Characteristics of spinopelvic alignment in Parkinson's disease: Comparison with adult spinal deformity

J Orthop Sci. 2017 Jan;22(1):16-21. doi: 10.1016/j.jos.2016.09.013. Epub 2016 Dec 10.


Purpose: The characteristics and pathogenesis of spinopelvic alignment in Parkinsons's disease (PD) patients-including differences compared to non-PD subjects and their relationships with the severity of PD-have not been clarified. The aim of this study was to investigate the characteristics of spinopelvic alignment in patients with PD.

Methods: Forty-eight PD patients complaining of chronic low back pain were included (PD group). The PD condition, determined using the Hoehn and Yahr (H&Y) stage and Unified Parkinson Disease Rating Scale (UPDRS) score; radiographic spinopelvic alignment; lumbar range of motion (ROM); and low back pain-related quality of life assessments were evaluated. Fifty age- and sex-matched patients with adult spinal deformities were included as controls (ASD group).

Results: The spinopelvic alignments of the PD/ASD groups demonstrated sagittal vertical axes of 120.9/106.3 mm and pelvic incidences of 49.7/52.9°, with no significant differences. Conversely, there were significant differences in the thoracic kyphosis (TK; 27.6/16.7°), lumbar lordosis (-22.7/-7.9°), and pelvic tilt (25.3/34.4°) (all, p < 0.05). With regard to correlations with the PD condition, the H&Y stage demonstrated significant correlations with the sagittal vertical axis, thoracolumbar kyphosis, and lumbar ROM (all, p < 0.05), and the UPDRS score tended to correlate with the TK and thoracolumbar kyphosis (both, p < 0.01).

Conclusion: Characteristic spinal conditions in PD exist, with progressed PD condition causing stooped posture with increased thoracic or thoracolumbar kyphosis and decreased lumbar ROM; moreover, global sagittal malalignment progresses without sufficient compensatory mechanisms such as loss of TK and pelvic retroversion.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Bone Malalignment / diagnostic imaging*
  • Cohort Studies
  • Female
  • Humans
  • Incidence
  • Kyphosis / diagnostic imaging
  • Kyphosis / epidemiology
  • Lordosis / diagnostic imaging
  • Lordosis / epidemiology
  • Low Back Pain / etiology
  • Low Back Pain / physiopathology*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / physiopathology
  • Male
  • Middle Aged
  • Parkinson Disease / epidemiology
  • Parkinson Disease / physiopathology*
  • Pelvis / diagnostic imaging
  • Pelvis / physiopathology*
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index
  • Sex Factors
  • Spinal Diseases / diagnostic imaging*
  • Spinal Diseases / physiopathology
  • Statistics, Nonparametric