gms | German Medical Science

Objective: Symptomatic movement disorders, especially when conventionally difficult to treat, have an influence on the spine due to a constant, and sometimes even increasing alteration of its physiological alignment. The aim of our study was to show whether there is a correlation between the coincidence of Parkinson's disease and stenosis of the spinal canal (SSC).

Method: We analysed data retrospectively from patients who underwent DBS-surgery for Parkinson's disease in our department from 1999 till 2012. Date of first diagnosis with PD, date of DBS-surgery, localisation of the SSC, date of first diagnosis with SSC and treatment (conservative vs. surgical) have been reviewed.

Results: From 01-12-1999 till 10-23-2012, 418 patients diagnosed with Parkinson's disease were surgically treated with DBS at the ages from 48 to 78 years. 54 patients (12.9%) were diagnosed simultaneously by clinical symptoms, spinal imaging or the patient's history with a symptomatic stenosis of the spinal canal, which occurred in 4 cases (7.4%) prior to the first diagnosis with PD, in 33 cases (61.1%) later on. Three cases (5.6%) were located on the cervical spine, 48 (88.9%) were located lumbar. No thoracic SSC was documented. Six patients (11.1%) were treated non-operatively, 39 (72.2%) underwent surgical decompression of the spinal canal. In 4 cases additional instrumentally assisted intervertebral stabilisation was performed, in 1 case an interspinous spacer has been placed. 17 patients did show poor to non-corresponding symptoms regarding a SSC, which did not justify imaging.

Conclusions: The various forms of movement disorders have a strong influence on the life quality due to their symptomatic relevance on the mobility of patients and even more when potentially abetting other kinds of movement-refining degenerative diseases. Our studies suggest that Parkinson's disease has a prominent influence on an increased coincidence of a spinal stenosis, given the fact that the average prevalence in normal population is named by 5 in 1000 individuals over the age of 50. The distribution of the localisation of the stenosis lies accordingly to the average population (75% lumbar spine), as well as the preferred form of surgical treatment. However, therapeutic consequences should still be drawn according to the severance of the symptoms and extensive consideration should be given to the sufficient treatment of the PD- induced stressing of the spine.