Early dynamic changes within the spine following posterior fusion using hybrid instrumentation in adolescents with idiopathic scoliosis: a gait analysis study.
Adolescent idiopathic scoliosis
Gait analysis
Hybrid instrumentation
Posterior spinal fusion
Segmental analysis
Sublaminar bands
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
received:
09
11
2020
accepted:
07
05
2021
pubmed:
20
5
2021
medline:
28
10
2022
entrez:
19
5
2021
Statut:
ppublish
Résumé
In adolescent idiopathic scoliosis (AIS) patients, mechanical consequences of posterior spinal fusion within the spine remain unclear. Through dynamic assessment, gait analysis could help elucidating this particular point. The aim of this study was to describe early changes within the spine following fusion with hybrid instrumentation in adolescents with idiopathic scoliosis, using gait analysis MATERIALS AND METHODS: We conducted a single-centre prospective study including AIS patients scheduled for posterior spinal fusion (PSF) using hybrid instrumentation with sublaminar bands. Patients underwent radiographic and gait analyses preoperatively and during early postoperative period. Among gait parameters, motion of cervicothoracic, thoracolumbar and lumbosacral junctions was measured in the three planes. We included 55 patients (mean age 15 years, 84% girls). Fusion was performed on 12 levels and mean follow-up was 8 months. There was a moderately strong correlation between thoracolumbar sagittal motion and lumbosacral junction pre- and postoperatively (R = - 0.6413 and R = - 0.7040, respectively, all p < 0.001), meaning that the more thoracolumbar junction was in extension, the more lumbosacral extension movements decreased. There was a trend to significance between postoperative SVA change and thoracolumbar sagittal motion change (R = - 0.2550, p = 0.059). This is the first series reporting dynamic changes within the spine following PSF using hybrid instrumentation in AIS patients. PSF led to symmetrization of gait pattern. In the sagittal plane, we found that thoracolumbar extension within the fused area led to decreased extension at cervicothoracic and lumbosacral junctions. Even though consequences of such phenomenon are unclear, attention must be paid not to give a too posterior alignment when performing PSF for AIS patients.
Identifiants
pubmed: 34008049
doi: 10.1007/s00402-021-03956-3
pii: 10.1007/s00402-021-03956-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3613-3621Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Weinstein SL, Dolan LA, Cheng JCY et al (2008) Adolescent idiopathic scoliosis. Lancet (London, England) 371:1527–1537. https://doi.org/10.1016/S0140-6736(08)60658-3
doi: 10.1016/S0140-6736(08)60658-3
Pesenti S, Jouve J-L, Morin C et al (2015) Evolution of adolescent idiopathic scoliosis: results of a multicenter study at 20 years’ follow-up. Orthop Traumatol Surg Res 101:619–622. https://doi.org/10.1016/j.otsr.2015.05.004
doi: 10.1016/j.otsr.2015.05.004
pubmed: 26194208
Lafage V, Schwab F, Skalli W et al (2008) Standing balance and sagittal plane spinal deformity: analysis of spinopelvic and gravity line parameters. Spine (Phila Pa 1976) 33:1572–1578. https://doi.org/10.1097/BRS.0b013e31817886a2
doi: 10.1097/BRS.0b013e31817886a2
Lykissas MG, Jain VV, Nathan ST et al (2013) Mid- to long-term outcomes in adolescent idiopathic scoliosis after instrumented posterior spinal fusion: a meta-analysis. Spine (Phila Pa 1976) 38:E113–E119. https://doi.org/10.1097/BRS.0b013e31827ae3d0
doi: 10.1097/BRS.0b013e31827ae3d0
Pesenti S, Prost S, Pomero V et al (2020) Does static trunk motion analysis reflect its true position during daily activities in adolescent with idiopathic scoliosis? Orthop Traumatol Surg Res. https://doi.org/10.1016/j.otsr.2019.12.023
doi: 10.1016/j.otsr.2019.12.023
pubmed: 33321233
Ryan N, Bruno P (2017) Analysis of 3D multi-segment lumbar spine motion during gait and prone hip extension. J Electromyogr Kinesiol 33:111–117. https://doi.org/10.1016/j.jelekin.2017.02.005
doi: 10.1016/j.jelekin.2017.02.005
pubmed: 28259003
Negrini S, Piovanelli B, Amici C et al (2016) Trunk motion analysis: a systematic review from a clinical and methodological perspective. Eur J Phys Rehabil Med 52:583–592
pubmed: 27455950
Mahaudens P, Banse X, Mousny M, Detrembleur C (2009) Gait in adolescent idiopathic scoliosis: kinematics and electromyographic analysis. Eur Spine J 18:512–521. https://doi.org/10.1007/s00586-009-0899-7
doi: 10.1007/s00586-009-0899-7
pubmed: 19224255
pmcid: 2899459
Syczewska M, Graff K, Kalinowska M et al (2012) Influence of the structural deformity of the spine on the gait pathology in scoliotic patients. Gait Posture. https://doi.org/10.1016/j.gaitpost.2011.09.008
doi: 10.1016/j.gaitpost.2011.09.008
pubmed: 21978792
