Daniel A C F Wong-Chung1,2, Janneke J P Schimmel1, Marinus de Kleuver2,3, Noël L W Keijsers4. 1. Sint Maartenskliniek Research, Sint Maartenskliniek, P.O. box 9011, 6500 GM, Nijmegen, The Netherlands. 2. Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands. 3. Department of Orthopaedic Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands. 4. Sint Maartenskliniek Research, Sint Maartenskliniek, P.O. box 9011, 6500 GM, Nijmegen, The Netherlands. n.keijsers@maartenskliniek.nl.
Abstract
PURPOSE: To investigate the effects of posterior spinal fusion (PSF) and curve type on upper body movements in Adolescent Idiopathic Scoliosis (AIS) patients during gait. METHODS: Twenty-four girls (12-18 years) with AIS underwent PSF. 3D-Gait-analyses were performed preoperatively, at 3 months and 1 year postoperatively. Mean position (0° represents symmetry) and range of motion (ROM) of the trunk (thorax-relative-to-pelvis) in all planes were assessed. Lower body kinematics and spatiotemporal parameters were also evaluated. RESULTS: Mean trunk position improved from 7.0° to 2.9° in transversal plane and from 5.0° to - 0.8° in frontal plane at 3 months postoperative (p < 0.001), and was maintained at 1 year. Trunk ROM in transverse plane decreased from 9.6° to 7.5° (p < 0.001) after surgery. No effects of PSF were observed on the lower body kinematics during the gait cycle. Patients with a double curve had a more axial rotated trunk before and after surgery (p = 0.013). CONCLUSION: In AIS patients, during gait an evident asymmetrical position of the trunk improved to an almost symmetric situation already 3 months after PSF and was maintained at 1 year. Despite a reduction of trunk ROM, patients were able to maintain the same walking pattern in the lower extremities after surgery. This improvement of symmetry and maintenance of normal gait can explain the rapid recovery and well functioning in daily life of AIS patients, despite undergoing a fusion of large parts of their spine.
PURPOSE: To investigate the effects of posterior spinal fusion (PSF) and curve type on upper body movements in Adolescent Idiopathic Scoliosis (AIS) patients during gait. METHODS: Twenty-four girls (12-18 years) with AIS underwent PSF. 3D-Gait-analyses were performed preoperatively, at 3 months and 1 year postoperatively. Mean position (0° represents symmetry) and range of motion (ROM) of the trunk (thorax-relative-to-pelvis) in all planes were assessed. Lower body kinematics and spatiotemporal parameters were also evaluated. RESULTS: Mean trunk position improved from 7.0° to 2.9° in transversal plane and from 5.0° to - 0.8° in frontal plane at 3 months postoperative (p < 0.001), and was maintained at 1 year. Trunk ROM in transverse plane decreased from 9.6° to 7.5° (p < 0.001) after surgery. No effects of PSF were observed on the lower body kinematics during the gait cycle. Patients with a double curve had a more axial rotated trunk before and after surgery (p = 0.013). CONCLUSION: In AISpatients, during gait an evident asymmetrical position of the trunk improved to an almost symmetric situation already 3 months after PSF and was maintained at 1 year. Despite a reduction of trunk ROM, patients were able to maintain the same walking pattern in the lower extremities after surgery. This improvement of symmetry and maintenance of normal gait can explain the rapid recovery and well functioning in daily life of AISpatients, despite undergoing a fusion of large parts of their spine.
Authors: Marinus de Kleuver; Stephen J Lewis; Niccole M Germscheid; Steven J Kamper; Ahmet Alanay; Sigurd H Berven; Kenneth M Cheung; Manabu Ito; Lawrence G Lenke; David W Polly; Yong Qiu; Maurits van Tulder; Christopher Shaffrey Journal: Eur Spine J Date: 2014-06-24 Impact factor: 3.134
Authors: J R Engsberg; K H Bridwell; A K Reitenbach; M L Uhrich; C Baldus; K Blanke; L G Lenke Journal: Spine (Phila Pa 1976) Date: 2001-09-15 Impact factor: 3.468