Skip to main content
SpringerLink
Log in

Early dynamic changes within the spine following posterior fusion using hybrid instrumentation in adolescents with idiopathic scoliosis: a gait analysis study

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

In adolescent idiopathic scoliosis (AIS) patients, mechanical consequences of posterior spinal fusion within the spine remain unclear. Through dynamic assessment, gait analysis could help elucidating this particular point. The aim of this study was to describe early changes within the spine following fusion with hybrid instrumentation in adolescents with idiopathic scoliosis, using gait analysis

Materials and methods

We conducted a single-centre prospective study including AIS patients scheduled for posterior spinal fusion (PSF) using hybrid instrumentation with sublaminar bands. Patients underwent radiographic and gait analyses preoperatively and during early postoperative period. Among gait parameters, motion of cervicothoracic, thoracolumbar and lumbosacral junctions was measured in the three planes.

Results

We included 55 patients (mean age 15 years, 84% girls). Fusion was performed on 12 levels and mean follow-up was 8 months. There was a moderately strong correlation between thoracolumbar sagittal motion and lumbosacral junction pre- and postoperatively (R = − 0.6413 and R = − 0.7040, respectively, all p < 0.001), meaning that the more thoracolumbar junction was in extension, the more lumbosacral extension movements decreased. There was a trend to significance between postoperative SVA change and thoracolumbar sagittal motion change (R = − 0.2550, p = 0.059).

Discussion

This is the first series reporting dynamic changes within the spine following PSF using hybrid instrumentation in AIS patients. PSF led to symmetrization of gait pattern. In the sagittal plane, we found that thoracolumbar extension within the fused area led to decreased extension at cervicothoracic and lumbosacral junctions. Even though consequences of such phenomenon are unclear, attention must be paid not to give a too posterior alignment when performing PSF for AIS patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Weinstein SL, Dolan LA, Cheng JCY et al (2008) Adolescent idiopathic scoliosis. Lancet (London, England) 371:1527–1537. https://doi.org/10.1016/S0140-6736(08)60658-3

    Article  Google Scholar 

  2. Pesenti S, Jouve J-L, Morin C et al (2015) Evolution of adolescent idiopathic scoliosis: results of a multicenter study at 20 years’ follow-up. Orthop Traumatol Surg Res 101:619–622. https://doi.org/10.1016/j.otsr.2015.05.004

    Article  CAS  PubMed  Google Scholar 

  3. Lafage V, Schwab F, Skalli W et al (2008) Standing balance and sagittal plane spinal deformity: analysis of spinopelvic and gravity line parameters. Spine (Phila Pa 1976) 33:1572–1578. https://doi.org/10.1097/BRS.0b013e31817886a2

    Article  Google Scholar 

  4. Lykissas MG, Jain VV, Nathan ST et al (2013) Mid- to long-term outcomes in adolescent idiopathic scoliosis after instrumented posterior spinal fusion: a meta-analysis. Spine (Phila Pa 1976) 38:E113–E119. https://doi.org/10.1097/BRS.0b013e31827ae3d0

    Article  Google Scholar 

  5. Pesenti S, Prost S, Pomero V et al (2020) Does static trunk motion analysis reflect its true position during daily activities in adolescent with idiopathic scoliosis? Orthop Traumatol Surg Res. https://doi.org/10.1016/j.otsr.2019.12.023

    Article  PubMed  Google Scholar 

  6. Ryan N, Bruno P (2017) Analysis of 3D multi-segment lumbar spine motion during gait and prone hip extension. J Electromyogr Kinesiol 33:111–117. https://doi.org/10.1016/j.jelekin.2017.02.005

    Article  PubMed  Google Scholar 

  7. Negrini S, Piovanelli B, Amici C et al (2016) Trunk motion analysis: a systematic review from a clinical and methodological perspective. Eur J Phys Rehabil Med 52:583–592

    PubMed  Google Scholar 

  8. Mahaudens P, Banse X, Mousny M, Detrembleur C (2009) Gait in adolescent idiopathic scoliosis: kinematics and electromyographic analysis. Eur Spine J 18:512–521. https://doi.org/10.1007/s00586-009-0899-7

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Syczewska M, Graff K, Kalinowska M et al (2012) Influence of the structural deformity of the spine on the gait pathology in scoliotic patients. Gait Posture. https://doi.org/10.1016/j.gaitpost.2011.09.008

    Article  PubMed  Google Scholar 

  10. Yang JH, Suh S-W, Sung PS, Park W-H (2013) Asymmetrical gait in adolescents with idiopathic scoliosis. Eur Spine J 22:2407–2413. https://doi.org/10.1007/s00586-013-2845-y

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kruger KM, Garman CMR, Krzak JJ et al (2018) Effects of spinal fusion for idiopathic scoliosis on lower body kinematics during gait. Spine Deform 6:441–447. https://doi.org/10.1016/j.jspd.2017.12.008

    Article  PubMed  Google Scholar 

  12. Pesenti S, Prost S, Pomero V et al (2019) Characterization of trunk motion in adolescents with right thoracic idiopathic scoliosis. Eur Spine J 28:2025–2033. https://doi.org/10.1007/s00586-019-06067-1

    Article  PubMed  Google Scholar 

  13. Blondel B, Pomero V, Moal B et al (2012) Sagittal spine posture assessment: feasibility of a protocol based on intersegmental moments. Orthop Traumatol Surg Res 98:109–113. https://doi.org/10.1016/j.otsr.2011.12.001

    Article  CAS  PubMed  Google Scholar 

  14. Blondel B, Viehweger E, Moal B et al (2015) Postural spinal balance defined by net intersegmental moments: results of a biomechanical approach and experimental errors measurement. World J Orthop 6:983–990. https://doi.org/10.5312/wjo.v6.i11.983

