Introduction: Deformity associating coronal and sagittal malalignment can severely impair quality of life in Parkinson's disease (PD). Realignment using patient-specific rods (PSRs) is useful for achieving alignment goals.

Methods: This was a retrospective single-center analysis of a prospectively maintained database of all PD patients who underwent surgery between January 2013 and January 2017.Clinical evaluation, preoperatively and at 1 year’s follow-up, used the Oswestry Disability Index (ODI).Radiological evaluation used systematic preoperative and 1-year postoperative full-spine radiographs.

Results: 12 patients were included: 6 female, 6 male; mean age, 68.4 years. Mean follow-up was 40.8 months [range 12-70]. On average, 14 levels were fused [range 10-18]. Unplanned revision surgery was necessary for 8 patients at a mean 15.625 months after index surgery. Mean preoperative ODI score was 64% preoperatively [range 56-70] versus 52% [range 28-64] at 1 year’s follow-up (p=0.004). Lumbar lordosis improved significantly, from -16.7° preoperatively to -41.4° at 1 year (p=0.006). Pelvic tilt was the least effectively corrected parameter, with a mean preoperative value of 31.6° vs. 27.8° at 1 year (p=0.19).Mean preoperative sagittal vertical axis was 149.7 mm versus 73.6 mm at 1 year (p=0.013). Mean preoperative coronal tilt was 68.2 mm versus 22.9 mm at 1 year (p=0.007).

Conclusion: Parkinson's disease is a degenerative disease frequently associated with major spine malalignment. The severity of the postural disorders in these patients needs special precautions to avoid complications.