Clinical and imaging features of surgically treated low lumbar osteoporotic vertebral collapse in patients with Parkinson’s disease

Abstract Osteoporosis and Parkinson’s disease (PD) are age-related diseases, and surgery for osteoporotic vertebral collapse (OVC) in PD patients become more common. OVC commonly affects the thoracolumbar spine, but low lumbar OVC is frequent in patients with lower bone mineral density (BMD). The ai...

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Main Authors: Hideaki Nakajima, Arisa Kubota, Shuji Watanabe, Kazuya Honjoh, Akihiko Matsumine
Format: Article
Language:English
Published: Nature Publishing Group 2021-07-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-021-93798-1
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spelling doaj-ad0c1876298c454d8cfb91744e225a412021-07-11T11:25:28ZengNature Publishing GroupScientific Reports2045-23222021-07-011111910.1038/s41598-021-93798-1Clinical and imaging features of surgically treated low lumbar osteoporotic vertebral collapse in patients with Parkinson’s diseaseHideaki Nakajima0Arisa Kubota1Shuji Watanabe2Kazuya Honjoh3Akihiko Matsumine4Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of FukuiDepartment of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of FukuiDepartment of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of FukuiDepartment of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of FukuiDepartment of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of FukuiAbstract Osteoporosis and Parkinson’s disease (PD) are age-related diseases, and surgery for osteoporotic vertebral collapse (OVC) in PD patients become more common. OVC commonly affects the thoracolumbar spine, but low lumbar OVC is frequent in patients with lower bone mineral density (BMD). The aim of this study was to identify differences in clinical and imaging features of low lumbar OVC with or without PD and to discuss the appropriate treatment. The subjects were 43 patients with low lumbar OVC below L3 who were treated surgically, including 11 patients with PD. The main clinical symptoms were radicular pain in non-PD cases and a cauda equina sign in PD cases. Rapid progression and destructive changes of OVC were seen in patients with PD. The morphological features of OVC were flat-type in non-PD cases with old compression fracture, and destruction-type in PD cases without old compression fracture. Progression of PD was associated with decreased lumbar lordosis, lower lumbar BMD, and severe sarcopenia. High postoperative complication rates were associated with vertebral fragility and longer fusion surgery. Progression of postural instability as a natural course of PD may lead to mechanical stress and instrumentation failure. Invasive long-fusion surgery should be avoided for single low lumbar OVC.https://doi.org/10.1038/s41598-021-93798-1
collection DOAJ
language English
format Article
sources DOAJ
author Hideaki Nakajima
Arisa Kubota
Shuji Watanabe
Kazuya Honjoh
Akihiko Matsumine
spellingShingle Hideaki Nakajima
Arisa Kubota
Shuji Watanabe
Kazuya Honjoh
Akihiko Matsumine
Clinical and imaging features of surgically treated low lumbar osteoporotic vertebral collapse in patients with Parkinson’s disease
Scientific Reports
author_facet Hideaki Nakajima
Arisa Kubota
Shuji Watanabe
Kazuya Honjoh
Akihiko Matsumine
author_sort Hideaki Nakajima
title Clinical and imaging features of surgically treated low lumbar osteoporotic vertebral collapse in patients with Parkinson’s disease
title_short Clinical and imaging features of surgically treated low lumbar osteoporotic vertebral collapse in patients with Parkinson’s disease
title_full Clinical and imaging features of surgically treated low lumbar osteoporotic vertebral collapse in patients with Parkinson’s disease
title_fullStr Clinical and imaging features of surgically treated low lumbar osteoporotic vertebral collapse in patients with Parkinson’s disease
title_full_unstemmed Clinical and imaging features of surgically treated low lumbar osteoporotic vertebral collapse in patients with Parkinson’s disease
title_sort clinical and imaging features of surgically treated low lumbar osteoporotic vertebral collapse in patients with parkinson’s disease
publisher Nature Publishing Group
series Scientific Reports
issn 2045-2322
publishDate 2021-07-01
description Abstract Osteoporosis and Parkinson’s disease (PD) are age-related diseases, and surgery for osteoporotic vertebral collapse (OVC) in PD patients become more common. OVC commonly affects the thoracolumbar spine, but low lumbar OVC is frequent in patients with lower bone mineral density (BMD). The aim of this study was to identify differences in clinical and imaging features of low lumbar OVC with or without PD and to discuss the appropriate treatment. The subjects were 43 patients with low lumbar OVC below L3 who were treated surgically, including 11 patients with PD. The main clinical symptoms were radicular pain in non-PD cases and a cauda equina sign in PD cases. Rapid progression and destructive changes of OVC were seen in patients with PD. The morphological features of OVC were flat-type in non-PD cases with old compression fracture, and destruction-type in PD cases without old compression fracture. Progression of PD was associated with decreased lumbar lordosis, lower lumbar BMD, and severe sarcopenia. High postoperative complication rates were associated with vertebral fragility and longer fusion surgery. Progression of postural instability as a natural course of PD may lead to mechanical stress and instrumentation failure. Invasive long-fusion surgery should be avoided for single low lumbar OVC.
url https://doi.org/10.1038/s41598-021-93798-1
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