Article

Previous studies show a limited alteration of gait at normal
walking speed after spinal fusion surgery for adolescent idiopathic scoliosis
(AIS), despite the presumed essential role of spinal mobility during gait. This
study analyses how spinal fusion affects gait at more challenging walking speeds.
More specifically, we investigated whether thoracic-pelvic rotations are reduced
to a larger extent at higher gait speeds and whether compensatory mechanisms
above and below the stiffened spine are present.
METHODS: 18 AIS patients
underwent gait analysis at increasing walking speeds (0.45 to 2.22m/s) before and
after spinal fusion. The range of motion (ROM) of the upper (thorax,
thoracic-pelvic and pelvis) and lower body (hip, knee and ankle) was determined
in all three planes. Spatiotemporal parameters of interest were stride length and
cadence. RESULTS: Spinal fusion diminished transverse plane thoracic-pelvic ROM
and this difference was more explicit at higher walking speeds. Transversal
pelvis ROM was also decreased but this effect was not affected by speed. Lower
body ROM, step length and cadence remained unaffected. DISCUSSION: Despite the
reduction of upper body ROM after spine surgery during high speed gait, no
altered spatiotemporal parameters or increased compensatory ROM above or below
the fusion (i.e. in the shoulder girdle or lower extremities) was identified.
Thus, it remains unclear how patients can cope so well with such major surgery.
Future studies should focus on analyzing the kinematics of individual spinal
levels above and below the fusion during gait to investigate possible
compensatory mechanisms within the spine.
CI - Copyright (c) 2017 Elsevier B.V. All rights reserved.

Langue : ANGLAIS