BACKGROUND: Up to 60% of Parkinson's disease (PD) patients suffer from low back pain (LBP) during the course of their disease. How LBP affects daily functional status and how to manage this aspect of PD has not been adequately explored. METHODS: We examined 16 patients undergoing bilateral subthalamic nucleus deep brain stimulation (STN DBS) who met the inclusion criteria for moderate disability from LBP, as classified by the Oswestry Low Back Pain Disability Index (OLBPD). RESULTS: Thirteen of 16 patients had attempted additional treatments for LBP, including medical management, massage, chiropractic, epidural steroid injections and/or surgery, with minimal relief. Following DBS, there was a significant improvement in the OLBPD at both the 6-month and 1-year time points (p < 0.02, p < 0.005, respectively). A mean improvement of 31.7% on the OLBPD score was noted. The Visual Analogue Scale (VAS) similarly decreased significantly at 1 year (p = 0.015). There was no correlation between the OLBPD score and other measures, including the Unified Parkinson's Disease Rating Scale (UPDRS), age and other nonmotor symptoms. CONCLUSION: Given the prevalent yet undertreated disability associated with LBP in PD, these results are novel in that they show that STN DBS has a significant positive effect on disability associated with LBP.
BACKGROUND: Up to 60% of Parkinson's disease (PD) patients suffer from low back pain (LBP) during the course of their disease. How LBP affects daily functional status and how to manage this aspect of PD has not been adequately explored. METHODS: We examined 16 patients undergoing bilateral subthalamic nucleus deep brain stimulation (STNDBS) who met the inclusion criteria for moderate disability from LBP, as classified by the Oswestry Low Back Pain Disability Index (OLBPD). RESULTS: Thirteen of 16 patients had attempted additional treatments for LBP, including medical management, massage, chiropractic, epidural steroid injections and/or surgery, with minimal relief. Following DBS, there was a significant improvement in the OLBPD at both the 6-month and 1-year time points (p < 0.02, p < 0.005, respectively). A mean improvement of 31.7% on the OLBPD score was noted. The Visual Analogue Scale (VAS) similarly decreased significantly at 1 year (p = 0.015). There was no correlation between the OLBPD score and other measures, including the Unified Parkinson's Disease Rating Scale (UPDRS), age and other nonmotor symptoms. CONCLUSION: Given the prevalent yet undertreated disability associated with LBP in PD, these results are novel in that they show that STNDBS has a significant positive effect on disability associated with LBP.
Authors: Janne Gierthmühlen; Philipp Arning; Andreas Binder; Jan Herzog; Günther Deuschl; Gunnar Wasner; Ralf Baron Journal: Mov Disord Date: 2010-07-15 Impact factor: 10.338
Authors: Daniel Ciampi de Andrade; Jean-Pascal Lefaucheur; Ricardo Galhardoni; Karine S L Ferreira; Anderson Rodrigues Brandão Paiva; Edson Bor-Seng-Shu; Luciana Alvarenga; Martin L Myczkowski; Marco Antonio Marcolin; Silvia R D T de Siqueira; Erich Fonoff; Egberto Reis Barbosa; Manoel Jacobsen Teixeira Journal: Pain Date: 2012-03-26 Impact factor: 6.961
Authors: Rubens G Cury; Ricardo Galhardoni; Erich T Fonoff; Maria G Dos Santos Ghilardi; Fernanda Fonoff; Debora Arnaut; Martin L Myczkowski; Marco A Marcolin; Edson Bor-Seng-Shu; Egberto R Barbosa; Manoel J Teixeira; Daniel Ciampi de Andrade Journal: Neurology Date: 2014-09-12 Impact factor: 9.910