Luciano Bissolotti1,2, Pedro Berjano3, Paola Zuccher1,2, Andrea Zenorini1,2, Riccardo Buraschi4, Jorge Hugo Villafañe5, Stefano Negrini6,4. 1. Rehabilitation Service, Fondazione Teresa Camplani Casa di Cura Domus Salutis, Brescia, Italy. 2. LARIN: Neuromuscular and Adapted Physical Activity Laboratory, Brescia, Italy. 3. IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. 4. IRCCS Don Gnocchi Foundation, Milan, Italy. 5. IRCCS Don Gnocchi Foundation, Milan, Italy. mail@villafane.it. 6. Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Abstract
PURPOSE: The aim of this study was to describe the disease-related sagittal balance changes in relation to the sacro-pelvic morphology of Parkinson's Disease patients with different duration of disease. METHODS: One hundred and seventy-five consecutive Parkinson's Disease (PD) patients (102 males, 73 females; age: 55-83 years) participated in the cross-sectional study. The clinical assessment included: Hoehn Yahr (H&Y) score; Tinetti score; plumb line (PL) distance from the spinous process of C7, L3 and S1 and kyphosis apex. Lumbar lordosis (LL), thoracic kyphosis (TK), spinosacral (SSA) and spinopelvic (SPA) angles, spinal tilt, pelvic incidence (PI), sacral slope (SS) and pelvic tilt (PT) were radiographically assessed. RESULTS: Spinosacral and spinopelvic were correlated with the duration of disease and Tinetti score, but not with age. We found a positive correlation between LL and both SSA and SPA. TK was significantly correlated with LL but not with pelvic parameters, while PI with SS and LL. CONCLUSIONS: Female gender, high PI and high LL together with a low PL-C7 distance can be considered as protective factors for spinal imbalance and fall risk; negative factors are represented by male gender, longer disease duration, higher H&Y Class, and low PL-L3 distance. Looking at the pelvis is revealing new important insights in spinal disease management, both surgical and rehabilitative.
PURPOSE: The aim of this study was to describe the disease-related sagittal balance changes in relation to the sacro-pelvic morphology of Parkinson's Diseasepatients with different duration of disease. METHODS: One hundred and seventy-five consecutive Parkinson's Disease (PD) patients (102 males, 73 females; age: 55-83 years) participated in the cross-sectional study. The clinical assessment included: Hoehn Yahr (H&Y) score; Tinetti score; plumb line (PL) distance from the spinous process of C7, L3 and S1 and kyphosis apex. Lumbar lordosis (LL), thoracic kyphosis (TK), spinosacral (SSA) and spinopelvic (SPA) angles, spinal tilt, pelvic incidence (PI), sacral slope (SS) and pelvic tilt (PT) were radiographically assessed. RESULTS: Spinosacral and spinopelvic were correlated with the duration of disease and Tinetti score, but not with age. We found a positive correlation between LL and both SSA and SPA. TK was significantly correlated with LL but not with pelvic parameters, while PI with SS and LL. CONCLUSIONS: Female gender, high PI and high LL together with a low PL-C7 distance can be considered as protective factors for spinal imbalance and fall risk; negative factors are represented by male gender, longer disease duration, higher H&Y Class, and low PL-L3 distance. Looking at the pelvis is revealing new important insights in spinal disease management, both surgical and rehabilitative.
Authors: William C Horton; Courtney W Brown; Keith H Bridwell; Steven D Glassman; Se-Il Suk; Charles W Cha Journal: Spine (Phila Pa 1976) Date: 2005-02-15 Impact factor: 3.468
Authors: Christian Götze; Ulf R Liljenqvist; Astrid Slomka; Hans Guenther Götze; Joern Steinbeck Journal: Spine (Phila Pa 1976) Date: 2002-07-01 Impact factor: 3.468