The effect of coronal decompensation on the biomechanical parameters in lower limbs in adolescent idiopathic scoliosis

Márkus, István; Schlégl, Ádám Tibor; Burkus, Máté; József, Kristóf; Niklai, Bálint; Than, Péter; Tunyogi-Csapó, Miklós

doi:10.1016/j.otsr.2018.06.002

Cited by 8 publications

(7 citation statements)

References 16 publications

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“…It has been proven that the increased varus at the knee joint in the coronal lower extremity compensates for coronal spinal decompensation in patients with adolescent idiopathic scoliosis [ 23 ]. The coronal spinal deformity correction improves coronal lower extremity alignment in patients with adult spinal deformity [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…The coronal spinal deformity correction improves coronal lower extremity alignment in patients with adult spinal deformity [ 24 ]. Those studies showed that coronal spinal malalignment was associated with lower extremity deformity in both young and adult patients with spinal deformity [ 23 , 24 ]. FTA is used to assess knee alignment in the coronal plane.…”

Section: Discussionmentioning

confidence: 99%

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How Is Degenerative Lumbar Scoliosis Associated with Spinopelvic and Lower-Extremity Alignments in the Elderly

et al. 2023

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Our aim is to investigate the relationship between degenerative lumbar scoliosis (DLS), and whole-body alignment, including spinopelvic and lower extremity alignments. Overview of Literature: DLS is a deformity commonly associated with aging. However, the correlation between whole-body alignment and DLS remains controversial. Methods: Adult volunteers aged over 50 years were included in the study after participating in the screening program. Characteristic data and standing radiographic parameters were assessed. A propensity score model was established with adjustments for age and sex after a preliminary analysis, and cases were divided into DLS (Cobb angle >10°) and non-DLS (Cobb angle ≤10°) groups. Results: There were significant differences in age, sex, C2 sagittal vertical axis (C2-SVA), C7-SVA, T1 pelvic angle (TPA), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), PI minus LL (PI-LL), knee angle, ankle angle, pelvic shift, C7-center sacral vertical line, L4 tilt, femur-tibia angle, and hip-knee-ankle angle (all p<0.05) using a preliminary analysis of 261 cases (75 DLS and 186 non-DLS). A one-to-one propensity score-matched analysis was used after 70 pairs of cases were selected. There were no significant differences in the characteristic data for lower extremity parameters. There were still significantly higher values of C2-SVA, TPA, PI, PT, and PI-LL in DLS group than in non-DLS group (all p<0.05). Conclusions: This study showed an important relationship between DLS and sagittal spinal deformity. However, DLS was not associated with the sagittal and coronal lower extremity alignments.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

How Is Degenerative Lumbar Scoliosis Associated with Spinopelvic and Lower-Extremity Alignments in the Elderly

et al. 2023

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“…Although these Lenke V AIS patients primarily had lumbar scoliosis, the deformity at this level is anatomically related to the pelvis ( Mac-thiong et al, 2006 ), which is an important determinant of lower limb loading pattern. It has been established that abnormal lower limb loading pattern ultimately leads to reduced balance ( Márkus et al, 2018 ). Although many studies have explored the correlation between balance and spinopelvic parameters, most of these studies are limited to a single anatomical plane ( Luo et al, 2021 ) ( Ma, 2019 ) ( Burkus et al, 2018 ); in contrast, we included spinopelvic parameters from all three dimensions.…”

Section: Discussionmentioning

confidence: 99%

Correlational analysis of three-dimensional spinopelvic parameters with standing balance and gait characteristics in adolescent idiopathic scoliosis: A preliminary research on Lenke V

Liu

Dou

et al. 2022

Front. Bioeng. Biotechnol.

