Wang Dan, Tsang Raymond, Li Qing, Chen Feng, Vasanthi Rajkumar Krishnan, Purushothaman Vinosh Kumar, Wang Song
School of Sports Medicine, Wuhan Sports University, Wuhan, China.
School of Medicine, Changsha Social Work College, Changsha, China.
J Orthop Surg Res. 2025 Aug 19;20(1):771. doi: 10.1186/s13018-025-06172-6.
Adolescent idiopathic scoliosis (AIS) is characterized by three-dimensional spinal deformities and often co-occurs with balance impairments. However, it remains unclear whether postural deficits in AIS are statistically associated with spinal morphology, or instead reflect independent alterations in sensorimotor integration.
This study aimed to examine whether postural control performance under sensory challenge is statistically associated with three-dimensional spinal morphology in adolescents with AIS.
A total of 64 young adults (35 with AIS, Cobb angle 10°–39°; and 29 healthy controls) were assessed using a cross-sectional design. Postural control was evaluated via the modified Clinical Test of Sensory Interaction and Balance (mCTSIB), which included four standard sensory conditions and an additional vestibular-challenging task involving rhythmic head movements. Spinal morphology was measured using the DIERS 4D Formetric system. Between-group differences were analyzed using Mann–Whitney U tests. Within-group correlations were tested via Spearman’s coefficients, and intergroup differences in correlation strength were evaluated using Fisher Z-transformation with false discovery rate (FDR) correction.
AIS participants exhibited significantly greater postural instability in two sway parameters—mediolateral (ML) average velocity and path length—but only under the most challenging vestibular condition (FoEC-HDM; < 0.01). Five spinal parameters also differed significantly between groups ( < 0.05). However, no significant correlations were observed between postural control and spinal morphology within either group. No intergroup differences in correlation strength were identified after FDR correction.
In yong adults with mild to moderate AIS (Cobb angle 10°–39°), postural instability and structural spinal deformities appear to be coexisting but statistically independent. No significant associations were found between spinal morphology and postural control under sensory challenge. These findings suggest that balance impairments may reflect central sensorimotor alterations rather than curve severity.Future studies should examine whether such independence persists across broader severity ranges or curve types in AIS.
The online version contains supplementary material available at 10.1186/s13018-025-06172-6.
青少年特发性脊柱侧凸（AIS）的特征是三维脊柱畸形，并且常伴有平衡功能障碍。然而，AIS患者的姿势缺陷与脊柱形态在统计学上是否相关，或者相反，是否反映了感觉运动整合的独立改变，目前尚不清楚。
本研究旨在探讨感觉挑战下的姿势控制表现与AIS青少年的三维脊柱形态在统计学上是否相关。
采用横断面设计对64名年轻人进行评估（35例AIS患者，Cobb角10°-39°；29名健康对照者）。通过改良的感觉交互与平衡临床测试（mCTSIB）评估姿势控制，该测试包括四种标准感觉条件以及一项涉及有节奏头部运动的额外前庭挑战任务。使用DIERS 4D Formetric系统测量脊柱形态。组间差异采用Mann-Whitney U检验进行分析。组内相关性通过Spearman系数进行测试，组间相关性强度差异采用Fisher Z变换并进行错误发现率（FDR）校正来评估。
AIS参与者在两个摆动参数——内外侧（ML）平均速度和路径长度上表现出明显更大的姿势不稳定性，但仅在最具挑战性的前庭条件下（FoEC-HDM；<0.01）。五个体脊柱参数在两组之间也存在显著差异（<0.05）。然而，两组中姿势控制与脊柱形态之间均未观察到显著相关性。FDR校正后未发现组间相关性强度存在差异。
在轻度至中度AIS（Cobb角10°-39°）的年轻成年人中，姿势不稳定性和脊柱结构畸形似乎并存，但在统计学上相互独立。在感觉挑战下，未发现脊柱形态与姿势控制之间存在显著关联。这些发现表明平衡功能障碍可能反映了中枢感觉运动改变而非侧弯严重程度。未来的研究应探讨这种独立性在AIS更广泛的严重程度范围或侧弯类型中是否持续存在。
在线版本包含可在10.1186/s13018-025-06172-6获取的补充材料。
