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Effect of Surgical Fusion on Volitional Weight-Shifting in Individuals With Adolescent Idiopathic Scoliosis

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Abstract

Study Design

Prospective.

Objectives

The goals of this study were to (1) evaluate the differences in weightbearing symmetry between individuals with adolescent idiopathic scoliosis (AIS) and typically developing controls; (2) observe the effect of posterior spinal fusion and instrumentation (PSFI) on volitional weight-shifting at 1 and 2 years postoperatively; and (3) evaluate whether lowest instrumented fusion level (ie, lowest instrumented vertebra [LIV]) in PSFI has an effect on volitional weight-shifting.

Summary of Background Data

Previous studies have conflicting findings with regard to the effect of scoliosis on postural control tasks as well as the effect of surgery. They have also noted an inconsistent effect of PSFI at different LIVs, with more distal LIVs exhibiting greater reductions in postoperative range of motion.

Methods

The study was designed with an AIS group of 41 patients (8 males and 33 females) with AIS who underwent PSFI, along with a Control Group of 24 age-matched typically developing participants (12 male and 12 female). Both groups performed postural control tasks (static balance and volitional weight-shifting), with the AIS group repeating the tasks at 1 and 2 years postoperatively.

Results

At baseline, the AIS group showed increased weightbearing asymmetry than the Control Group (p =.01). The AIS group showed improvements in volitional weight-shifting at 2 years over baseline (p <.01). There was no effect of LIV on volitional weight-shifting by the second postoperative year.

Conclusions

Individuals with AIS have greater weightbearing asymmetry but improved volitional weight-shifting over typically developing controls. PSFI improves volitional weight-shifting beyond preoperative baseline but does not differ significantly by LIV.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA

    Nikhil T. Kurapati MD

  2. College of Engineering, Marquette University, Milwaukee, WI, USA

    Nikhil T. Kurapati MD & Gerald F. Harris PhD, PE

  3. Motion Analysis Laboratory, Shriners Hospital for Children, Chicago, IL, USA

    Nikhil T. Kurapati MD, Joseph J. Krzak PT, PhD, PCS, Adam Graf MS, Sahar Hassani MS, Peter F. Sturm MD, Kim Hammerberg MD, Purnendu Gupta MD & Gerald F. Harris PhD, PE

  4. Physical Therapy Program, College of Health Sciences, Midwestern University, Downers Grove, IL, USA

    Joseph J. Krzak PT, PhD, PCS

  5. Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA

    Sergey Tarima PhD

  6. Division of Orthopaedic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Peter F. Sturm MD

Authors
  1. Nikhil T. Kurapati MD
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  2. Joseph J. Krzak PT, PhD, PCS
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  3. Adam Graf MS
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  4. Sahar Hassani MS
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  8. Purnendu Gupta MD
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  9. Gerald F. Harris PhD, PE
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Corresponding author

Correspondence to Nikhil T. Kurapati MD.

Additional information

Author disclosures: NTK (grants from U.S. Department of Health and Human Services–National Institute on Disability, Independent Living, and Rehabilitation Research, during the conduct of the study); JJK (none); AG (none); SH (none); ST (none); PFS (none); KH (none); PG (none); GFH (none).

The study was supported by a grant from the U.S. Department of Health and Human Services–National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR): Advanced Rehabilitation Research Training in Pediatric Mobility for Physicians and Engineers. 90AR5022-01-00 (Formerly H133P140023-14). The contents of this manuscript do not necessarily represent the policy of NIDILRR, ACL, HHS, and one should not assume endorsement by the Federal Government. Support for the study also came from the Hainer Foundation and DePuy Spine.

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Kurapati, N.T., Krzak, J.J., Graf, A. et al. Effect of Surgical Fusion on Volitional Weight-Shifting in Individuals With Adolescent Idiopathic Scoliosis. Spine Deform 4, 432–438 (2016). https://doi.org/10.1016/j.jspd.2016.08.004

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  • DOI: https://doi.org/10.1016/j.jspd.2016.08.004

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