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P16. Spinopelvic deformities and postural malalignment affect gait patterns in ASD patients

P16. Spinopelvic deformities and postural malalignment affect gait patterns in ASD patients

Authors :
Wafa Skalli
Georges Kawkabani
Mario Mekhael
Rami Rachkidi
Khalil Kharrat
Ayman Assi
Ismat Ghanem
Eddy Saad
Renée Maria Saliby
Virginie Lafage
Renaud Lafage
Source :
The Spine Journal. 20:S155
Publication Year :
2020
Publisher :
Elsevier BV, 2020.

Abstract

BACKGROUND CONTEXT Adults with spinal deformity (ASD) are known to have postural malalignment affecting their quality of life. Classical evaluation and follow-up are usually based on full-body static radiographs and health related quality of life questionnaires. Despite being an essential daily life activity, a formal gait assessment is lacking in clinical practice. Moreover, gait alterations and their relationships with static deformities in ASD still remain to be elucidated PURPOSE To investigate gait alterations in subjects with ASD and their static radiographic determinants. STUDY DESIGN/SETTING Prospective Single Center. PATIENT SAMPLE A total of 52 Adult Spinal Deformity patients, and 63 control subjects. OUTCOME MEASURES Full body image, 3D gait analysis. METHODS A total of 52 Adult Spinal Deformity (ASD) patients age and weight-matched to 63 controls underwent full-body 3D gait analysis with extraction of 3D lower limb and trunk kinematics. All subjects underwent full-body biplanar X-rays with subsequent calculation of classical 3D postural parameters. Kinematics and postural parameters were compared between ASD and controls. Determinants of gait alterations among postural radiographic parameters were explored in ASD. RESULTS ASD subjects had significantly increased SVA (33.6±59 vs -4.6±20mm), CAM-HA (12±62 vs -21±26mm), PT (19±13 vs 11±6°), frontal Cobb (25±21 vs 4±6°) compared to controls (all p CONCLUSIONS Subjects with ASD are known to have spinal malalignment causing postural alterations such as forward bending of the trunk; they also recruit compensatory mechanisms in the pelvis and lower limbs by increasing radiographic pelvic tilt and knee flexion. This study showed that static compensations in the lower limbs persist during gait where ASD patient exhibit a flexed attitude at the trunk, hips and knees, a reduced hip mobility and loss of lordosis. ASD walked at a slower pace with an elevation of their single support time that might contribute to their stability while walking. These dynamic discrepancies were shown to be strongly related to skeletal radiological alterations, specifically the increased forward shift of the head and trunk, the pelvic retroversion and the lack of lumbar lordosis. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Details

ISSN :
15299430
Volume :
20
Database :
OpenAIRE
Journal :
The Spine Journal
Accession number :
edsair.doi...........99d564e8513918d8b20ebe377b85d97a
Full Text :
https://doi.org/10.1016/j.spinee.2020.05.414