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Degenerative

Outcomes Following Lumbar Decompression Surgery in Patients with Parkinsons Disease

Wednesday, February 21, 2024

    Presenting Author(s)

  • Barry Cheaney, II, MD

    Resident Physician
    Oregon Health and Science University
    Portland, OR, US

    • Co-Author(s)

  • PG

    Paxton Gehling, MD MPH

    Resident Physician
    Oregon Health and Science University
    Portland, Oregon, United States

  • CL

    Clifford Lin, MD

    Assistant Professor
    Oregon Health and Science University, United States

  • Won Hyung Andrew Ryu, MD

    Assistant Professor
    Oregon Health & Science University
    Portland, OR, US

  • CW

    Christina Wright, MD

    Associate Professor
    Oregon Health and Science University, United States

  • JW

    James Wright, MD

    Assistant Professor of Neurosurgery
    Department of Neurological Surgery, Oregon Health and Science University
    Portland, Oregon, United States

  • JY

    Jung Yoo, MD

    Professor of Orthopedics
    Department of Orthopaedic Surgery, Oregon Health & Science University, United States

Introduction: Patients with Parkinson’s disease (PD) are at greater risk of perioperative complications following spinal fusion surgeries. Their postoperative course is characterized by increased length of stay, post-operative complications, and need for reoperation. In comparison, the literature is lacking in outcomes data following lumbar decompression in this patient population, with few studies to date. This study aims to compare outcomes following lumbar decompression in patients with PD.

Methods: PearlDiver (Colorado Springs, CO), a private analytics database of both commercial and Medicaid claims data, was utilized to search for patients with PD and patients without (control group) who underwent lumbar decompression. Medical complications, emergency room visits within 90-days, readmission, and revision surgery were compared using Chi-squared tests. A p < 0.01 (Bonferonni correction) was considered statistically significant.

Results: A total of 383,289 patients who underwent lumbar decompression were included in the study and of those, 8,895 had PD. There was no statistically significant difference in the rate of revision surgery between PD and control group (2.2% versus 2.4%, p = 0.04). The rates of revision to fusion in the PD group were 3.5% and in the control were 3.2% over the course of 5 years. There was a statistically significant difference in 90-day readmission (p < 0.0001) between the PD (5.9%) and control (4.2%). A similar difference is seen when comparing medical complications with PD at a rate of 4.5% compared to 3.2% in the control group. Emergency room visits were higher for patients with PD (7.7%) than in patients without (6.7%) (p = 0.0001).

Conclusion : This study found no difference in reoperation rates after lumbar laminectomy between those with and without PD. However, those with PD are at an increased risk of postoperative medical complications, 90-day readmission, and post op emergency room visits when compared to the general population.