    Article  PubMed  PubMed Central  Google Scholar 

  15. Pesenti S, Prost S, Blondel B et al (2019) Correlations linking static quantitative gait analysis parameters to radiographic parameters in adolescent idiopathic scoliosis. Orthop Traumatol Surg Res 105:541–545. https://doi.org/10.1016/j.otsr.2018.09.024

    Article  PubMed  Google Scholar 

  16. Pesenti S, Pomero V, Prost S et al (2020) 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. https://doi.org/10.1007/s00586-020-06361-3

    Article  PubMed  Google Scholar 

  17. Lenke LG (2005) Lenke classification system of adolescent idiopathic scoliosis: treatment recommendations. Instr Course Lect 54:537–542

    PubMed  Google Scholar 

  18. Kramers-De Quervain IA, Müller R, Stacoff A et al (2004) Gait analysis in patients with idiopathic scoliosis. Eur Spine J 13:449–456. https://doi.org/10.1007/s00586-003-0588-x

    Article  PubMed  PubMed Central  Google Scholar 

  19. Park HJ, Sim T, Suh SW et al (2016) Analysis of coordination between thoracic and pelvic kinematic movements during gait in adolescents with idiopathic scoliosis. Eur Spine J. https://doi.org/10.1007/s00586-015-3931-0

    Article  PubMed  Google Scholar 

  20. Nishida M, Nagura T, Fujita N et al (2017) Position of the major curve influences asymmetrical trunk kinematics during gait in adolescent idiopathic scoliosis. Gait Posture 51:142–148. https://doi.org/10.1016/j.gaitpost.2016.10.004

    Article  PubMed  Google Scholar 

  21. Wu K-W, Wang T-M, Hu C-C et al (2019) Postural adjustments in adolescent idiopathic thoracic scoliosis during walking. Gait Posture 68:423–429. https://doi.org/10.1016/j.gaitpost.2018.12.024

    Article  PubMed  Google Scholar 

  22. Jiang H, Shao W, Xu E et al (2018) Coronal imbalance after selective posterior thoracic fusion in patients with Lenke 1 and 2 adolescent idiopathic scoliosis. Biomed Res Int 2018:3476425. https://doi.org/10.1155/2018/3476425

    Article  PubMed  PubMed Central  Google Scholar 

  23. Lenke LG, Engsberg JR, Ross SA et al (2001) Prospective dynamic functional evaluation of gait and spinal balance following spinal fusion in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 26:E330–E337

    Article  CAS  Google Scholar 

  24. Paul JC, Patel A, Bianco K et al (2014) Gait stability improvement after fusion surgery for adolescent idiopathic scoliosis is influenced by corrective measures in coronal and sagittal planes. Gait Posture 40:510–515. https://doi.org/10.1016/j.gaitpost.2014.06.006

    Article  PubMed  Google Scholar 

  25. Mahaudens P, Detrembleur C, Mousny M, Banse X (2010) Gait in thoracolumbar/lumbar adolescent idiopathic scoliosis: effect of surgery on gait mechanisms. Eur Spine J. https://doi.org/10.1007/s00586-010-1292-2

    Article  PubMed  PubMed Central  Google Scholar 

  26. Holewijn RM, Kingma I, de Kleuver M, Keijsers NLW (2018) Posterior spinal surgery for adolescent idiopathic scoliosis does not induce compensatory increases in distal adjacent segment motion: a prospective gait analysis study. Spine J 18:2213–2219. https://doi.org/10.1016/j.spinee.2018.05.010

    Article  PubMed  Google Scholar 

  27. Nishida M, Nagura T, Fujita N et al (2019) Spinal correction surgery improves asymmetrical trunk kinematics during gait in adolescent idiopathic scoliosis with thoracic major curve. Eur Spine J 28:619–626. https://doi.org/10.1007/s00586-018-5741-7

    Article  PubMed  Google Scholar 

Download references

Funding

No funding was received for this work.

Author information

Authors and Affiliations

  1. Pediatric Orthopedics, Timone Enfants, Aix Marseille University, 264 rue Saint Pierre, 13005, Marseille, France

    Sébastien Pesenti, Solene Prost, Matthieu Severyns, Lionel Roscigni, Christophe Boulay, Benjamin Blondel & Jean-Luc Jouve

  2. Gait Analysis Laboratory, Timone, Aix Marseille University, Marseille, France

    Sébastien Pesenti, Solene Prost, Vincent Pomero, Guillaume Authier, Lionel Roscigni, Christophe Boulay, Benjamin Blondel & Jean-Luc Jouve

  3. Orthopédie Infantile, CNRS, ISM, Aix-Marseille Université, Hôpital de La Timone, AP-HM, Marseille, France

    Sébastien Pesenti, Solene Prost, Christophe Boulay & Benjamin Blondel

Authors
  1. Sébastien Pesenti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Solene Prost
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vincent Pomero
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Guillaume Authier
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Matthieu Severyns
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lionel Roscigni
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Christophe Boulay
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Benjamin Blondel
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jean-Luc Jouve
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sébastien Pesenti.

Ethics declarations

Conflict of interest

The authors declare they have no conflict of interest related to this work.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pesenti, S., Prost, S., Pomero, V. et al. Early dynamic changes within the spine following posterior fusion using hybrid instrumentation in adolescents with idiopathic scoliosis: a gait analysis study. Arch Orthop Trauma Surg 142, 3613–3621 (2022). https://doi.org/10.1007/s00402-021-03956-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-021-03956-3

Keywords

Search

Navigation