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European Spine Journal

, Volume 27, Issue 11, pp 2847–2853 | Cite as

The prevalence of chronic low back pain and lumbar deformities in patients with Parkinson’s disease: implications on spinal surgery

  • Imke GalazkyEmail author
  • Christina Caspari
  • Hans-Jochen Heinze
  • Joerg Franke
Original Article

Abstract

Purpose

This observational study was aimed at quantification of low back pain (LBP) in Parkinsonian patients and its morphological correlation.

Background

Parkinson’s disease (PD) is a common disabling condition in the elderly population. Parkinsonian patients frequently are troubled by LBP. Causes for LBP in PD are muscular imbalances by the movement disorder itself and skeletal degeneration.

Methods

Ninety-seven PD patients and 97 controls were inquired about low back pain through the Oswestry Low Back Pain Disability Questionnaire and visual analogue scales. Fifty-four patients with LBP underwent X-ray of the lumbar spine in two planes and flexion–extension views. Parkinson’s disease was characterized by stage, disease duration, motor score, lateralization of symptoms and dosage of medication.

Results

LBP occurred significantly more frequent in PD (87.6%) compared to controls (62.6%) with longer duration and higher pain intensity. Pain intensity and disability scores were associated with higher PD stages and higher motor scores. Patients with the hypokinetic PD subtype experienced more pain intensity. X-ray of the lumbar spine revealed lumbar arthrosis in 79.6%, scoliosis in 38.8% and spondylolisthesis in 24.1% of PD patients with LBP. Lateralization of scoliosis and PD symptoms were significantly correlated. Only a small portion of PD patients with LBP received specialized orthopaedic treatment.

Conclusion

LBP and lumbar degeneration are common in PD. Both are related to movement disorder symptoms. The knowledge about musculoskeletal conditions in Parkinson’s disease is important for an interdisciplinary conservative or operative treatment decision of LBP.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Keywords

Low back pain Lumbar degeneration Parkinson’s disease Adult spinal deformity 

Abbreviations

DBS

Deep brain stimulation

GPi

Globus pallidus internus

H&Y

Hoehn & Yahr stage

LBP

Low back pain

LEDD

Levodopa equivalent daily dosage

NMS

Non-motor symptom

ODI

Oswestry Low Back Pain Disability Questionnaire

PD

Parkinson’s disease

RSA

Other pain

RSB

Burning

RSK

Paraesthesia

RSS

Generally pain

RSST

Pricking

RST

Tingling

SCS

Spinal cord stimulation

STN

Subthalamic nucleus

UPDRS III

Unified Parkinson’s disease rating scale, part III

VAS

Visual analogue scale

Notes

Compliance with ethical standards

Conflict of interest

The authors report no conflict of interest.

Supplementary material

586_2018_5748_MOESM1_ESM.pptx (267 kb)
Supplementary material 1 (PPTX 266 kb)
586_2018_5748_MOESM2_ESM.docx (25 kb)
An overview and time course of surgical interventions as well as infiltrations in the PD cohort. Abbreviations: ASD (adjacent segment disease), CT (computed tomography), H&Y (Hoehn & Yahr stage), L3, 4, 5 (lumbar segments 3, 4, 5), S1 (sacral segment 1), PD (Parkinson’s disease), PLIF (posterior lumbar interbody fusion), TLIF (transforaminal lumbar interbody fusion). (DOCX 26 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Imke Galazky
    • 1
    Email author
  • Christina Caspari
    • 1
  • Hans-Jochen Heinze
    • 1
    • 2
    • 3
  • Joerg Franke
    • 4
  1. 1.Department of NeurologyOtto-von-Guericke UniversityMagdeburgGermany
  2. 2.German Centre for Neurodegenerative DiseasesOtto-von-Guericke UniversityMagdeburgGermany
  3. 3.Department of Behavioural NeurologyLeibniz Institute of NeurobiologyMagdeburgGermany
  4. 4.Department of OrthopaedicsKlinikum Magdeburg GmbHMagdeburgGermany

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