Sébastien Pesenti1,2,3, Solenne Prost4,5,6, Vincent Pomero5, Guillaume Authier5, Mathieu Severyns4, Elke Viehweger4,5,6, Benjamin Blondel4,5,6, Jean-Luc Jouve4,5,6. 1. Paediatric Orthopaedics, Hopital d'enfants de la Timone, Aix Marseille University, 264 rue Saint Pierre, 13005, Marseille, France. seb.pesenti@gmail.com. 2. Gait Analysis Platform, Timone, Aix Marseille University, Marseille, France. seb.pesenti@gmail.com. 3. Orthopédie pédiatrique, APHM, CNRS, ISM, Hôpital de la Timone, Aix Marseille University, Marseille, France. seb.pesenti@gmail.com. 4. Paediatric Orthopaedics, Hopital d'enfants de la Timone, Aix Marseille University, 264 rue Saint Pierre, 13005, Marseille, France. 5. Gait Analysis Platform, Timone, Aix Marseille University, Marseille, France. 6. Orthopédie pédiatrique, APHM, CNRS, ISM, Hôpital de la Timone, Aix Marseille University, Marseille, France.
Abstract
BACKGROUND: Although standard radiography is currently used for deformity assessment in AIS patients, it is performed in a constrained position and probably not reflective of spinal balance during daily-life activities. Our main objective was to compare trunk motion in Lenke 1 and 2 AIS patients to healthy volunteers, using gait analysis. MATERIAL AND METHODS: Lenke 1 or 2 AIS patients planned for surgery were included. The day before surgery, they underwent radiographic evaluation and gait analysis. Among the gait parameters, sagittal vertical axis (Dyn-SVA), shoulder line rotation (Dyn-SL rotation), pelvis rotation (Dyn-P rotation) and acromion pelvis angle (Dyn-APA) were measured. AIS patients were compared to 25 asymptomatic controls. RESULTS: A total of 57 patients were included in the study, with a mean Cobb angle of 55.4°. AIS patients had a lower Dyn-SVA when compared to controls (47.0 vs. 62.9 mm, p = 0.012). Dyn-APA and Dyn-SL rotation were negative in AIS patients, meaning that shoulder line was rotated towards the left (- 6.4 vs. 7.8° and - 7.5 vs. - 0.4°, p<0.001, respectively). On the other hand, Dyn-P rotation was positive, meaning that pelvis was rotated towards the right side during gait (1.1 vs. - 0.5, p = 0.026). DISCUSSION: This is one of the largest series of gait analysis in AIS patients. We demonstrated that AIS patients have an abnormal gait pattern, with a decreased anterior tilt of the trunk and transverse plane abnormalities. We found that gait deviation was not related to radiographic measurements, pointing out that dynamic assessment provides new data about spinal posture. These slides can be retrieved under Electronic Supplementary Material.
BACKGROUND: Although standard radiography is currently used for deformity assessment in AISpatients, it is performed in a constrained position and probably not reflective of spinal balance during daily-life activities. Our main objective was to compare trunk motion in Lenke 1 and 2 AISpatients to healthy volunteers, using gait analysis. MATERIAL AND METHODS: Lenke 1 or 2 AISpatients planned for surgery were included. The day before surgery, they underwent radiographic evaluation and gait analysis. Among the gait parameters, sagittal vertical axis (Dyn-SVA), shoulder line rotation (Dyn-SL rotation), pelvis rotation (Dyn-P rotation) and acromion pelvis angle (Dyn-APA) were measured. AISpatients were compared to 25 asymptomatic controls. RESULTS: A total of 57 patients were included in the study, with a mean Cobb angle of 55.4°. AISpatients had a lower Dyn-SVA when compared to controls (47.0 vs. 62.9 mm, p = 0.012). Dyn-APA and Dyn-SL rotation were negative in AISpatients, meaning that shoulder line was rotated towards the left (- 6.4 vs. 7.8° and - 7.5 vs. - 0.4°, p<0.001, respectively). On the other hand, Dyn-P rotation was positive, meaning that pelvis was rotated towards the right side during gait (1.1 vs. - 0.5, p = 0.026). DISCUSSION: This is one of the largest series of gait analysis in AISpatients. We demonstrated that AISpatients have an abnormal gait pattern, with a decreased anterior tilt of the trunk and transverse plane abnormalities. We found that gait deviation was not related to radiographic measurements, pointing out that dynamic assessment provides new data about spinal posture. These slides can be retrieved under Electronic Supplementary Material.
Authors: B Blondel; V Pomero; B Moal; V Lafage; J-L Jouve; P Tropiano; G Bollini; R Dumas; E Viehweger Journal: Orthop Traumatol Surg Res Date: 2012-01-20 Impact factor: 2.256
Authors: Patrick O Riley; Gabriele Paolini; Ugo Della Croce; Kate W Paylo; D Casey Kerrigan Journal: Gait Posture Date: 2006-08-14 Impact factor: 2.840
Authors: Regina J Konz; Stefania Fatone; Rebecca L Stine; Aruna Ganju; Steven A Gard; Stephen L Ondra Journal: Spine (Phila Pa 1976) Date: 2006-11-15 Impact factor: 3.468