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Axial postural deformities in Parkinson’s disease

Doherty, K; (2014) Axial postural deformities in Parkinson’s disease. Doctoral thesis , UCL (University College London). Green open access

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Abstract

Studies have been performed to detail the phenomenology, investigate the skeletal changes and explore the spinal biomechanics underlying the main axial deformities – Pisa syndrome and camptocormia in Parkinson’s disease. Results demonstrate that the clinical picture of these deformities varies greatly but that certain particular features allow distinction from other neurological, muscular and bony aetiologies. The tone of the axial muscles, the level at which spinal flexion occurs, the patient’s ability and method to try to overcome the chronically abnormal posture, and the flexibility or fixity of the trunk provide clinical pointers to the likely underlying cause. The scoliotic curve in a patient with Pisa syndrome was C-shaped, involved a large element of collapse and occurred without evidence of a secondary upper compensatory curvature (S-shaped curve). On supine imaging patients with camptocormia were severely mechanically disadvantaged as a result of their alordotic lumbar spines in relation to pelvic angulation. This lumbar alordosis may reflect the effects of Parkinson’s disease on the axial musculature, particularly in those with axial akinetic rigid predominant PD. Radiological examination also demonstrated that Pisa syndrome was different from de novo degenerative scoliosis and camptocormia not typical of adult onset degenerative kyphosis. Fixed bony changes were rare but the severity of these postural deformities and their consequent effects (e.g. knee flexion contractures, gluteal muscle atrophy) are likely to render conservative interventions unsuccessful unless instigated very early in the evolution of the abnormal posture.

Type: Thesis (Doctoral)
Title: Axial postural deformities in Parkinson’s disease
Open access status: An open access version is available from UCL Discovery
Language: English
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
URI: https://discovery.ucl.ac.uk/id/eprint/1419081
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