AB159. SOH24AB_033. Outcomes following spinal surgery in patients with Parkinson’s disease: a systematic review and meta-analysis
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AB159. SOH24AB_033. Outcomes following spinal surgery in patients with Parkinson’s disease: a systematic review and meta-analysis

Ahmad Alissa1, Jake McDonnell2, Tayler Ross3, Neil Wu1, Aubrie Sowa2, Julia Wall2, Stacey Darwish2, Joseph Butler2

1School of Medicine, University College Dublin, Dublin, Ireland; 2National Spinal Injuries Unit, Mater Mesericordiae University Hospital, Dublin, Ireland; 3Department of Orthopaedic Surgery, University of Toronto, Toronto, Canada

Background: Parkinson’s disease (PD) patients represent challenging spinal surgery candidates due to associated deformity. This study consolidates the literature concerning spinal surgery outcomes in PD versus non-PD patients, to evaluate if PD predisposes patients to worse post-operative outcomes, so that treatment protocols can be optimised.

Methods: A systematic review and meta-analysis was conducted of PubMed/Medline, Embase, and Google Scholar databases per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies of interest included comparative (PD vs. non-PD) cohorts undergoing spinal surgery. Post-operative clinical outcomes were collated and compared for significance between cohorts. All statistical analysis was performed using The R Project for Statistical Computing (version 4.1.2), with a P value of P<0.05 deemed statistically significant.

Results: In total, 494,049 patients were included across the 7 studies. Of those, 485,374 (98.2%) were patients without PD (non-PD), while 8,675 (1.8%) patients had PD at time of surgery. The collective mean age was noted as 69.9 years (PD: 70.9 years vs. non-PD: 68.5 years). Comparatively, there were 209,761 males (PD: 4,526; non-PD: 205185) and 284,288 females (PD: 4,147; non-PD: 279,976). Overall, there were more post-operative complications in the PD cohort (P=0.02). PD-patients experienced more mechanical complications (P=0.03), surgical site infections (P<0.01), and trended towards increased rates of post-operative delirium (P=0.06) and revision surgeries (P=0.09). No difference existed between cohorts for mortality (P=0.42).

Conclusions: Although more robust prospective studies are needed, the results of this study highlight the need for advanced wound care management in the postoperative period, both in-hospital and in the community, in addition to comprehensive multidisciplinary care from allied health professionals, with potential for the use of enhanced recovery after surgery (ERAS) protocols in PD-patients undergoing spine surgery.

Keywords: Parkinson’s disease (PD); spine surgery; complications; surgical site infections; revision surgeries

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab159
Cite this abstract as: Alissa A, McDonnell J, Ross T, Wu N, Sowa A, Wall J, Darwish S, Butler J. AB159. SOH24AB_033. Outcomes following spinal surgery in patients with Parkinson’s disease: a systematic review and meta-analysis. Mesentery Peritoneum 2024;8:AB159.

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