Quantification of intervertebral efforts during walking: comparison between a healthy and a scoliotic subject.

The accurate quantification of internal efforts in the human body is still a challenge in biomechanics. The aim of this study is to quantify the intervertebral efforts along the spine during walking, in order to compare the dynamical behaviours between a healthy and a scoliotic subject. Practically, one healthy subject, one scoliotic patient before an instrumentation surgery (Cobb 41 degrees ) and after this instrumentation (Cobb 7.5 degrees ) walked on a treadmill at 4 km/h. The acquisition system included optokinetic sensors, recording the 3D-joint coordinates, a treadmill equipped with strain gauges, measuring the external forces independently applied to both feet, and bi-planar radiographs, enabling the 3D reconstruction of the spine from C7 to L5, using a free form interpolation technique. The intervertebral efforts were computed using an inverse dynamical model of the human body in 3D. As results, significant differences of the spine kinematics were recorded which lead to different internal effort behaviour in magnitude, shift, coordination and pattern when normalized to the subject mass. Particularly, the normalized antero-posterior intervertebral torques are less uniform for the scoliotic patient (from min -2.5 to max 1.9 Nm/kg) than the healthy subject (from -1.5 to 1.5 Nm/kg). This disequilibrium in the left-right balance of the scoliotic patient is a bit rectified after surgery (from -1.3 to 1.1 Nm/kg).