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Gait Posture. 2018 Mar;61:141-148. doi: 10.1016/j.gaitpost.2018.01.007. Epub 2018 Jan 11.

Gait in patients with adolescent idiopathic scoliosis. Effect of surgery at 10 years of follow-up.

Author information

1
Cliniques Universitaires St Luc, Service d'orthopédie et de traumatologie de l'appareil locomoteur, Avenue Hippocrate 10, B-1200 Brussels, Belgium; Université Catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimental et Clinique, Neuro Musculo Skeletal Lab (NMSK), Avenue Mounier 53, B-1200 Brussels, Belgium; Cliniques Universitaires St Luc, Service de médecine physique et réadaptation, Avenue Hippocrate 10, B-1200 Brussels, Belgium. Electronic address: philippe.mahaudens@uclouvain.be.
2
Cliniques Universitaires St Luc, Service d'orthopédie et de traumatologie de l'appareil locomoteur, Avenue Hippocrate 10, B-1200 Brussels, Belgium.
3
Cliniques Universitaires St Luc, Service d'orthopédie et de traumatologie de l'appareil locomoteur, Avenue Hippocrate 10, B-1200 Brussels, Belgium; Université Catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimental et Clinique, Neuro Musculo Skeletal Lab (NMSK), Avenue Mounier 53, B-1200 Brussels, Belgium.
4
Université Catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimental et Clinique, Neuro Musculo Skeletal Lab (NMSK), Avenue Mounier 53, B-1200 Brussels, Belgium.

Abstract

PURPOSE:

To assess radiological and gait biomechanical changes before, at one and 10 years after surgery in AIS patients.

METHODS:

This clinical prospective study included fifteen adult women (mean[SD] age: 26 [1] years) diagnosed with thoraco-lumbar/lumbar AIS and operated 10 years ago. Clinical, radiological and gait variables, including kinematics, electromyography (EMG), mechanics and energetics were compared between presurgery (S0), 1 year (S1) and 10 years (S2) postsurgery period using a one way repeated measure ANOVA.

RESULTS:

The Cobb angle of the scoliosis curve was reduced by 55% at 1 year postsugery but only by 37% at 10 years postsurgery suggesting a loss of 32% over time. Frontal plumb line C7-S1 distance was significantly improved by surgery (-44%) and remained stable at 10 years postsurgery. Lower limb kinematics was not affected by the surgery at long term. Excessive bilateral activation of lombo-pelvic muscles, observed before surgery, decreased significantly at S1 and S2 period. Mechanical energy increased significantly between S0, S1 and S2 session, without any change for the energetic variables.

CONCLUSIONS:

Between 1 and 10 years post-surgery, thoraco-lumbar/lumbar AIS women showed a few decompensation of the curve without any change of the improved frontal body balance. Lower limbs and pelvic motion, during gait, was not affected by the surgery. But presurgical excessive EMG activity of the lumbo-pelvic muscle and reduced mechanical energy produced to walk get similar to normal patterns. Only the oxygen consumption remained excessive probably due to physical deconditioning or postural instability.

KEYWORDS:

AIS; Cobb angle; EMG; Energetics; Follow-up; Gait; Surgery

PMID:
29353740
DOI:
10.1016/j.gaitpost.2018.01.007
[Indexed for MEDLINE]

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