Department of Orthopedic Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.
Department of Clinical Biomechanics, School of Medicine, Keio University, Tokyo, Japan.
Eur Spine J. 2019 Mar;28(3):619-626. doi: 10.1007/s00586-018-5741-7. Epub 2018 Aug 25.
To clarify the effect of posterior correction and fusion surgery on the trunk-pelvic kinematics during gait in adolescent idiopathic scoliosis (AIS) patients with single thoracic major curve.
Among preoperative AIS patients who planned correction surgery, 18 patients with Lenke type 1A or B were selected for this study. All patients were female. The patients' trunk and pelvic kinematics during gait were measured three-dimensionally and dynamically using reflective markers, optoelectronic motion capture system. The gait analysis was performed before and 1-2 years after surgery. The trunk and pelvic symmetry during gait was evaluated at coronal, sagittal, and transverse planes between concave and convex sides.
The trunk and pelvic angles in sagittal and coronal planes were equivalent between concave and convex sides before and after surgery. Preoperatively, transverse trunk rotation angles were significantly deviated toward the concave (left) side during both static standing (4.3 ± 2.0°) and gait (8.8 ± 0.6°, p < 0.01). Preoperative transverse pelvic rotation angles were significantly deviated toward the convex side during static standing (4.0 ± 3.8°). However, pelvis displayed with symmetric rotational kinematics during gait. Postoperatively, the deviated transverse trunk rotation angle significantly decreased (1.6 ± 0.3°), and the transverse rotational kinematics of both trunk and pelvis improved to symmetric.
Posterior correction and fusion surgery have improved preoperative asymmetric global rotational kinematics of trunk and pelvis in transverse plane to symmetric postoperatively in AIS patients with thoracic single major curve. These slides can be retrieved under Electronic Supplementary Material.
明确后路矫正融合术对单一胸主弯型青少年特发性脊柱侧凸（AIS）患者步态时躯干-骨盆运动学的影响。
在计划矫正手术的术前 AIS 患者中，选择 18 例 Lenke 1A 或 1B 型患者进行本研究。所有患者均为女性。使用反光标记和光电运动捕捉系统三维动态测量患者步态时的躯干和骨盆运动学。在术前和术后 1-2 年进行步态分析。在冠状面、矢状面和横断面评估凹侧和凸侧的躯干和骨盆对称性。
术前和术后，矢状面和冠状面的躯干和骨盆角度在凹侧和凸侧之间是相等的。术前，在静态站立（4.3 ± 2.0°）和步态（8.8 ± 0.6°，p < 0.01）时，横向躯干旋转角度明显向凹侧（左侧）偏斜。术前静态站立时，横向骨盆旋转角度明显向凸侧偏斜（4.0 ± 3.8°）。然而，骨盆在步态时表现出对称的旋转运动学。术后，偏斜的横向躯干旋转角度明显减小（1.6 ± 0.3°），躯干和骨盆的横向旋转运动学改善为对称。
后路矫正融合术可改善单一胸主弯型 AIS 患者术前躯干-骨盆在横断面上不对称的整体旋转运动学，术后达到对称。这些幻灯片可以在电子补充材料中检索到。
