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Determination of the amount of leg length inequality that alters spinal posture in healthy subjects using rasterstereography

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Abstract

Purpose

Leg length inequalities (LLIs) can result in an increased energy consumption, abnormal gait or osteoarthritis of the hip. In a previous study we simulated different LLIs of up to 15 mm and evaluated their effects on the pelvic position and spinal posture. We found a correlation between LLIs and resulting changes of the pelvic position. Despite suggestions in the literature we were not able to detect significant changes of the spinal posture. Therefore, the purpose of this study was to determine the amount of LLI that would in fact alter the spinal posture.

Methods

The subjects were placed on a simulation platform, whose height could be precisely controlled by the measuring device, to simulate different LLIs of up to 20 mm. For LLIs >20 mm, additional precision-cut wooden blocks were used under one foot. After an adaptation period the resulting changes of the pelvis and spine were measured with a rasterstereographic device.

Results

We found a significant correlation between platform height changes and changes of the pelvic position. The frontal spinal parameters surface rotation and lateral deviation changed significantly when simulating differences greater than 20 mm. No changes of the sagittal spinal curvature were measured, however, a trend to decreasing kyphotic angles was noted.

Conclusions

Our study has shown for the first time that LLIs >20 mm will lead to significant changes in the spinal posture of healthy test subjects. However, these changes were only found in frontal (surface rotation and lateral flexion) spinal parameters, but not in sagittal parameters. Here for the kyphotic angle only a tendency to decreasing angles was noted. We have also found a significant correlation between different leg lengths and changes of the pelvic position. Further, females and males seem to react in the same way to LLIs.

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Acknowledgments

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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Authors and Affiliations

  1. Department of Trauma and Hand Surgery, University Hospital Duesseldorf, Duesseldorf, Germany

    Marcel Betsch, Anna Przibylla, Pascal Jungbluth, Mohssen Hakimi, Johannes Schneppendahl & Simon Thelen

  2. Department of Sports Medicine, University Hospital Tuebingen, Tuebingen, Germany

    Walter Rapp

  3. Department of Trauma and Orthopaedic Surgery, Klinikum Darmstadt, Darmstadt, Germany

    Michael Wild

  4. Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, 3181 S.W. Sam Jackson Park Rd., Portland, OR, 97239-3098, USA

    Marcel Betsch

Authors
  1. Marcel Betsch
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  2. Walter Rapp
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  3. Anna Przibylla
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  4. Pascal Jungbluth
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  8. Michael Wild
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Correspondence to Marcel Betsch.

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Betsch, M., Rapp, W., Przibylla, A. et al. Determination of the amount of leg length inequality that alters spinal posture in healthy subjects using rasterstereography. Eur Spine J 22, 1354–1361 (2013). https://doi.org/10.1007/s00586-013-2720-x

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  • DOI: https://doi.org/10.1007/s00586-013-2720-x

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