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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

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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.

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Funding

No funding was received by any of the author for this study.

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Authors and Affiliations

  1. Paediatric Orthopaedics, Hôpital D’enfants de La Timone, Aix Marseille University, 264 rue Saint Pierre, 13005, Marseille, France

    Sébastien Pesenti, Solène Prost, Mathieu Severyns, Lionel Roscigni, Elke Viehweger, Benjamin Blondel & Jean Luc Jouve

  2. Gait Analysis Platform, Timone, Aix-Marseille University, Marseille, France

    Sébastien Pesenti, Vincent Pomero, Solène Prost, Guillaume Authier, Lionel Roscigni, Elke Viehweger, Benjamin Blondel & Jean Luc Jouve

  3. Orthopédie pédiatrique, APHM, CNRS, ISM, Hôpital de La Timone, Aix Marseille Univ, Marseille, France

    Sébastien Pesenti, Solène Prost, Lionel Roscigni, Elke Viehweger & Benjamin Blondel

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  1. Sébastien Pesenti
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  2. Vincent Pomero
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  3. Solène Prost
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  4. Mathieu Severyns
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  9. Jean Luc Jouve
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Correspondence to Sébastien Pesenti.

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Pesenti, S., Pomero, V., Prost, S. et al. Curve location influences spinal balance in coronal and sagittal planes but not transversal trunk motion in adolescents with idiopathic scoliosis: a prospective observational study. Eur Spine J 29, 1972–1980 (2020). https://doi.org/10.1007/s00586-020-06361-3

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