Austin H. Carroll , James Fookes , Alejandro Quinonez , Christopher P. Bellaire , Brian McCormick , Lancelot Benn , Jonathan P. Japa , Kevin Yoon , Fred Mo , Mark Ehioghae , Addisu Mesfin
{"title":"帕金森病患者脊柱畸形手术后的结果:倾向匹配分析","authors":"Austin H. Carroll , James Fookes , Alejandro Quinonez , Christopher P. Bellaire , Brian McCormick , Lancelot Benn , Jonathan P. Japa , Kevin Yoon , Fred Mo , Mark Ehioghae , Addisu Mesfin","doi":"10.1016/j.jocn.2025.111630","DOIUrl":null,"url":null,"abstract":"<div><div>Adult spinal deformity remains a complex challenge with medical and surgical complication rates post-operatively reported to be around 40 %. Patients with Parkinson’s Disease (PD) are particularly susceptible to musculoskeletal disease secondary to postural deformity, muscle rigidity, and bradykinesia and have an increased risk of spinal deformity compared to the general population. There is a paucity of literature investigating the outcomes of multi-level spinal deformity surgery in this at-risk population. Patients undergoing multi-level posterior spinal fusion for spinal deformity with a diagnosis of Parkinson’s Disease were identified using the PearlDiver database. Patients with PD were propensity-matched in a 1:1 ratio to a control group by age, Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI). Medical complications and rates of surgical site infection (SSI) were assessed at 90 days. Surgical revision rates were assessed at 2 years. A total of 2776 patients met criteria with 1,388 patients in the PD group and 1,388 in the control group after propensity matching. Patients with PD had a significantly higher rate of surgical revision at 2 years and an increased risk of 90-day medical complications post-operatively. There was no difference in infection rates between groups within 90 days. Patients with Parkinson’s Disease undergoing multilevel posterior spinal fusion for spinal deformity correction have an increased risk of medical complications and need for surgical revision compared to age and comorbidity matched controls. Non-operative management should be exhausted prior to surgical treatment and further research is needed to optimize outcomes in this high-risk patient population.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"142 ","pages":"Article 111630"},"PeriodicalIF":1.8000,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcomes after spinal deformity surgery in patients with Parkinson’s Disease: a propensity matched analysis\",\"authors\":\"Austin H. Carroll , James Fookes , Alejandro Quinonez , Christopher P. Bellaire , Brian McCormick , Lancelot Benn , Jonathan P. Japa , Kevin Yoon , Fred Mo , Mark Ehioghae , Addisu Mesfin\",\"doi\":\"10.1016/j.jocn.2025.111630\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Adult spinal deformity remains a complex challenge with medical and surgical complication rates post-operatively reported to be around 40 %. Patients with Parkinson’s Disease (PD) are particularly susceptible to musculoskeletal disease secondary to postural deformity, muscle rigidity, and bradykinesia and have an increased risk of spinal deformity compared to the general population. There is a paucity of literature investigating the outcomes of multi-level spinal deformity surgery in this at-risk population. Patients undergoing multi-level posterior spinal fusion for spinal deformity with a diagnosis of Parkinson’s Disease were identified using the PearlDiver database. Patients with PD were propensity-matched in a 1:1 ratio to a control group by age, Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI). Medical complications and rates of surgical site infection (SSI) were assessed at 90 days. Surgical revision rates were assessed at 2 years. A total of 2776 patients met criteria with 1,388 patients in the PD group and 1,388 in the control group after propensity matching. Patients with PD had a significantly higher rate of surgical revision at 2 years and an increased risk of 90-day medical complications post-operatively. There was no difference in infection rates between groups within 90 days. Patients with Parkinson’s Disease undergoing multilevel posterior spinal fusion for spinal deformity correction have an increased risk of medical complications and need for surgical revision compared to age and comorbidity matched controls. Non-operative management should be exhausted prior to surgical treatment and further research is needed to optimize outcomes in this high-risk patient population.</div></div>\",\"PeriodicalId\":15487,\"journal\":{\"name\":\"Journal of Clinical Neuroscience\",\"volume\":\"142 \",\"pages\":\"Article 111630\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-09-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Neuroscience\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0967586825006034\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Neuroscience","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0967586825006034","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Outcomes after spinal deformity surgery in patients with Parkinson’s Disease: a propensity matched analysis
Adult spinal deformity remains a complex challenge with medical and surgical complication rates post-operatively reported to be around 40 %. Patients with Parkinson’s Disease (PD) are particularly susceptible to musculoskeletal disease secondary to postural deformity, muscle rigidity, and bradykinesia and have an increased risk of spinal deformity compared to the general population. There is a paucity of literature investigating the outcomes of multi-level spinal deformity surgery in this at-risk population. Patients undergoing multi-level posterior spinal fusion for spinal deformity with a diagnosis of Parkinson’s Disease were identified using the PearlDiver database. Patients with PD were propensity-matched in a 1:1 ratio to a control group by age, Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI). Medical complications and rates of surgical site infection (SSI) were assessed at 90 days. Surgical revision rates were assessed at 2 years. A total of 2776 patients met criteria with 1,388 patients in the PD group and 1,388 in the control group after propensity matching. Patients with PD had a significantly higher rate of surgical revision at 2 years and an increased risk of 90-day medical complications post-operatively. There was no difference in infection rates between groups within 90 days. Patients with Parkinson’s Disease undergoing multilevel posterior spinal fusion for spinal deformity correction have an increased risk of medical complications and need for surgical revision compared to age and comorbidity matched controls. Non-operative management should be exhausted prior to surgical treatment and further research is needed to optimize outcomes in this high-risk patient population.
期刊介绍:
This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology.
The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.