Ould-Slimane Mourad, Luc François, Chastan Nathalie, Dujardin Franck, Michelin Paul, Tavolacci Marie-Pierre, Gillibert André, Gauthé Rémi
Rouen University Hospital, Department of orthopedic surgery, Spine Unit, 76000 Rouen, France; Normandy university, UNICAEN, INSERM U1075, COMETE, 14000 Caen, France.
Rouen University Hospital, Department of pediatric surgery, 76000 Rouen, France.
Orthop Traumatol Surg Res. 2022 Dec;108(8):103195. doi: 10.1016/j.otsr.2021.103195. Epub 2021 Dec 23.
Anterior sagittal imbalance (ASI) is a severity factor in spinal pathology. Stabilometric study of the dynamic position of the center of pressure (CoP) assesses orthostatic control. These analyses provide the energy expenditure used for this control.
Stabilometric signs are associated with ASI indicate increased energy expenditure.
Healthy male volunteers were subjected to reversible ASI induced by wearing a kyphotic thermoformed thoracolumbar corset. The deformation was assessed by C7 tilt on EOS whole-spine views. Static and dynamic posturographic force platform study was performed under conditions of anteroposterior and mediolateral instability. Mean CoP position (X, Y) was studied on statokinesigram, with scatter assessed as confidence ellipse (CE). Path length according to CE surface (LAS) indicated energy expenditure. The stabilogram quantified displacement over time as lengths (L, L) and amplitudes (A, A).
The corset significantly increased C7 tilt (p<0.0001). This did not significantly change mean CoP positions (X and Y), but LAS was significantly increased (p=0.003). Static tests showed changes in L (p=0.0008) and A (p=0.003), and dynamic tests showed changes in L (p<0.0001), L (p<0.0001), A (p<0.0001), A (p<0.05) and CE (p<0.004).
Posturographic parameters were impacted by inducing ASI in healthy subjects. Significant differences were seen in stabilography, CE and LAS, were greater on dynamic testing, and correlated with radiologic sagittal balance. Force platforms can reveal increased energy expenditure in maintaining posture.
II; Single-center prospective study involving healthy volunteers.
矢状面失衡（ASI）是脊柱病变的一个严重因素。对压力中心（CoP）动态位置的稳定测量研究可评估直立控制。这些分析提供了用于这种控制的能量消耗。
与ASI相关的稳定测量体征表明能量消耗增加。
健康男性志愿者穿着后凸热成型胸腰段束身衣诱导可逆性ASI。通过EOS全脊柱视图上的C7倾斜度评估变形情况。在前后和内外侧不稳定的条件下进行静态和动态姿势描记测力平台研究。在静态运动图上研究平均CoP位置（X，Y），以置信椭圆（CE）评估散点情况。根据CE面积计算的路径长度（LAS）表明能量消耗。稳定图将随时间的位移量化为长度（L，L）和幅度（A，A）。
束身衣显著增加了C7倾斜度（p<0.0001）。这并未显著改变平均CoP位置（X和Y），但LAS显著增加（p=0.003）。静态测试显示L（p=0.0008）和A（p=0.003）有变化，动态测试显示L（p<0.0001）、L（p<0.0001）、A（p<0.0001）、A（p<0.05）和CE（p<0.004）有变化。
在健康受试者中诱导ASI会影响姿势描记参数。在稳定测量、CE和LAS方面存在显著差异，动态测试时差异更大，且与放射学矢状面平衡相关。测力平台可揭示维持姿势时能量消耗增加。
II级；涉及健康志愿者的单中心前瞻性研究。
