[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-416445-105":3,"detail-sidebar-cat-0-en-105":73,"doc-detail-416445-en":122},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":66,"head_meta":68,"extra_data":70,"updated_unix":72},105,"en","lumbar-lateral-dislocation-fracture-with-progressive-worsening-of-trunk-tilt-in-pisa-syndrome-associated-with-parkinsons-disease","Lumbar Lateral Dislocation Fracture With Progressive Worsening of Trunk Tilt in Pisa Syndrome Associated With Parkinson's Disease","","Case Reports in Orthopedics presents a clinical case of a 73-year-old man with Parkinson's disease who developed Pisa syndrome after minor trauma. The patient initially underwent single-segment L2–3 interbody fusion with temporary neurological improvement. Six months later, implant breakage and worsening trunk tilt occurred, with progressive neurological decline. Salvage long-range corrective surgery using fixation from T3 to the pelvis improved trunk alignment and functional independence in daily living, highlighting limits of short-segment fixation and the role of early long-range fusion consideration.",{"@graph":14,"@context":65},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/lumbar-lateral-dislocation-fracture-with-progressive-worsening-of-trunk-tilt-in-pisa-syndrome-associated-with-parkinsons-disease/416445/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/lumbar-lateral-dislocation-fracture-with-progressive-worsening-of-trunk-tilt-in-pisa-syndrome-associated-with-parkinsons-disease/416445.png","ImageObject",300,407,{"name":42,"@type":43},"Elsa","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-07","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",7,{"@type":57,"mainEntity":58},"FAQPage",[59],{"name":60,"@type":61,"acceptedAnswer":62},"What did the salvage surgery involve, and what was the result?","Question",{"text":63,"@type":64},"Salvage corrective surgery used long-range fixation to improve trunk tilt. Fixation from T3 to the pelvis showed good progress 1 year after surgery and the patient regained independence in activities of daily living.","Answer","https://schema.org",{"og:url":32,"og:type":67,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":69,"canonical":32},"index,follow",{"doc_id":71,"site_id":7},416445,1791102596,{"code":4,"msg":74,"data":75},"success",[76,80,84,88,93,98,101,106,111,114,118],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":77,"show_sort_weight":78,"slug":79},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":81,"show_sort_weight":82,"slug":83},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Exam",70,"exam",{"id":89,"doc_module":4,"doc_module_name":25,"category_name":90,"show_sort_weight":91,"slug":92},5,"Comic",60,"comic",{"id":94,"doc_module":4,"doc_module_name":25,"category_name":95,"show_sort_weight":96,"slug":97},6,"Technology",50,"technology",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":99,"slug":100},40,"healthcare",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},8,"Research & Report",30,"research-report",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":108,"show_sort_weight":109,"slug":110},9,"Religion & Spirituality",20,"religion-spirituality",{"id":109,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":109,"slug":113},"World Cup","world-cup",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":115,"slug":117},10,"Lifestyle","lifestyle",{"id":119,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":89,"slug":121},19,"General","general",{"code":4,"msg":74,"data":123},{"doc_id":71,"user_id":124,"nickname":42,"user_avatar":125,"doc_module":4,"category_id":55,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":126,"file_id":127,"file_url":128,"file_type":129,"file_size":130,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":94,"language":131,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":132,"faqs":133,"seo_title":134,"seo_description":12,"update_tm":135,"read_time":136,"preview_page_count":4},137455077381,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Wiley  \nCase Reports in Orthopedics  \nVolume 2026, Article ID 3774288, 6 pages [https://doi.org/10.1155/cro/3774288](https://doi.org/10.1155/cro/3774288)  \nCase Report  \nLumbar Lateral Dislocation Fracture With Progressive Worsening of Trunk Tilt in Pisa Syndrome Associated With Parkinson's Disease  \nKazuki Fujimoto , 1 Narumi Maki, 1,2 Daisuke Hashiba, 1,2 Toshifumi Maeyama, 1,2 Haruki Ito, 1,2 Ryosuke Nakagawa, 1 Tetsuhiro Ishikawa,3 Hajime Arai, 1 and Seiji Ohtori2 1Department of Orthopedic Surgery, National Kohnodai Medical Center, Japan Institute for Health Security, Ichikawa City, Chiba, Japan  \n2Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba City, Chiba, Japan  \n3Department of Orthopedic Surgery, Sanmu Medical Center, Sanmu City, Chiba, Japan  \nCorrespondence should be addressed to Kazuki Fujimoto; [s9082@nms.ac.jp](s9082@nms.ac.jp)  \nReceived 31 December 2024; Revised 16 November 2025; Accepted 26 November 2025  \nAcademic Editor: Shashank Kaushik  \nCopyright © 2026 Kazuki Fujimoto et al. Case Reports in Orthopedics published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \nIntroduction: 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.  \nCase 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.  \nConclusion: 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.  \nKeywords: lumbar fracture; Parkinson's disease; Pisa syndrome; trunk tilt  \n1. Introduction  \nWith an aging society, the incidence of Parkinson's disease (PD) has increased [1] . Among the postural abnormalities of PD, Pisa syndrome presents with a lateral flexion posture without spinal or vertebral deformities. Although various effective therapeutic interventions have been reported [2], corrective fusion surgery may still be required in some cases [3–6] . No reports exist of vertebral dislocation fractures in Pisa syndrome. Herein, we report a case of Pisa syndrome in which minor trauma resulted in a lumbar lateral dislocation fracture with lower limb paralysis. In this patient, single-level posterior fixation failed soon after surgery. However, salvage corrective surgery involving long-  \nrange fixation from T3 to the pelvis showed good progress 1 year after surgery.  \n2. Case Presentation  \nThe patient was a 73-year-old man who had been diagnosed with PD 5 years earlier with bradykinesia and postural instability that manifested as abnormal gait posture. He was treated with oral medication, beginning with a dopamine agonist, the dosage of which was gradually increased. The most recent treatment consisted of levodopa (750mg/day) and a dopamine agonist (3mg/day) . Then, 4 months before being examined by our institution, the patient's trunk tilting to the right became more noticeable. Then, 3 months before  \n2 Case Reports in Orthopedics  \nFigure 1: Initial radiographs and magnetic resonance images.The radiographs show focal scoliosis at the L2–3 level (a [arrowhead] and b) . T2-weight","cbCaijeslCMr454y","https://ap.wps.com/l/cbCaijeslCMr454y","pdf",2657788,"English","# Introduction\n# Case Presentation\n## Imaging and Diagnosis\n## Initial Surgery and Outcome\n# Conclusion","[{\"question\":\"What did the salvage surgery involve, and what was the result?\",\"answer\":\"Salvage corrective surgery used long-range fixation to improve trunk tilt. Fixation from T3 to the pelvis showed good progress 1 year after surgery and the patient regained independence in activities of daily living.\"}]","Lumbar Lateral Dislocation Fracture With Progressive Worsening of Trunk Tilt in Pisa Syndrome Associated With Parkinson's Disease | PDF",1790605488,15]