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Effects of Spinal Fusion for Idiopathic Scoliosis on Lower Body Kinematics During Gait. Spine Deform 2018 Jul - Aug;6(4):441-447

Date

06/12/2018

Pubmed ID

29886917

DOI

10.1016/j.jspd.2017.12.008

Scopus ID

2-s2.0-85048536613   1 Citation

Abstract

STUDY DESIGN: Prospective.

OBJECTIVES: The purpose of this study was to compare gait among patients with scoliosis undergoing posterior spinal fusion and instrumentation (PSFI) to typically developing subjects and determine if the location of the lowest instrumented vertebra impacted results.

SUMMARY OF BACKGROUND DATA: PSFI is the standard of care for correcting spine deformities, allowing the preservation of body equilibrium while maintaining as many mobile spinal segments as possible. The effect of surgery on joint motion distal to the spine must also be considered. Very few studies have addressed the effect of PSFI on activities such as walking and even fewer address how surgical choice of the lowest instrumented vertebra (LIV) influences possible motion reduction.

METHODS: Individuals with scoliosis undergoing PSFI (n = 38) completed gait analysis preoperatively and at postoperative years 1 and 2 along with a control group (n = 24). Comparisons were made with the control group at each time point and between patients fused at L2 and above (L2+) versus L3 and below (L3-).

RESULTS: The kinematic results of the AIS group showed some differences when compared to the Control Group, most notably decreased range of motion (ROM) in pelvic tilt and trunk lateral bending. When comparing the LIV groups, only minor differences were observed, and the results showed decreased coronal trunk and pelvis ROM at the one-year visit and decreased hip rotation ROM at the two-year visit in the L3- group.

CONCLUSIONS: Patients with AIS showed decreased ROM preoperatively with further decreases postoperatively. These changes remained relatively consistent following the two-year visit, indicating that most kinematic changes occurred in the first year following surgery. Limited functional differences between the two LIV groups may be due to the lack of full ROM used during normal gait, and future work could address tasks that use greater ROM.

LEVEL OF EVIDENCE: Level II.

Author List

Kruger KM, Garman CMR, Krzak JJ, Graf A, Hassani S, Tarima S, Sturm PF, Hammerberg KW, Gupta P, Harris GF

Authors

Gerald Harris PhD Director in the Orthopaedic Research Engineering Center (OREC) department at Marquette University
Sergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Biomechanical Phenomena
Female
Gait
Humans
Lower Extremity
Male
Prospective Studies
Scoliosis
Spinal Fusion
jenkins-FCD Prod-480 9a4deaf152b0b06dd18151814fff2e18f6c05280