Surgery for Degenerative Spinal Pathologies in Parkinson's Patients: Low Surgical Benefits for High Risks

Area of Science:

• Neurosurgery
• Neurology
• Geriatric Medicine

Background:

• Parkinson disease (PD) patients frequently develop degenerative spinal pathologies like lumbar disc herniation, canal stenosis, and cervicarthrosis.
• Spinal surgery in PD patients is associated with significant risks and unpredictable functional outcomes.

Purpose of the Study:

• To evaluate the outcomes of spinal surgery in patients with Parkinson disease (PD).
• To determine the risks and benefits of surgical intervention for degenerative spinal conditions in the PD population.

Main Methods:

• A retrospective study identified 38 PD patients who underwent spinal surgery between 2017 and 2021.
• Data collected included patient demographics, neurological function, complications, and survival rates.

Main Results:

• The median age of patients was 70.7 years, with a median overall survival (OS) of 7 years post-surgery.
• Instrumented surgery was associated with significantly lower OS (2.97 years vs. 6.99 years).
• Functional improvements were limited: 44.7% improved walking, and 52.6% reported reduced pain. Key prognostic factors for better OS included Hoehn and Yahr Scale ≤4 and ASA score ≤2.

Conclusions:

• Spinal surgery, particularly instrumented or simple fusion, in PD patients results in poor functional outcomes and numerous complications.
• A multidisciplinary perioperative approach and minimally invasive techniques are crucial for optimizing surgical success and patient well-being in this fragile population.