Thoracic kyphosis and pelvic anteversion in patients with adult spinal deformity increase while walking: analyses of dynamic alignment change using a three-dimensional gait motion analysis system

European spine journal

article

Kousei Miura¹  Hideki Kadone³  Masao Koda¹  Tetsuya Abe¹  Toru Funayama¹  Hiroshi Noguchi¹  Kentaro Mataki¹  Katsuya Nagashima¹  Hiroshi Kumagai¹  Yosuke Shibao¹  Kenji Suzuki⁴  Masashi Yamazaki¹ 

[1] Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba;Department of Rehabilitation Medicine, Faculty of Medicine, University of Tsukuba Hospital;Center for Innovative Medicine and Engineering, University of Tsukuba Hospital;Center for Cybernics Research, University of Tsukuba

关键词: Adult spinal deformity;    Three-dimensional motion analysis;    Gait analysis;    Spinal balance;   

DOI  :  10.1007/s00586-020-06312-y

来源: Springer

【 摘 要 】

To determine dynamic changes of spinopelvic alignment while walking using a three-dimensional (3D) gait motion analysis in adult spinal deformity (ASD) patients. This study included 20 ASD patients. The 3D gait motion analysis (Vicon) was performed during continuous walking to their limit. Dynamic parameters were obtained using reflective markers on the spinous processes, which were segmented into thoracic (T-), lumbar (L-), and whole spine (S-), sagittal spinal distance (SVA) and coronal one (CVA), sagittal spinal angle to the vertical axis (SA) and coronal one (CA), sagittal pelvic angle to the horizontal axis (P-SA) and coronal (P-CA), and thoracic limited spinal angle to the pelvic angle (T-P SA) and lumbar one (L-P SA). The dynamic variables at the final lap were compared with those at the first lap of an oval walkway. Spinal kyphotic deformity deteriorated significantly. As for pelvic angle, the mean P-SA parameters (first lap/final lap) were 3.2°/5.2°. Anteversion of pelvic sagittal angle increased significantly after continuous walking to their limit. In particular, regarding limited spinal angle to the pelvic angle, the mean T-P SA parameters were 30.5°/36.2° and L-P SA parameters were 6.4°/6.8°. Thoracic kyphotic angle increased significantly, but lumbar kyphotic angle did not change. Decrease of thoracic kyphosis and pelvic retroversion has been recognized as a compensation for ASD on standing radiograph. Our 3D gait motion analysis to determine spinal balance found thoracic kyphosis and pelvic anteversion increased significantly in patients with ASD after continuous walking to the limit of their endurance until they were fatigued, indicating a failure of compensation for ASD. These slides can be retrieved under Electronic Supplementary Material.

【 授权许可】

Unknown