Clinical Outcomes Following Surgical Management of Coexisting Parkinson Disease and Cervical Spondylotic Myelopathy

Abstract

This study is the first to characterize outcomes following cervical decompression in patients with PD and CSM. PD patients experienced symptomatic improvement but less overall improvement in myelopathy compared to controls. However, PD patients demonstrated improvement in upper extremity motor, upper extremity sensory, and sphincter symptoms no worse than control patients.

Spinal Surgery after Bilateral Subthalamic Stimulation for Patients with Parkinson’s Disease: A Retrospective Outcome Analysis of Pain and Functional Control

“…Other reports also showed that PD patients have an increased risk of poor postoperative outcomes following spinal surgery compared to non-PD patients. 4,[9][10][11][12][13][14][15][16] A Hoehn and Yahr score over 3 in advanced PD patients was reported as a significant risk factor for requiring additional surgical intervention including revision surgeries. 10,12,17) Severe PD patients with spinal diseases are not usually considered appropriate candidates for surgical intervention.…”

A comparison of in-hospital outcomes after elective anterior cervical discectomy and fusion in cases with and without Parkinson's Disease

“…[8][9][10][11] Several studies assessed outcomes following thoracolumbar surgery and cervical decompression, finding that patients with PD had high rates of surgical complications and, compared to non-PD patients, had less symptom improvement and reduced improvement in quality of life. 12,13 Given these poorer outcomes, the risks of surgery must be weighed more heavily when considering surgical intervention. Some studies suggest an association of PD with postoperative medical complications.…”

“…Prior studies have investigated surgical and medical complications following orthopedic surgery in patients with PD [8] , [9] , [10] , [11] . Several studies assessed outcomes following thoracolumbar surgery and cervical decompression, finding that patients with PD had high rates of surgical complications and, compared to non-PD patients, had less symptom improvement and reduced improvement in quality of life [ 12 , 13 ]. Given these poorer outcomes, the risks of surgery must be weighed more heavily when considering surgical intervention.…”

Outcomes of Patients With Parkinson Disease Undergoing Cervical Spine Surgery for Radiculopathy and Myelopathy With Minimum 2-Year Follow-up

“…5 The resulting symptoms are similar to those encountered with spinal cord compression-including musculoskeletal pain, neurological deficits, and autonomic dysfunction-potentially requiring surgical intervention. 6,7 Although surgery may alleviate malalignment-associated symptoms, PD patients pose additional challenges to the practicing orthopedic surgeon. 6,7 These individuals possess lower bone mineral density compared to the general population, which predisposes them to osteoporosis and fractures.…”

“…6,7 Although surgery may alleviate malalignment-associated symptoms, PD patients pose additional challenges to the practicing orthopedic surgeon. 6,7 These individuals possess lower bone mineral density compared to the general population, which predisposes them to osteoporosis and fractures. 8 Consequently, orthopedic surgeries on PD patients may result in different postoperative outcomes than in patients without PD.…”