Sébastien Pesenti1,2,3, Vincent Pomero4, Solène Prost5,4,6, Mathieu Severyns5, Guillaume Authier4, Lionel Roscigni5,4,6, Elke Viehweger5,4,6, Benjamin Blondel5,4,6, Jean Luc Jouve5,4. 1. Paediatric Orthopaedics, Hôpital 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 Univ, Marseille, France. seb.pesenti@gmail.com. 4. Gait Analysis Platform, Timone, Aix-Marseille University, Marseille, France. 5. Paediatric Orthopaedics, Hôpital D'enfants de La Timone, Aix Marseille University, 264 rue Saint Pierre, 13005, Marseille, France. 6. Orthopédie pédiatrique, APHM, CNRS, ISM, Hôpital de La Timone, Aix Marseille Univ, Marseille, France.
Abstract
PURPOSE: In adolescent idiopathic scoliosis (AIS), spinal deformity can be seen in the thoracic or in the lumbar area. Although differences according to curve location are well described on standard radiographs, dynamic consequences of such difference remain unclear. Our objective was to explore the differences in dynamic spinal balance according to curve location in AIS patients using gait analysis METHODS: We prospectively included 22 females with AIS planned for surgical correction (16.3 years old, 81% Risser ≥ 4). Patients were divided into two matched cohorts, according to major curve location [right thoracic (Lenke 1) or left lumbar (Lenke 5)]. Gait analysis was performed the day before surgery. Global balance was analyzed as the primary outcome. Local curves parameters (dynamic Cobb angles) were defined as the secondary outcome. RESULTS: In coronal plane, Lenke 5 patients had a left trunk shift, whereas trunk was shifted to the right in Lenke 1 patients (- 20.7 vs 6.3, p = 0.001). In the sagittal plane, the main difference between the two groups was T12 position that remained over the pelvis during gait in Lenke 5 patients, whereas it was anterior to the pelvis in Lenke 1 patients. In the transversal plane, Lenke 5 and Lenke 1 patients presented the same gait abnormalities, with a global trunk rotation to the left (- 4.8 vs - 7.6, p = 0,165). CONCLUSION: This is the first study to provide the results of a direct comparison between Lenke 1 and Lenke 5 patients during gait. Curve location influenced coronal and sagittal balance, but abnormalities of transversal trunk motion were the same, wherever the curve was located. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: In adolescent idiopathic scoliosis (AIS), spinal deformity can be seen in the thoracic or in the lumbar area. Although differences according to curve location are well described on standard radiographs, dynamic consequences of such difference remain unclear. Our objective was to explore the differences in dynamic spinal balance according to curve location in AISpatients using gait analysis METHODS: We prospectively included 22 females with AIS planned for surgical correction (16.3 years old, 81% Risser ≥ 4). Patients were divided into two matched cohorts, according to major curve location [right thoracic (Lenke 1) or left lumbar (Lenke 5)]. Gait analysis was performed the day before surgery. Global balance was analyzed as the primary outcome. Local curves parameters (dynamic Cobb angles) were defined as the secondary outcome. RESULTS: In coronal plane, Lenke 5 patients had a left trunk shift, whereas trunk was shifted to the right in Lenke 1 patients (- 20.7 vs 6.3, p = 0.001). In the sagittal plane, the main difference between the two groups was T12 position that remained over the pelvis during gait in Lenke 5 patients, whereas it was anterior to the pelvis in Lenke 1 patients. In the transversal plane, Lenke 5 and Lenke 1 patients presented the same gait abnormalities, with a global trunk rotation to the left (- 4.8 vs - 7.6, p = 0,165). CONCLUSION: This is the first study to provide the results of a direct comparison between Lenke 1 and Lenke 5 patients during gait. Curve location influenced coronal and sagittal balance, but abnormalities of transversal trunk motion were the same, wherever the curve was located. These slides can be retrieved under Electronic Supplementary Material.
Entities:
Keywords:
Adolescent idiopathic scoliosis; Left lumbar; Right thoracic; Sagittal balance; Transversal plane; Trunk balance
Authors: Lucas Struber; Vincent Nougier; Jacques Griffet; Olivier Daniel; Alexandre Moreau-Gaudry; Philippe Cinquin; Aurélien Courvoisier Journal: Children (Basel) Date: 2022-05-18
Authors: Annemarijn Weber; Stephanie M D Huysmans; Sander M J van Kuijk; Silvia M A A Evers; Elisabeth M C Jutten; Rachel Senden; Aggie T G Paulus; Joop P W van den Bergh; Rob A de Bie; Johannes M R Merk; Sandrine P G Bours; Mark Hulsbosch; Esther R C Janssen; Inez Curfs; Wouter L W van Hemert; Martijn G M Schotanus; Paul de Baat; Niek C Schepel; Willem A den Boer; Johannes G E Hendriks; Wai-Yan Liu; Marinus de Kleuver; Martin H Pouw; Miranda L van Hooff; Eva Jacobs; Paul C P H Willems Journal: BMJ Open Date: 2022-05-24 Impact factor: 3.006