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European Spine Journal

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01-08-2016 | Original Article

Dynamic global sagittal alignment evaluated by three-dimensional gait analysis in patients with degenerative lumbar kyphoscoliosis

Authors: Yo Shiba, Hiroshi Taneichi, Satoshi Inami, Hiroshi Moridaira, Daisaku Takeuchi, Yutaka Nohara

Published in: European Spine Journal | Issue 8/2016

Abstract

Purpose

Sagittal vertical axis (SVA) is the most commonly used parameter for evaluating global sagittal alignment (GSA) in a static condition. However, its dynamic statuses remain unclear. The aim of this study was to evaluate dynamic GSA of degenerative lumbar kyphoscoliosis (DLKS) using three-dimensional motion analysis system (3D-MAS).

Methods

Twenty-six patients with DLKS underwent gait analysis using 3D-MAS. Static (S-) and dynamic (D-) trunk angle (TA) (the angle between the vertical axis and the line connecting C7 and S1 spinous processes) and S-sagittal trunk shift (STS) and D-STS (the distance between the two vertical lines running through C7 and S1 spinous process) were recorded during treadmill walking. Pelvic angle (PA) (the angle between the horizontal axis and the line connecting the posterior and anterior superior iliac spine) were also recorded. S-PA and D-PA represent retroversion or anteversion of the pelvis, which can be substituted for pelvic tilt. As to dynamic parameters, those at the initial five steps (Di) and the final five steps (Df) of treadmill walking were also recorded.

Results

The median S-TA, S-STS, and S-PA were 16.0°, 11.9 cm, and −5.5° (retroversion). The median D parameters were Di-TA/Df-TA 21.8°/26.9°; Di-STS/Df-STS 14.1/21.1 cm; and Di-PA/Df-PA 15.7°/22.8° (anteversion). All D parameters were significantly greater than S parameters (P < 0.01) and all Df parameters were also significantly worse than Di parameters (P < 0.001). Thus, compensated GSA by pelvic retroversion in static condition was lost due to anteversion change of the pelvis immediately after start of walking and worsened over time.

Conclusion

Dynamic GSA assessment using 3D-MAS can avoid underestimation of GSA loss that is detected by static standing full-length radiography.

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Title: Dynamic global sagittal alignment evaluated by three-dimensional gait analysis in patients with degenerative lumbar kyphoscoliosis
Authors: Yo Shiba
Hiroshi Taneichi
Satoshi Inami
Hiroshi Moridaira
Daisaku Takeuchi
Yutaka Nohara
Publication date: 01-08-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 8/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-016-4648-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Dynamic global sagittal alignment evaluated by three-dimensional gait analysis in patients with degenerative lumbar kyphoscoliosis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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