Deep Brain Stimulation Significantly Decreases Disability from Low Back Pain in Patients with Advanced Parkinson's Disease

作者：Smith Heather; Gee Lucy; Kumar Vignessh; Ramirez Zamora Adolfo; Durphy Jennifer; Hanspal Era; Barba Anne; Molho Eric; Shin Damian; Pilitsis Julie G^*

来源：Stereotactic and Functional Neurosurgery, 2015, 93(3): 206-211.

DOI：10.1159/000380827

• Deep brain stimulation
• Low back pain
• Parkinson's disease
• Subthalamic nucleus
• Disability
• Pain

Background: Up to 60% of Parkinson's disease (PD) patients suffer from low back pain (LBP) during the course of their disease. How LBP affects daily functional status and how to manage this aspect of PD has not been adequately explored. Methods: We examined 16 patients undergoing bilateral subthalamic nucleus deep brain stimulation (STN DBS) who met the inclusion criteria for moderate disability from LBP, as classified by the Oswestry Low Back Pain Disability Index (OLBPD). Results: Thirteen of 16 patients had attempted additional treatments for LBP, including medical management, massage, chiropractic, epidural steroid injections and/or surgery, with minimal relief. Following DBS, there was a significant improvement in the OLBPD at both the 6-month and 1-year time points (p < 0.02, p < 0.005, respectively). A mean improvement of 31.7% on the OLBPD score was noted. The Visual Analogue Scale (VAS) similarly decreased significantly at 1 year (p = 0.015). There was no correlation between the OLBPD score and other measures, including the Unified Parkinson's Disease Rating Scale (UPDRS), age and other non-motor symptoms. Conclusion: Given the prevalent yet undertreated disability associated with LBP in PD, these results are novel in that they show that STN DBS has a significant positive effect on disability associated with LBP.

• 出版日期2015