Curve location influences spinal balance in coronal and sagittal planes but not transversal trunk motion in adolescents with idiopathic scoliosis: a prospective observational study.,European Spine Journal

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Curve location influences spinal balance in coronal and sagittal planes but not transversal trunk motion in adolescents with idiopathic scoliosis: a prospective observational study.
European Spine Journal ( IF 2.6 ) Pub Date : 2020-03-05 , DOI: 10.1007/s00586-020-06361-3
Sébastien Pesenti _{1,

2,

3} , Vincent Pomero ₂ , Solène Prost _{1,

2,

3} , Mathieu Severyns ₁ , Guillaume Authier ₂ , Lionel Roscigni _{1,

2,

3} , Elke Viehweger _{1,

2,

3} , Benjamin Blondel _{1,

2,

3} , Jean Luc Jouve _{1,

2}

Affiliation

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.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

中文翻译：

曲线位置影响青少年特发性脊柱侧弯的冠状面和矢状面的脊柱平衡，但不影响躯干横向运动：一项前瞻性观察研究。

目的

在青少年特发性脊柱侧弯 (AIS) 中，可以在胸椎或腰椎区域看到脊柱畸形。尽管在标准射线照片上很好地描述了根据曲线位置的差异，但这种差异的动态后果仍不清楚。我们的目标是使用步态分析探索 AIS 患者根据弯曲位置的动态脊柱平衡的差异

方法

我们前瞻性地纳入了 22 名计划进行手术矫正的 AIS 女性（16.3 岁，81% Risser ≥ 4）。根据主要曲线位置 [右胸椎 (Lenke 1) 或左腰椎 (Lenke 5)]，将患者分为两个匹配的队列。在手术前一天进行步态分析。全球平衡被分析为主要结果。局部曲线参数（动态 Cobb 角）被定义为次要结果。

结果

在冠状平面上，Lenke 5 患者的躯干向左移位，而 Lenke 1 患者的躯干向右移位（- 20.7 vs 6.3，p = 0 . 001）。在矢状面，两组之间的主要差异是 Lenke 5 患者在步态过程中 T12 位置保持在骨盆上方，而 Lenke 1 患者则位于骨盆前方。在横向平面上，Lenke 5 和 Lenke 1 患者表现出相同的步态异常，躯干整体向左旋转（− 4.8 vs − 7.6，p = 0 , 165）。