gms | German Medical Science

Objectives: In the increasingly aging population Parkinsons Disease (PD) is gaining importance as a risk factor in surgery in general. Only a few studies examined the influence of PD on related risk factors in spinal surgery in general but none has analysed the influence of PD in specific lumbar decompression surgery.

Methods: Retrospective matched-pair study of all patients with PD undergoing elective lumbar decompression surgery in two university hospital departments between December 2003 and July 2016. Patients database was reviewed for perioperative complications, reoperation rate, length of hospital stay and specific predictors for reoperation and perioperative complications. For each patient with PD, 2 control patients with the same diagnose, procedure and sex with similar age (±5), year of surgery (±3) and a similar profile of comorbidities were selected.

Results and Conclusion: 36 patients with PD were matched with 72 patients without PD (mean age: PD 72,51 years, no-PD: 72,60 years). The mean follow up was 1,19 ± 1,57 years in the PD-group and 1,38 ± 2,11 years in the control group. The mean hospital stay was 14,47 days (range: 3-45) in the PD group and 8,21 days (range: 3-21) in the control group (p<0,001). The overall complication rate in the PD-group was 47,2% and 19,4% in the control group (p=0,003). The most frequent complication in the PD-group was a urinary tract infection (PD: 19,4%, no-PD: 2,8%). The reoperation rate in the PD-group was 27,8% and 9,7% in the control group (p=0,015).

In view of perioperative complications in patients with PD undergoing elective decompression surgery, the risks appear to be a manageable. Despite the differences in major complications where small, minor complications were more frequent in PD patients. Besides strict indication for surgery special attention should be paid in patients with previous surgery at the same segment and more severe PD as they presented with a significantly higher rate of reoperation.