Yang JH, Suh S-W, Sung PS, Park W-H (2013) Asymmetrical gait in adolescents with idiopathic scoliosis. Eur Spine J 22:2407–2413. https://doi.org/10.1007/s00586-013-2845-y
doi: 10.1007/s00586-013-2845-y
pubmed: 23732766
pmcid: 3886502
Kruger KM, Garman CMR, Krzak JJ et al (2018) Effects of spinal fusion for idiopathic scoliosis on lower body kinematics during gait. Spine Deform 6:441–447. https://doi.org/10.1016/j.jspd.2017.12.008
doi: 10.1016/j.jspd.2017.12.008
pubmed: 29886917
Pesenti S, Prost S, Pomero V et al (2019) Characterization of trunk motion in adolescents with right thoracic idiopathic scoliosis. Eur Spine J 28:2025–2033. https://doi.org/10.1007/s00586-019-06067-1
doi: 10.1007/s00586-019-06067-1
pubmed: 31317309
Blondel B, Pomero V, Moal B et al (2012) Sagittal spine posture assessment: feasibility of a protocol based on intersegmental moments. Orthop Traumatol Surg Res 98:109–113. https://doi.org/10.1016/j.otsr.2011.12.001
doi: 10.1016/j.otsr.2011.12.001
pubmed: 22264566
Blondel B, Viehweger E, Moal B et al (2015) Postural spinal balance defined by net intersegmental moments: results of a biomechanical approach and experimental errors measurement. World J Orthop 6:983–990. https://doi.org/10.5312/wjo.v6.i11.983
doi: 10.5312/wjo.v6.i11.983
pubmed: 26716095
pmcid: 4686446
Pesenti S, Prost S, Blondel B et al (2019) Correlations linking static quantitative gait analysis parameters to radiographic parameters in adolescent idiopathic scoliosis. Orthop Traumatol Surg Res 105:541–545. https://doi.org/10.1016/j.otsr.2018.09.024
doi: 10.1016/j.otsr.2018.09.024
pubmed: 30930135
Pesenti S, Pomero V, Prost S et al (2020) Curve location influences spinal balance in coronal and sagittal planes but not transversal trunk motion in adolescents with idiopathic scoliosis: a prospective observational study. Eur Spine J. https://doi.org/10.1007/s00586-020-06361-3
doi: 10.1007/s00586-020-06361-3
pubmed: 32140786
Lenke LG (2005) Lenke classification system of adolescent idiopathic scoliosis: treatment recommendations. Instr Course Lect 54:537–542
pubmed: 15948478
Kramers-De Quervain IA, Müller R, Stacoff A et al (2004) Gait analysis in patients with idiopathic scoliosis. Eur Spine J 13:449–456. https://doi.org/10.1007/s00586-003-0588-x
doi: 10.1007/s00586-003-0588-x
pubmed: 15064994
pmcid: 3476595
Park HJ, Sim T, Suh SW et al (2016) Analysis of coordination between thoracic and pelvic kinematic movements during gait in adolescents with idiopathic scoliosis. Eur Spine J. https://doi.org/10.1007/s00586-015-3931-0
doi: 10.1007/s00586-015-3931-0
pubmed: 28012078
Nishida M, Nagura T, Fujita N et al (2017) Position of the major curve influences asymmetrical trunk kinematics during gait in adolescent idiopathic scoliosis. Gait Posture 51:142–148. https://doi.org/10.1016/j.gaitpost.2016.10.004
doi: 10.1016/j.gaitpost.2016.10.004
pubmed: 27764749
Wu K-W, Wang T-M, Hu C-C et al (2019) Postural adjustments in adolescent idiopathic thoracic scoliosis during walking. Gait Posture 68:423–429. https://doi.org/10.1016/j.gaitpost.2018.12.024
doi: 10.1016/j.gaitpost.2018.12.024
pubmed: 30594870
Jiang H, Shao W, Xu E et al (2018) Coronal imbalance after selective posterior thoracic fusion in patients with Lenke 1 and 2 adolescent idiopathic scoliosis. Biomed Res Int 2018:3476425. https://doi.org/10.1155/2018/3476425
doi: 10.1155/2018/3476425
pubmed: 30627550
pmcid: 6304582
Lenke LG, Engsberg JR, Ross SA et al (2001) Prospective dynamic functional evaluation of gait and spinal balance following spinal fusion in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 26:E330–E337
doi: 10.1097/00007632-200107150-00020
Paul JC, Patel A, Bianco K et al (2014) Gait stability improvement after fusion surgery for adolescent idiopathic scoliosis is influenced by corrective measures in coronal and sagittal planes. Gait Posture 40:510–515. https://doi.org/10.1016/j.gaitpost.2014.06.006
doi: 10.1016/j.gaitpost.2014.06.006
pubmed: 25023225
Mahaudens P, Detrembleur C, Mousny M, Banse X (2010) Gait in thoracolumbar/lumbar adolescent idiopathic scoliosis: effect of surgery on gait mechanisms. Eur Spine J. https://doi.org/10.1007/s00586-010-1292-2
doi: 10.1007/s00586-010-1292-2
pubmed: 20148341
pmcid: 2900025
Holewijn RM, Kingma I, de Kleuver M, Keijsers NLW (2018) Posterior spinal surgery for adolescent idiopathic scoliosis does not induce compensatory increases in distal adjacent segment motion: a prospective gait analysis study. Spine J 18:2213–2219. https://doi.org/10.1016/j.spinee.2018.05.010
doi: 10.1016/j.spinee.2018.05.010
pubmed: 29746962
Nishida M, Nagura T, Fujita N et al (2019) Spinal correction surgery improves asymmetrical trunk kinematics during gait in adolescent idiopathic scoliosis with thoracic major curve. Eur Spine J 28:619–626. https://doi.org/10.1007/s00586-018-5741-7
doi: 10.1007/s00586-018-5741-7
pubmed: 30145657