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.