Painful camptocormia: the relevance of shaking your patient’s hand

Dupeyron, Arnaud; Stober, Nina; Gélis, Anthony; Castelnovo, G.; Labauge, Pierre; Pélissier, J.

doi:10.1007/s00586-009-1086-6

Cited by 10 publications

(2 citation statements)

References 21 publications

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“…Camptocormia is an abnormal posture with marked flexion of the thoracolumbar spine, and it increases with time and fatigue during the day and during walking; it is a progressive postural insufficiency that abates in recumbent position, sitting or volitionally when the PD patient leans against a wall. There are usually no radiographic abnormalities or structural changes referring to that kind of neuromuscular dysfunction [1,12,24,32,39]. Camptocormia in PD patients was observed with an incidence of 7% dependant on the clinical severity of the PD.…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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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“…Myopathies, motor neuron disease, myasthenia gravis, and chronic inflammatory demyelinating polyneuropathy may lead to camptocormia by causing weakness of the vertebral extensor muscles . Camptocormia as the presenting manifestation of myopathy has been described in case reports and small series of patients with inflammatory myopathies [sporadic inclusion body myositis (sIBM), polymyositis, and dermatomyositis], amyloid myopathy, myotonic dystrophy, muscular dystrophies [facioscapulohumeral dystrophy type 1 (FSHD1), X‐linked myopathy with postural muscle atrophy due to four‐and‐a‐half lim domains 1 mutation, dysferlinopathy, manifesting carrier of dystrophinopathy, and calpainopathy], myofibrillar myopathy, congenital myopathy, sporadic late‐onset nemaline myopathy (SLONM), and metabolic myopathies (McArdle disease and mitochondrial myopathy). Laroche et al .…”

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confidence: 99%