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. 2022 Oct 24;4(17):CASE22357.
doi: 10.3171/CASE22357. Print 2022 Oct 24.

Improvement in sagittal alignment and mechanical low-back pain following deep brain stimulation for Parkinson's disease: illustrative case

Jaime R Guerrero  1 , Lokeshwar S Bhenderu  1 , Khaled M Taghlabi  1 , Jesus G Cruz-Garza  1 , Comron Saifi  2 , Amir H Faraji  1
Affiliations

Improvement in sagittal alignment and mechanical low-back pain following deep brain stimulation for Parkinson's disease: illustrative case

Jaime R Guerrero et al. J Neurosurg Case Lessons. .

Abstract

Background: Parkinson's disease (PD) is a common neurogenerative disease marked by the characteristic triad of bradykinesia, rigidity, and tremor. A significant percentage of patients with PD also demonstrate postural abnormalities (camptocormia) that limit ambulation and accelerate degenerative pathologies of the spine. Although deep brain stimulation (DBS) is a well-established treatment for the motor fluctuations and tremor seen in PD, the efficacy of DBS on postural abnormalities in these patients is less clear.

Observations: The authors present a patient with a history of PD and prior lumbosacral fusion who underwent bilateral subthalamic nucleus DBS and experienced immediate improvement in sagittal alignment and subjective relief of mechanical low-back pain.

Lessons: DBS may improve postural abnormalities seen in PD and potentially delay or reduce the need for spinal deformity surgery.

Keywords: Parkinson’s disease; camptocormia; deep brain stimulation; sagittal alignment.

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Conflict of interest statement

Disclosures Dr. Saifi reported personal fees from Nuvasive outside the submitted work; consulting and shares (stock) for Restor3d; consulting from Alphatec Spine; and shares (stock) for Vertera. No other disclosures were reported.

Figures

FIG. 1.
FIG. 1.
Preoperative postmyelography CT demonstrated pseudoarthrosis and spondylolisthesis at L5–S1.
FIG. 2.
FIG. 2.
Left: Placement of bilateral STN depth electrodes using Clearpoint 2. Right: BrainLab atlas postoperative reconstruction confirming DBS placement within bilateral STNs (green). The red nucleus is depicted in red.
FIG. 3.
FIG. 3.
Sacropelvic parameters before (left) and after (right) DBS surgery for PD. Note the improvement in SVA after DBS.
See this image and copyright information in PMC

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