Imke Galazky1, Christina Caspari2, Hans-Jochen Heinze2,3,4, Joerg Franke5. 1. Department of Neurology, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany. imke.galazky@med.ovgu.de. 2. Department of Neurology, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany. 3. German Centre for Neurodegenerative Diseases, Otto-von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany. 4. Department of Behavioural Neurology, Leibniz Institute of Neurobiology, Brenneckestr. 6, 39120, Magdeburg, Germany. 5. Department of Orthopaedics, Klinikum Magdeburg GmbH, Birkenallee 34, 39130, Magdeburg, Germany.
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. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: This observational study was aimed at quantification of low back pain (LBP) in Parkinsonianpatients and its morphological correlation. BACKGROUND:Parkinson's disease (PD) is a common disabling condition in the elderly population. Parkinsonianpatients frequently are troubled by LBP. Causes for LBP in PD are muscular imbalances by the movement disorder itself and skeletal degeneration. METHODS: Ninety-seven PDpatients 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 PDpatients with LBP. Lateralization of scoliosis and PD symptoms were significantly correlated. Only a small portion of PDpatients 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. These slides can be retrieved under Electronic Supplementary Material.
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