Study Design: Case report. Objective: We report a case of treated failure spinal construct and pseudarthrosis in a patient with Parkinson's disease. Summary of Literature Review: There have been no reports about revision surgery due to failure and pseuarthrosis of degenerative lumbar spine disease in patients with Parkinson's disease. Materials and Methods: A 55-year-old female who had been diagnosed with Parkinson's disease 4 years ago presented with back pain and radiating pain on both legs.

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... adiographic assessment showed spinal stenosis from L2 to L5 combined with degenerative spondylolisthesis at L3-4. Posterior decompression, instrumentation, and posterolateral fusion were performed and her symptoms improved. Results: Two years after the operation, she complained of severe back pain without injury. A simple X-ray showed the pull out of bilateral L5 screws, and revision surgery was performed. Three years after the revision, she underwent re-reoperation due to metal failure. The breakage of a unilateral pedicle screw at L5 was found, and her fusion level was extended to S1 with a posterior lumbar interbody fusion with cages and alar screws. Finally, she has not shown any further failure but, a sagittal imbalance and aggravation of pelvic incidence due to Parkinson's disease have been detected. Conclusions: Spine surgeons always should consider metal failure, pseudarthrosis, and aggravated spinal imbalance caused by natural history in patients with Parkinson's disease.