Characteristics of spinopelvic alignment in Parkinson's disease: Comparison with adult spinal deformity

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• 作者：Kei Watanabe^a ; ^{keiwatanabe_39jp@live.jp} ; Toru Hirano^a ; Keiichi Katsumi^a ; Masayuki Ohashi^a ; Hirokazu Shoji^a ; Kazuhiro Hasegawa^c ; Akiyoshi Yamazaki^d ; Atsushi Ishikawa^e ; Ryoko Koike^f ; Naoto Endo^a ; Masatoyo Nishizawa^b ; Takayoshi Shimohata^b
• 刊名：Journal of Orthopaedic Science
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：22
• 期：1
• 页码：16-21
• 全文大小：492 K
• 卷排序：22

文摘

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.MethodsForty-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).ResultsThe 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).ConclusionCharacteristic 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.