Journal of neurosurgery. Spine · 2026
Spatiotemporal gait parameters are independently associated with disability at presentation in adult spinal deformity patients.
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Sastry Rahul A, Semonche Alexa, Grady Conor, Fu Adrian, Azad Tej D, Scheer Justin K, Clark Aaron J, Deviren Vedat, Ames Christopher P
Аннотация
OBJECTIVE: The aim of this study was to evaluate the relationship between spatiotemporal gait parameters and preoperative disability in adult spinal deformity (ASD), controlling for age, sarcopenia, and static alignment.
METHODS: Adults (aged ≥ 18 years) with ASD, defined by Scoliosis Research Society (SRS)-Schwab criteria, were prospectively enrolled between December 2023 and August 2025. Spatiotemporal gait parameters were obtained using the GAITRite system. The skeletal muscle index (SMI) was measured using the Inbody 970 analyzer. Radiographic parameters included pelvic incidence, pelvic tilt, sagittal vertical axis, lumbar lordosis, and knee flexion (KF). The Oswestry Disability Index (ODI) served as the primary outcome, and the SRS-22 total score as secondary. Principal component analysis (PCA) was performed on normalized gait parameters. Multivariable linear regression with multiple imputation was used to identify predictors of disability.
RESULTS: Seventy-eight patients met inclusion criteria (median age 69.7 years). The mean gait velocity was 67.1 (SD 24.3) cm/sec; 89.7% of patients walked slower than 100 cm/sec. PCA identified 5 components explaining 86.5% of variance; the first 2 reflected temporal coordination and rhythm/timing. In regression for ODI, gait principal component 1 (β = 1.8, p = 0.002), KF (β = 0.87, p = 0.006), age (β = -0.52, p = 0.015), and SMI (β = -3.34, p = 0.032) were independently significant predictors.
CONCLUSIONS: ASD patients exhibit markedly reduced gait velocity and abnormal temporal coordination. Even after adjusting for age, sarcopenia, and static alignment, dynamic gait parameters remain independently associated with disability. Quantitative gait analysis may serve as a useful adjunct to radiographic evaluation in ASD.
METHODS: Adults (aged ≥ 18 years) with ASD, defined by Scoliosis Research Society (SRS)-Schwab criteria, were prospectively enrolled between December 2023 and August 2025. Spatiotemporal gait parameters were obtained using the GAITRite system. The skeletal muscle index (SMI) was measured using the Inbody 970 analyzer. Radiographic parameters included pelvic incidence, pelvic tilt, sagittal vertical axis, lumbar lordosis, and knee flexion (KF). The Oswestry Disability Index (ODI) served as the primary outcome, and the SRS-22 total score as secondary. Principal component analysis (PCA) was performed on normalized gait parameters. Multivariable linear regression with multiple imputation was used to identify predictors of disability.
RESULTS: Seventy-eight patients met inclusion criteria (median age 69.7 years). The mean gait velocity was 67.1 (SD 24.3) cm/sec; 89.7% of patients walked slower than 100 cm/sec. PCA identified 5 components explaining 86.5% of variance; the first 2 reflected temporal coordination and rhythm/timing. In regression for ODI, gait principal component 1 (β = 1.8, p = 0.002), KF (β = 0.87, p = 0.006), age (β = -0.52, p = 0.015), and SMI (β = -3.34, p = 0.032) were independently significant predictors.
CONCLUSIONS: ASD patients exhibit markedly reduced gait velocity and abnormal temporal coordination. Even after adjusting for age, sarcopenia, and static alignment, dynamic gait parameters remain independently associated with disability. Quantitative gait analysis may serve as a useful adjunct to radiographic evaluation in ASD.