Bone mineral density in patients with Parkinson??s disease measured by dual photon absorptiometry

Kao, Chia‐Hung; Chen, C C; Wang, S J; Chia, Lie‐Gan; Yeh, Su‐Ling

doi:10.1097/00006231-199403000-00010

Cited by 76 publications

(46 citation statements)

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“…The common mechanism of failure was assumed to be the kyphosis adjacent to the levels operated on initially. Actually, PD was shown to confer poor bone quality [21][22][23] and our observations echo those of Babat. Poor fusionlevel selection, neglect, and a lack of reconstruction of sagittal balance are frequent mistakes that can cause failure of the index surgery [14,15,26,30,37], but, failure of spinal surgery in PD patient does have additional risk factors that are difficult to control.…”

Section: Discussionsupporting

confidence: 83%

Spinal surgery in patients with Parkinson’s disease: experiences with the challenges posed by sagittal imbalance and the Parkinson’s spine

et al. 2010

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Only a few reports exist concerning biomechanical challenges spine surgeons face when treating Parkinson's disease (PD) patients with spinal deformity. We recognized patients suffering from spinal deformity aggravated by the burden of PD to stress the principles of sagittal balance in surgical treatment. Treatment of sagittal imbalance in PD is difficult due to brittle bone and (the neuromuscular disorder) with postural dysfunction. We performed a retrospective review of 23 PD patients treated surgically for spinal disorders. Mean ASA score was 2.3 (2-3). Outcome analysis included review of medical records focusing on failure characteristics, complications, and radiographic analysis of balance parameters to characterize special risk factors or precautions to be considered in PD patients. The sample included 15 female and 8 male PD patients with mean age of 66.3 years (57-76) at index surgery and 67.9 years (59-76) at follow-up. 10 patients (43.5%) presented with the sequels of failed previous surgery. 18 patients (78.3%) underwent multilevel fusion (C3 level) with 16 patients (69.6%) having fusion to S1, S2 or the Ilium. At a mean follow-up of 14.5 months (1-59) we noted medical complications in 7 patients (30.4%) and surgical complications in 12 patients (52.2%). C7-sagittal center vertical line was 12.2 cm (8-57) preoperatively, 6.9 cm postoperatively, and 7.6 cm at follow-up. Detailed analysis of radiographs, sagittal spinal, and spino-pelvic balance, stressed a positive C7 off-set of 10 cm on average in 25% of patients at follow-up requiring revision surgery in 4 of them. Statistical analysis revealed that patients with a postoperative or follow-up sagittal imbalance (C7-SVL [10 cm) had a significantly increased rate of revision done or scheduled (p = 0.03). Patients with revision surgery as index procedure also were found more likely to suffer postoperative or final sagittal imbalance (C7-SPL, 10 cm; p = 0.008). At all, 33% of patients had any early or late revision performed. Nevertheless, 78% of patients were satisfied or very satisfied with their clinical outcome, while 22% were either not satisfied or uncertain regarding their outcome. The surgical history of PD patients treated for spinal disorders and the reasons necessitating redo surgery for recalcitrant global sagittal imbalance in our sample stressed the mainstays of spinal surgery in Parkinson's: If spinal surgery is indicated, the reconstruction of spinopelvic balance with focus on lumbar lordosis and global sagittal alignment is required.

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Section: Discussionsupporting

confidence: 83%

Spinal surgery in patients with Parkinson’s disease: experiences with the challenges posed by sagittal imbalance and the Parkinson’s spine

et al. 2010

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“…An abduction brace was applied for 6 weeks to prevent redislocation, and none has occurred. Five patients were followed up to 13,15,17,19, and 25 months after dislocation, respectively. Patients in Group I who experienced dislocations had cerebral infarction (n = 1) and Parkinsonism (n = 1) ( Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Patients with neuromuscular diseases also apparently have increased rates of osteoporosis that might not be related solely to immobility [7,17]. With increased risks for falls and osteoporosis, patients with neuromuscular diseases may be at an increased risk of fracture of the femoral neck.…”

Section: Introductionmentioning

confidence: 99%

Is the Dislocation Rate Higher after Bipolar Hemiarthroplasty in Patients with Neuromuscular Diseases?

Suh

Kim

Lee

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Patients with neuromuscular disease reportedly have a higher incidence of postoperative dislocation after bipolar hemiarthroplasty. Although the literature has focused on a high prevalence of preoperative neurologic conditions in patients who had dislocations after bipolar hemiarthroplasties, the relative incidence of dislocation in patients with neuromuscular disease and without is unclear. Questions/purposes We therefore (1) asked whether the incidence of postoperative dislocation after bipolar hemiarthroplasty was greater in patients with neuromuscular disease than for those without, and (2) whether function differed between the two groups, and (3) explored potential risk factors for dislocation in two groups.

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“…[1][2][3] The hip is the most common site of fracture in the PD population and has been well studied. 4,5 Vertebral fracture, being the second most common type of fracture in PD patients, should not be overlooked.…”

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confidence: 99%

Trunk muscle strength, but not trunk rigidity, is independently associated with bone mineral density of the lumbar spine in patients with Parkinson's disease

Pang

Mak

2009

Movement Disorders

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Previous literature suggested that muscle forces applied to the skeleton may be an important factor in increasing bone mineral density (BMD). This purpose of this study was to determine whether trunk rigidity and trunk muscle strength were associated with lumbar spine BMD in patients with Parkinson's disease (PD). Forty-three PD patients and 29 controls participated in this study. Dual-energy X-ray absorptiometry was used to measure lumbar spine BMD of PD patients. Additionally, an isokinetic dynamometer was used to evaluate trunk rigidity and trunk muscle strength of all subjects. The results showed that PD patients had significantly lower trunk muscle strength, but more trunk rigidity than controls by 46.6 and 162.8%, respectively (P < 0.001). In bivariate correlation analysis, lumbar spine BMD was significantly related to trunk muscle strength (r = 0.475, P = 0.001), but not trunk rigidity (r = 0.271, P = 0.079). In multiple regression analysis, after adjusting for relevant factors, only trunk muscle strength remained independently associated with lumbar spine BMD, accounting for 10.0% of the variance (R(2) = 0.342, F(5,) (37) = 3.838, P = 0.007). Trunk muscle strength, but not trunk rigidity, is independently associated with lumbar spine BMD in patients with PD. Further randomized controlled studies are required to determine whether trunk muscle strengthening exercise is effective in enhancing lumbar spine BMD.

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Bone mineral density in patients with Parkinson??s disease measured by dual photon absorptiometry

Cited by 76 publications

References 0 publications

Spinal surgery in patients with Parkinson’s disease: experiences with the challenges posed by sagittal imbalance and the Parkinson’s spine

Spinal surgery in patients with Parkinson’s disease: experiences with the challenges posed by sagittal imbalance and the Parkinson’s spine

Is the Dislocation Rate Higher after Bipolar Hemiarthroplasty in Patients with Neuromuscular Diseases?

Trunk muscle strength, but not trunk rigidity, is independently associated with bone mineral density of the lumbar spine in patients with Parkinson's disease

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