Gait & posture · 2026
Spinal fusion limits trunk movement, but improves gait in patients with adult spinal deformity.
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Huysmans Stephanie M D, Senden Rachel, Jacobs Eva, Weber Annemarijn, Willems Paul J B, Marcellis Rik G J, van den Boogaart Mark, Meijer Kenneth, Willems Paul C
Аннотация
BACKGROUND: Adult spinal deformity (ASD) alters posture and gait, leading to greater functional impairment and lower quality of life than other chronic conditions [1, 2]. Coronal deformities (scoliosis) and sagittal imbalance impact gait differently [3]. Spinal fusion is associated with improvements in pain and physical function, yet little is known about its effects on gait [4-6].
RESEARCH QUESTION: How do spatiotemporal (SPT) parameters and joint kinematics differ in ASD patients with either coronal or sagittal imbalance compared to controls, and does spinal fusion improve SPT and joint kinematics, matching controls levels?
METHODS: Gait was evaluated before and after spinal fusion in 29 ASD-coronal and 29 ASD-sagittal patients and compared to healthy controls. Gait was measured at comfortable walking speed on an instrumented treadmill with a 3D motion capture system. Radiographic parameters, SPT and range of motion (ROM) in joint angles of ASD patients were compared before and after spinal fusion and compared to controls. Statistical parametric mapping was used to compare 3D trunk, pelvis and sagittal lower extremities kinematic waveforms between groups.
RESULTS: ASD-coronal patients increased their walking speed and stride length after spinal fusion, matching control levels. Before spinal fusion, ASD-coronal patients walked with trunk lateroflexion towards the concave side of the thoracic curve during most of the gait cycle. Spinal fusion resulted in a more symmetrical trunk lateroflexion but with decreased 3D trunk ROM. ASD-sagittal patients walked significantly slower with wider steps and decreased cadence and stride length before spinal fusion, only step width matched control levels after spinal fusion. Increased anterior trunk tilt resolved after spinal fusion, but 3D trunk ROM was decreased.
SIGNIFICANCE: Spinal deformity and spinal fusion both affect SPT parameters and limit 3D trunk movement in ASD patients, while improving trunk lateroflexion in ASD-coronal and trunk tilt in ASD-sagittal patients.
RESEARCH QUESTION: How do spatiotemporal (SPT) parameters and joint kinematics differ in ASD patients with either coronal or sagittal imbalance compared to controls, and does spinal fusion improve SPT and joint kinematics, matching controls levels?
METHODS: Gait was evaluated before and after spinal fusion in 29 ASD-coronal and 29 ASD-sagittal patients and compared to healthy controls. Gait was measured at comfortable walking speed on an instrumented treadmill with a 3D motion capture system. Radiographic parameters, SPT and range of motion (ROM) in joint angles of ASD patients were compared before and after spinal fusion and compared to controls. Statistical parametric mapping was used to compare 3D trunk, pelvis and sagittal lower extremities kinematic waveforms between groups.
RESULTS: ASD-coronal patients increased their walking speed and stride length after spinal fusion, matching control levels. Before spinal fusion, ASD-coronal patients walked with trunk lateroflexion towards the concave side of the thoracic curve during most of the gait cycle. Spinal fusion resulted in a more symmetrical trunk lateroflexion but with decreased 3D trunk ROM. ASD-sagittal patients walked significantly slower with wider steps and decreased cadence and stride length before spinal fusion, only step width matched control levels after spinal fusion. Increased anterior trunk tilt resolved after spinal fusion, but 3D trunk ROM was decreased.
SIGNIFICANCE: Spinal deformity and spinal fusion both affect SPT parameters and limit 3D trunk movement in ASD patients, while improving trunk lateroflexion in ASD-coronal and trunk tilt in ASD-sagittal patients.