Choi Minjun, Goh Tae Sik, Lee Jung Sub
Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University, Busan, Korea.
Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University, Busan, Korea.
J Clin Neurosci. 2025 Sep;139:111444. doi: 10.1016/j.jocn.2025.111444. Epub 2025 Jul 1.
Adolescent idiopathic scoliosis (AIS) is a complex three-dimensional structural deformity of the spine. While studies have reported gait abnormalities in AIS patients and their impact on patients' quality of life, the interrelationship between the sagittal spino-pelvic alignment and gait kinematics has not yet been elucidated. The purpose of this study is to investigate the association between gait profile and sagittal alignment in AIS patients, especially with Lenke type 1 and 5 curve deformities. The study group consisted of 111 AIS patients and sixty healthy controls. Standing spinal radiographs and gait analysis were performed for all participants. Gait parameters included gait speed, step length, stance phase, cadence, single leg support, double legs support, gait asymmetry (GA), and phase coordination index (PCI). Radiographic parameters included pelvic tilt (PT), sacral slope (SS), pelvic incidence (PI), thoracic kyphosis (TK), lumbar lordosis (LL), Cobb's major curve angle, sagittal vertical axis (SVA), and coronal balance (CB). There were statistically significant differences between the AIS group and the control in gait speed, step length, cadence, single leg support, double legs support, GA, PT, TK, SVA, and CB. However, no significant difference was observed between the groups in stance phase, PCI, SS, PI, and LL (p > 0.05). In addition, correlation analysis revealed significant relationships between the following pairs of gait and sagittal alignment parameters in the AIS patients; step length was related with SS, PT, and LL, PCI with CB, GA with TK and CB. Multiple regression analysis of gait and sagittal profile also indicated that PT and SS are accurate predictors of step length and CB is a predictor of GA. In conclusion, our findings demonstrated that there are significant differences in gait kinematics and sagittal spino-pelvic alignment between the AIS patients and healthy population and that these parameters are closely correlated in the AIS patients.
青少年特发性脊柱侧凸（AIS）是一种复杂的脊柱三维结构畸形。虽然已有研究报道AIS患者存在步态异常及其对患者生活质量的影响，但矢状面脊柱-骨盆对线与步态运动学之间的相互关系尚未阐明。本研究的目的是探讨AIS患者，尤其是Lenke 1型和5型曲线畸形患者的步态特征与矢状面排列之间的关联。研究组由111例AIS患者和60名健康对照组成。对所有参与者进行了站立位脊柱X线片检查和步态分析。步态参数包括步速、步长、站立相、步频、单腿支撑、双腿支撑、步态不对称（GA）和相位协调指数（PCI）。影像学参数包括骨盆倾斜（PT）、骶骨斜率（SS）、骨盆入射角（PI）、胸椎后凸（TK）、腰椎前凸（LL）、Cobb主弯角度、矢状垂直轴（SVA）和冠状面平衡（CB）。AIS组与对照组在步速、步长、步频、单腿支撑、双腿支撑、GA、PT、TK、SVA和CB方面存在统计学显著差异。然而，两组在站立相、PCI、SS、PI和LL方面未观察到显著差异（p>0.05）。此外，相关性分析显示AIS患者的以下几对步态和矢状面排列参数之间存在显著关系；步长与SS、PT和LL相关，PCI与CB相关，GA与TK和CB相关。步态和矢状面轮廓的多元回归分析还表明，PT和SS是步长的准确预测因子，CB是GA的预测因子。总之，我们的研究结果表明，AIS患者与健康人群在步态运动学和矢状面脊柱-骨盆对线方面存在显著差异，并且这些参数在AIS患者中密切相关。
