Is Spine Surgery Safe in Patients with Parkinson’s Disease: A Single Centre Retrospective Analysis of 60 Consecutive Patients

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by tremors, bradykinesia, and rigidity. Patients with PD often develop spinal deformities, degenerative pathologies, and osteoporotic fractures, placing them at an increased risk for complications following spine surgery. With limited existing literature on spine surgery outcomes in Indian patients with PD, this study examines the safety and perioperative risks in this population. Materials and Methods: A retrospective analysis was conducted on 60 patients with idiopathic PD who underwent spinal surgery at a tertiary care center between 2000 and 2024, with a minimum follow-up of 1-year. Patients with atypical/secondary PD or those undergoing day-care procedures were excluded from this study. Data collected included demographics, comorbidities, Charlson Comorbidity Index (CCI), bone mineral density (BMD), type of surgery (open surgery vs. minimally invasive surgery [MIS]), operative duration, and number of fusion levels. Complications were categorized as medical (respiratory distress [RD], delirium, urinary complications, cerebrovascular accidents, pressure sores, cardiac arrest) or surgical (proximal/distal junctional kyphosis, adjacent segment disease/fractures, implant failure, surgical site infection [SSI]). Statistical analysis included descriptive statistics and univariate and multivariate comparisons. Results: Mean age was 66.2 and 64.76 years, respectively, in the complication and noncomplication groups, with comparable BMD (–2.36 vs. –2.29). The mean follow-up duration in the complication and noncomplication groups was 3.35 and 4.6 years, respectively. Complications occurred in 18 patients (30%). Open surgery accounted for 77.8% of complications, compared to 16.7% with MIS and 5.6% with percutaneous techniques. Patients with complications had higher CCI scores and longer operative durations. Surgical complications included junctional kyphosis (9, 42%), adjacent segment disease (3, 14.28%), implant failure (1, 4.76%), SSI (4, 19.04%), and adjacent segment fractures (4, 19.04%). Medical complications included RD (3, 25%), delirium (1, 8.33%), pressure sores (2, 16.66%), urinary tract infection (2, 16.66%), urinary retention (1, 8.33%), cerebrovascular accident (1, 8.33%), and cardiac arrest (2, 16.66%). Revision surgery was required in 11 cases. Conclusion: PD patients undergoing spinal surgery are at increased risk for both medical and surgical complications. Key risk factors include open procedures, long-segment fusions, prolonged operative times, poor bone quality, and multiple comorbidities. Minimally invasive techniques, careful preoperative optimization, and vigilant postoperative monitoring are recommended. Individualized perioperative planning is critical to improve outcomes in this high-risk population.