The purpose of this research was to evaluate the efficacy of spinal fusion surgery for Parkinson’s disease (PD) patients who had had elective treatment. The prevalence of PD has risen along with the elderly population. Previous work has shown conflicting results about the efficacy of surgical treatment for degenerative spine disease in this population, despite the fact that it is typically necessary. The Quality Outcomes Database (QOD) was queried for data between April 2013 and January 2019. Elective lumbar procedures, cervical procedures for myelopathy, and cervical procedures for radiculopathy were separated out as distinct surgical categories. Patients without PD were propensity matched against patients with PD in a 5:1 ratio without replacement based on American Society of Anesthesiology grade, arthrodesis, surgical approach, number of operated levels, age, and pre-operative Oswestry Disability Index, pre-operative Numeric Rating Scale (NRS) extremity pain, pre-operative NRS back pain, and pre-operative EuroQol 5-Dimensions scores (EQ-5D). For continuous outcomes (Oswestry Disability Index, NRS leg pain, NRS back pain, and EQ-5D at 3 and 12 mo following surgery), we estimated the mean difference, and for binary outcomes, researchers calculated the risk difference (patient satisfaction, complications, readmission, reoperation, and mortality). At 12 months, patients with PD had a greater rate of reoperation compared to patients without PD (risk difference=0.057, P=0.015) and a poorer mean EQ-5D score (mean difference=-0.053, P=0.005). Patient satisfaction was worse in the cervical myelopathy group for those with PD (risk difference=-0.262, P=0.041), and NRS neck pain levels were lower in those with PD (mean difference=-0.829, P=0.005) after 3 months of treatment. In addition, patients with PD had a decreased risk of readmission at 3 months for cervical radiculopathy (risk difference=-0.045, P=0.014) than those without PD. In the matched analysis, patients with and without PD experienced similar rates of complications, readmissions, and repeat surgeries. These findings show that PD alone is not a substantial contraindication to elective spinal surgery.

 

Source: journals.lww.com/spinejournal/Abstract/2022/10150/Complications,_Readmissions,_Revisions,_and.7.aspx