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Background: Adolescent idiopathic scoliosis (AIS), the most common spinal deformity, possibly develops due to imbalanced spinal loading following asymmetric development. Since altered loading patterns may affect standing balance and gait, we investigated whether a correlation exists between balance ability, gait pattern, and the three-dimensional radiographic spinopelvic parameters in AIS patients.Methods: A cross-sectional observational study was conducted with 34 AIS patients (aged 10–18 years) and an equal number of healthy age and sex-matched teenagers (normal group). We obtained the spinopelvic three-dimensional parameters and balance parameters simultaneously through the EOS imaging system and gait and center of pressure (CoP) characteristics using a plantar pressure measurement mat. Besides determining the intergroup differences in balance and gait parameters, multiple linear regression analyses were performed to identify any correlation between the static plantar pressure and radiographic parameters.Results: Compared to the normal group, the CoPx is lower, the CoP path length and 90% confidence ellipse area were significantly higher in AIS patients (AIS: −13.7 ± 5.7 mm, 147.4 ± 58.1 mm, 150.5 ± 62.8 mm2; normal: −7.0 ± 5.4 mm, 78.8 ± 32.0 mm, 92.1 ± 41.7 mm2, respectively), correlated with apical vertebra translation, sagittal pelvic tilt, and pelvis axial rotation, respectively. Moreover, AIS patients had a shorter stance phase (61.35 ± 0.97 s vs. 62.39 ± 1.09 s), a longer swing phase (38.66 ± 0.97 s vs. 37.62 ± 1.08 s), and smaller maximum pressure peaks in the gait cycle, especially on the left foot, as compared to healthy subjects. Moreover, the CoP trajectory in AIS patients was different from the latter, and changes in the bipedal trend were not consistent.Conclusion: The standing balance and gait characteristics of AIS patients are different from those of healthy subjects, as reflected in their three-dimensional spinopelvic radiographic parameters. Trial registration: The study protocol was registered with the Chinese Clinical Trial Registry (Number ChCTR1800018310) and the Human Subject Committee of Guangzhou Sport University (Number: 2018LCLL003).

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“…Mean CVA was calculated for both the absolute value and the standard value. In keeping with previous literature,20,21 a clinically significant change in CVA was a priori defined as a change of ≥1 cm. χ 2 , t tests, and variance-comparison tests were performed to assess changes in CVA from immediately postoperative to 2-years.…”

Section: Methodsmentioning

confidence: 99%

Patients With Coronal Malalignment Undergoing Adult Spinal Deformity Surgery

Zuckerman

Chanbour

Hassan

et al. 2022

Clinical Spine Surgery: A Spine Publication

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Objectives: The objectives were to: (1) characterize the changes in coronal vertical axis (CVA) after adult spinal deformity (ASD) surgery from immediate postoperative to 2-years postoperative, and (2) assess for predictors of CVA change from immediate postoperative to 2-years postoperative.Summary of Background Data: It is unknown whether coronal correction obtained immediately postoperative accurately reflects long-term coronal alignment. Materials and Methods:A retrospective, single-institution registry was queried for patients undergoing ASD surgery from 2015-2019, including patients undergoing ≥ 6-level fusions with preoperative coronal malalignment (CM), defined as CVA ≥ 3 cm. A clinically significant change in CVA was defined a priori as ≥ 1 cm. Radiographic variables were obtained preoperatively, immediately postoperative, and at 2-years postoperative.Results: Of 368 patients undergoing ASD surgery, 124 (33.7%) had preoperative CM, and 64 (17.0%) completed 2-years follow-up. Among 64 patients, mean age was 53.6 ± 15.4 years. Preoperatively, absolute mean CVA was 5.4 ± 3.1 cm, which improved to 2.3 ± 2.0 cm (P < 0.001) immediately postoperative and 2.2 ± 1.6 cm (P < 0.001) at 2-years. The mean change in CVA from preoperative to immediately postoperative was 2.2 ± 1.9 cm (0.3-14.4). During the immediate postoperative to 2-years interval, 29/64 (45.3%) patients experienced a significant change of CVA by ≥ 1 cm, of which 22/29 (76%) improved by a mean of 1.7 cm and 7/29 (24%) worsened by a mean of 3.5 cm. No preoperative or surgical factors were associated with changed CVA from immediately postoperative to 2-years.Conclusion: Among 64 patients undergoing ASD surgery with preoperative CM, 45.3% experienced a significant ( ≥ 1 cm) change in their CVA from immediately postoperative to 2-years postoperative. Of these 29 patients, 22/29 (76%) improved, whereas 7/29 (24%) worsened. Although no factors were associated with undergoing a change in CVA, this information is useful in understanding the evolution and spontaneous coronal alignment changes that take place after major ASD coronal plane correction.

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The effect of coronal decompensation on the biomechanical parameters in lower limbs in adolescent idiopathic scoliosis

Abstract: III, case-control study.

Cited by 8 publications

References 16 publications

How Is Degenerative Lumbar Scoliosis Associated with Spinopelvic and Lower-Extremity Alignments in the Elderly

How Is Degenerative Lumbar Scoliosis Associated with Spinopelvic and Lower-Extremity Alignments in the Elderly

Correlational analysis of three-dimensional spinopelvic parameters with standing balance and gait characteristics in adolescent idiopathic scoliosis: A preliminary research on Lenke V

Patients With Coronal Malalignment Undergoing Adult Spinal Deformity Surgery

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