2025 Volume 16 Issue 1 Pages 2-8
Introduction: The mechanisms underlying postural abnormalities in Parkinson's disease (PD) are unclear, and their characteristics are not well characterized. The PD clinical database (DB) was established jointly by the Department of Orthopedics and Department of Neurology at our institution, and we investigated the characteristics of spinal balance and skeletal muscle mass in patients with PD.
Methods: We analyzed 42 of the 426 patients with PD enrolled in the DB at our institution. The investigation items were spinal alignment evaluation using whole spine x-rays and skeletal muscle mass evaluation using whole-body DXA.
Results: The PD duration was 9.1±5.0 years, and the Hoenhn & Yahr classification was as follows: grade I: 1 patient, grade II: 16 patients, grade III: 17 patients, grade IV: 6 patients, and grade V: 2 patients. The spinal alignment of all PD patients showed high C7-CSVL, high C7-SVA, PI-LL mismatch, thoracic hyperkyphosis, elevated T1 slope, and imbalance in the coronal and sagittal planes, with a high percentage of patients with severe imbalance (45.2%). It tended to worsen as the PD progressed. The prevalence of muscle mass sarcopenia was 38.1%, with a high rate of 48.0% in patients with Yahr III or more.
Conclusions: It was suggested that patients with PD tend to have severe coronal and, especially, sagittal and spinal imbalances as the disease severity progresses, and that there is a high prevalence of sarcopenia, which may be involved in postural abnormalities and spinal balance.
