Lumbar Lateral Dislocation Fracture With Progressive Worsening of Trunk Tilt in Pisa Syndrome Associated With Parkinson's Disease.

INTRODUCTION

Parkinson's disease rarely presents with Pisa syndrome, for which a patient may require corrective surgery because of trunk tilt. Herein, we report a case of lumbar dislocation fracture caused by minor trauma. The patient's trunk tilt progressed, and neurological symptoms worsened, requiring surgical treatment.

CASE REPORT: A 73-year-old man with Parkinson's disease fell and gradually developed lower back pain, lower limb pain, and paralysis. Single-segment interbody fusion at the dislocated intervertebral level temporarily improved neurological symptoms. However, 6 months after surgery, the implant had broken, and the trunk tilt had worsened. Salvage corrective surgery involving long-range fixation improved trunk tilt. The patient recovered independence in activities of daily living.

CONCLUSION

In Parkinson's disease, minor trauma can cause lumbar dislocation fractures, which may worsen Pisa syndrome. Short-segment fixation cannot control deformity progression; therefore, long-range fusion should be considered during the initial surgery.