The Relationship of Static Spinopelvic Parameters with Dynamic Biomechanical Parameters Measured by Gait and Balance Analyses in Patients with Adult Degenerative Scoliosis

Presented at SMISS Annual Forum 2018
By Isador Lieberman MD, MBA, FRCSC
With R. Haddas ,

Disclosures: Isador Lieberman MD, MBA, FRCSC A; Mazor Robotics. B; Mazor Robotics, Stryker Spine, Globus, Misonix, Safe Orthopaedics, Medtronic, SI Bone. D; Mazor Robotics. F; Mazor Robotics R. Haddas A; Medtronic Inc., Alphatec Spine Inc., The Cervical Spine Research Society, Aspen Medical Products,

Introduction:

Gait and balance analyses can provide an objective measure of function. Patients with adult degenerative scoliosis (ADS) demonstrate an altered gait and balance pattern. Spinopelvic parameters are commonly used by clinicians to evaluate patients with ADS. However, to the best of our knowledge, no studies have examined the correlation between patients’ spinopelvic parameters and objective biomechanical gait and balance analyses.

Aims/Objectives:

To determine the correlation between radiographic spinopelvic parameters with objective biomechanical measures of function.

Methods:

Forty-four patients with symptomatic ADS who have been deemed appropriate surgical candidate were analyzed. Radiographic Spinopelvic parameters were obtained the week before surgery. Gait and functional balance analyses were performed on the same day. Correlations were determined between the spinopelvic parameters and objective gait and balance analyses biomechanical data using Pearson's Product Correlation in SPSS.

Results:

All patients completed the gait and balance evaluation. The Cobb angle was correlated with walking speed (r=-0.494, p=0.001) and single support time (r=0.396, p=0.035) during gait. The Cobb angle was correlated with COM total sway (r=0.441, p=0.036), multifidus (r=-0.432, p=0.035), semitendinosus (r=0.484, p=0.021), and tibialisanterior (r=0.422, p=0.039) muscle activity during the balance test. The CVA was correlated with walking speed (r=-0.353, p=0.048), opposite foot off (r=-0.369, p=0.045), double support time (r=0.412, p=0.026), and gait width (r=-0.339, p=0.048) during gait. The CVA was correlated with sagittal COM (r=0.458, p=0.028) and head (r=0.351, p=0.050) sway, EO (r=0.551, p=0.008), and multifidus (r=-0.369, p=0.045) muscle activity during the balance test. The SVA was correlated with single support time (r=0.440, p=0.020) during gait. The SVA was correlated with coronal COM (r=0.716, p=0.001) and head (r=0.551, p=0.004) sway, ES (r=-0.421, p=0.038), gluteus maximus (r=0.453, p=0.031), and tibialisanterior (r=0.331, p=0.047) muscle activity during the balance test. The PI-LL was correlated with stride time (r=0.434, p=0.021), step time (r=0.321, p=0.045), and single support time (r=0.493, p=0.140) during gait. The PI-LL was correlated with multifidus (r=-0.406, p=0.045) and semitendinosus (r=0.464, p=0.010) muscle activity during the balance test.

Conclusions:

This study demonstrated a strong correlation between biomechanical parameters as measured with objective gait and balance analyses and spinopelvic parameters in ADS patients. With higher values of the spinopelvic parameters, single support time, COM and head sway and neuromuscular activity were increased. Quantified gait and balance analyses can be a useful tool to evaluate patient outcomes. Objective functional performance measures can help to improve the evaluation and understanding of the biomechanical effects of spinal disorders on locomotion.