Spinopelvic balance: new biomechanical insights with clinical implications for Parkinson’s Disease
© Bissolotti et al; licensee BioMed Central Ltd. 2014
Published: 4 December 2014
Compared to the amount of data regarding non neurogenic deformities, scientific papers focusing on sacro-pelvic morphology and sagittal balance in patients affected by Parkinson's Disease (PD) are represented by few case studies or cohorts.
The aim of this study was to describe the disease-related sagittal balance changes in relation to the sacropelvic morphology of PD patients with different duration of disease.
Thirty-one consecutive PD patients (26 males, 5 females; mean age 69.5±7.9years, range 55-83 years) participated in the cross sectional study. The clinical assessment included: Hohen Yahr score; plumb line distance from C7, kyphosis apex, L3 and S1. Lumbar lordosis, thoracic kyphosis, spinosacral angle, spinopelvic angle, spinal tilt, pelvic incidence, sacral slope and pelvic tilt were radiographically assessed.
Radiographic spinopelvic angles appeared normal, but many patients presented variations from normality. In particular, pelvic tilt increased (21.2±12.1°) and sacral slope decreased (33.8±10.9°); spinosacral (108.8±20.2°) and spinopelvic angles (150.3±17.1°) were reduced compared to healthy people. Five patients (16.1%) were presenting a camptocormic behavior while walking; 21 patients (67.7%) had an anterior decompensation (average PKA 32.6±27.7mm) while 10 (32.3%) had a posterior one (average distance PS1 24.5±9.4mm); 8 patients (25.8%) had a scoliosis above 20° (Cobb angle=30.8±14.4°), while 11 (35.4%) presented a mild form between 11° and 20° (Cobb angle= 11.2±2.1°). Even if the average value of radiographic parameters appeared normal (Table 2), 3 patients (9.6%) had a LL below 20°, and 3 (9.6%) a lumbar kyphosis; 12 (38.7%) presented a TK above 55°.
Sagittal balance evaluation provides new valuable insights for biomechanical understanding of PD patients. Specific spinal parameters (spinosacral, spinopelvic and spinal tilt angles), and their clinical correlation, as well as pelvic parameters like pelvic tilt and sacral slope, appear particularly interesting for their clinical implications in terms of spinal deformities correction in PD population.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.