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Chirurgie de la déformation chez les patients parkinsoniens : résultats fonctionnels et satisfaction du patient

SCEMAMA C; MANGONE G; BONACCORSI R; PASCAL MOUSSELLARD H
REV CHIR ORTHOP TRAUMATOL , 2018, vol. 104, n° 3, p. 288-292
Doc n°: 186978
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1016/j.otsr.2017.12.019
Descripteurs : AF5 - PARKINSON, CA6 - PATHOLOGIE - RACHIS

Patients with Parkinson's disease often present abnormal posture or
severe sagittal malalignment, causing significant disability. Surgical fusion is
these cases shows high rates of complications, but may nevertheless provide
functional benefit; however, this remains to be assessed.
Long fusion
for patients with Parkinson's disease and postural disorder could alleviate
disability despite the high risk of complications. METHODS:
We retrospectively
reviewed 18 Parkinson patients treated by long fusion for spinal deformity.
Functional results on the Oswestry Disability Index (ODI) and patient
satisfaction were assessed at a minimum 2 years' follow-up. Predictive factors
for good outcome were analyzed. RESULTS: Median follow-up was 44.4 months (IQR,
36-62.4 months). ODI showed significant improvement, from 64 (IQR, 59-77)
preoperatively to 49 (IQR, 40-57) at last follow-up (p=0.0014). Fifteen patients
(83%) were very satisfied (n=5) or satisfied (n=10) with the procedure. On
multivariate analysis, only age was significantly associated with improvement in
ODI at last follow-up
(estimate: -9.8; p=0.5). DISCUSSION: Although long spinal
fusion involves a high risk of complications in Parkinson's patients, the
improvement in autonomy and patient satisfaction should be borne in mind before
rejecting surgery, especially with motivated patients.
CI - Copyright (c) 2018 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS

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