Wataru Kuwahara1, Masataka Deie2, Naoto Fujita3, Nobuhiro Tanaka4, Kazuyoshi Nakanishi4, Toru Sunagawa5, Makoto Asaeda1, Haruka Nakamura1, Yoshifumi Kono6, Mitsuo Ochi4. 1. Health Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan. 2. Department of Orthopaedic Surgery, Aichi Medical University, Aichi, Japan. Electronic address: snm3@aichi-med-u.ac.jp. 3. Department of Musculoskeletal Functional Research and Regeneration, Hiroshima University, Hiroshima, Japan. 4. Department of Orthopaedic Surgery, Hiroshima University, Hiroshima, Japan. 5. Department of Analysis and Control of Upper Extremity Function, Hiroshima University, Hiroshima, Japan. 6. Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan.
Abstract
BACKGROUND: Although gait analysis has been previously conducted for lumbar spinal stenosis patients, the vertebral segmental movements, such as of the thoracic and lumbar regions, and whether the spinal movement during gait changes after decompression surgery remain unclear. METHODS: Ten patients with lumbar spinal stenosis and 10 healthy controls participated. Clinical outcomes were assessed using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire and Visual Analogue Scale. Spinal kinematic data of the participants during gait were acquired using a three-dimensional motion analysis system. The trunk (whole spine), thoracic, and lumbar flexion and pelvic tilting values were calculated. Spinal kinematic data and clinical outcomes were collected preoperatively and 1month postoperatively for the patients. FINDINGS: Compared to that observed preoperatively, the clinical outcomes significantly improved at 1month postoperatively. In the standing position, the preoperative lumbar extension of the patients was significantly smaller than that of the controls. Moreover, during gait, the lumbar flexion relative to the standing position of the patients was smaller than that of the controls preoperatively, and increased at 1month postoperatively. The sum of the thoracic and lumbar flexion values during gait negatively correlated with the score for leg pain. INTERPRETATION: The epidural pressure of lumbar spinal stenosis patients is known to be higher than that of normal subjects during gait, and to decrease during walking with lumbar flexion. Preoperatively, smaller thoracic and lumbar flexion movements during gait relative to the standing position cannot decrease epidural pressure; as a result, severe leg pain might be induced. Copyright Â
BACKGROUND: Although gait analysis has been previously conducted for lumbar spinal stenosispatients, the vertebral segmental movements, such as of the thoracic and lumbar regions, and whether the spinal movement during gait changes after decompression surgery remain unclear. METHODS: Ten patients with lumbar spinal stenosis and 10 healthy controls participated. Clinical outcomes were assessed using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire and Visual Analogue Scale. Spinal kinematic data of the participants during gait were acquired using a three-dimensional motion analysis system. The trunk (whole spine), thoracic, and lumbar flexion and pelvic tilting values were calculated. Spinal kinematic data and clinical outcomes were collected preoperatively and 1month postoperatively for the patients. FINDINGS: Compared to that observed preoperatively, the clinical outcomes significantly improved at 1month postoperatively. In the standing position, the preoperative lumbar extension of the patients was significantly smaller than that of the controls. Moreover, during gait, the lumbar flexion relative to the standing position of the patients was smaller than that of the controls preoperatively, and increased at 1month postoperatively. The sum of the thoracic and lumbar flexion values during gait negatively correlated with the score for leg pain. INTERPRETATION: The epidural pressure of lumbar spinal stenosispatients is known to be higher than that of normal subjects during gait, and to decrease during walking with lumbar flexion. Preoperatively, smaller thoracic and lumbar flexion movements during gait relative to the standing position cannot decrease epidural pressure; as a result, severe leg pain might be induced. Copyright Â
Authors: Seyed Javad Mousavi; Rebecca Tromp; Matthew C Swann; Andrew P White; Dennis E Anderson Journal: J Biomech Date: 2018-09-03 Impact factor: 2.712
Authors: Tae Sik Goh; Jong Ki Shin; Myung Soo Youn; Hong Seok Lee; Taek Hoon Kim; Jung Sub Lee Journal: Eur Spine J Date: 2017-02-28 Impact factor: 3.134