Dynamic sagittal alignment and compensation strategies in adult spinal deformity during walking

BACKGROUND CONTEXT Radiographic evaluation in adult spinal deformity (ASD) offers no information on spinopelvic alignment and compensation during dynamic conditions. Motion analysis the potential to bridge gap between static radiographic measurement, increasing our understanding how ASD impacts function. PURPOSE This study aimed explore changes sagittal strategies upright standing walking, compared control subjects within different groups. Ten patients were measured pre- six months postoperatively impact of surgical correction gait. STUDY DESIGN Prospective study. SAMPLE SIZE Full protocol: 58 20 controls; Spinal kinematic analysis: 43 18 Postoperative 10 ASD. OUTCOME MEASURES Standing walking (thoracic kyphosis (TK), lumbar lordosis (LL), vertical axis (SVA), pelvis), lower limb kinematics, (? ie, difference mean angle), kinetics, spatiotemporal parameters, balance (BESTest), patient-reported outcome scores (SRS-22r, ODI, FES-I) parameters. METHODS was used assess as well kinetics walking. All parameters controls with ASD, divided three groups based their (ASD 1: decompensated malalignment; 2: compensated 3: scoliosis normal alignment). reassessed 6 after corrective surgery. Continuous kinetic data analyzed through statistical parametric mapping. RESULTS patient walked increased forward trunk tilt (?SVA=41.43 mm, p<.001) combination anterior pelvic (?Pelvis=2.58°, standing, also observed (?SVA=37.86 p<.001; ?Pelvis=1.62°, p=.012). Patients SVA, decreased LL alterations kinematics terminal stance initial swing, altered Subgroup could link these gait malalignment 1 2). After correction, not significantly improved. CONCLUSIONS To compensate for anteversion show patterns, which have previously been associated risk falling secondary pathology. Since did lead improvements, further research underlying mechanisms is necessary improve