examination was performed in addition to the routine follow-up or the patients were interviewed by phone.

Results: A total of 13 patients (6 females and 7 males) with a mean age of 70.0 years (range 61.2–81.2 years) were treated with a dorsal or combined ventrodorsal spondylodesis. One patient underwent dorsal cervical and 12 underwent thoracolumbar stabilization. The mean follow-up period was 27 months (range 9 to 53 months). Six patients (46%) required additional surgery at the same or adjacent level whereas three (23%) had multiple reoperations (> three). The maximum number was eight revision operations on one patient. Until now, the five remaining patients (39%) did not need a secondary intervention and for two (15%) a follow-up was not possible. Overall 21 additional surgeries were required. Nine had a screw loosening or pullout, five had an adjacent level disease and two had both. Furthermore, there were four cases of wound infection and one with a dislocated cage in the infected level. Ten percent of all patients had two co-morbidities, 30% had three, 20% had four and 40% of the patients had more than four co-morbidities. Of 13 patients five had a secured osteoporosis.

Conclusions: Parkinson´s disease is associated with an extremely high rate of hardware failure after spinal instrumentation. However, the literature provides little data of the outcome of spinal instrumentation, only. The present series with the highest number of patients so far demonstrates a very high reoperation rate in this population. Therefore, the decision for spinal instrumentation in this group of patients should considered carefully.