Failure of Pelvic Compensation in Patients With Severe Positive Sagittal Imbalance

Comparison Between Static Radiographs and Gait Analysis of Spinopelvic Parameters in Adult Spinal Deformity and Lumbar Stenosis

Ho Joong Kim, Feng Shen, Kyoung Tak Kang, Heoung Jae Chun, Sung Taeck Kim, Bong Soon Chang, Choon Ki Lee, Jin S. Yeom

Research output: Contribution to journalArticle

Abstract

STUDY DESIGN: Case-control study for motion analysis. OBJECTIVE: To compare spinopelvic parameters using static radiographs with the values obtained using motion analysis during gait between adult spinal deformity (ASD) or lumbar spinal stenosis (LSS). SUMMARY OF BACKGROUND DATA: It is still unclear whether measurement of radiological parameters using static radiographs can reflect natural sagittal balance during gait in the patients with severe positive sagittal imbalance. METHODS: In this age- and sex-matched case control study, a total of 40 patients, each 20 subjects with either ASD or LSS who were scheduled to undergo surgery were included. Both clinical outcomes and sagittal spinopelvic parameters, including sagittal vertical axis (SVA), lumbar lordosis (LL), pelvic tilt (PT), sacral slope (SS), and pelvic incidence (PI) were measured. In motion analysis during walking, the angle of anterior pelvic tilt and the angles of the pelvis, hip, and knee were estimated. The correlation between variables was analyzed. RESULTS: On standing lateral x-rays, SVA, PT, and PI - LL were significantly higher in the ASD group while SS and LL were significantly lower in the ASD group. However, on motion analysis, the average mean anterior pelvic tilt ± SD values in the ASD group were 8.3 ± 10.7 and 8.5 ± 10.7 on the right and left, respectively, and were not different from matched values in the LSS group. A Bland-Altman plot demonstrated a good agreement between the SS in the x-ray and anterior pelvic tilt in the motion analysis. In the ASD group, SS and SVA showed a significant positive correlation with mean anterior pelvic tilt in motion analysis during gait. CONCLUSION: The present study showed that the failure of pelvic compensation would likely occur in patients with severe positive sagittal imbalance during walking.3.

Original languageEnglish
Pages (from-to)E759-E765
JournalSpine
Volume44
Issue number13
DOIs
Publication statusPublished - 2019 Jul 1

Fingerprint

Gait
Pathologic Constriction
Spinal Stenosis
Lordosis
Case-Control Studies
X-Rays
Incidence
Pelvis
Walking
Hip
Knee

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Kim, Ho Joong ; Shen, Feng ; Kang, Kyoung Tak ; Chun, Heoung Jae ; Kim, Sung Taeck ; Chang, Bong Soon ; Lee, Choon Ki ; Yeom, Jin S. / Failure of Pelvic Compensation in Patients With Severe Positive Sagittal Imbalance : Comparison Between Static Radiographs and Gait Analysis of Spinopelvic Parameters in Adult Spinal Deformity and Lumbar Stenosis. In: Spine. 2019 ; Vol. 44, No. 13. pp. E759-E765.
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abstract = "STUDY DESIGN: Case-control study for motion analysis. OBJECTIVE: To compare spinopelvic parameters using static radiographs with the values obtained using motion analysis during gait between adult spinal deformity (ASD) or lumbar spinal stenosis (LSS). SUMMARY OF BACKGROUND DATA: It is still unclear whether measurement of radiological parameters using static radiographs can reflect natural sagittal balance during gait in the patients with severe positive sagittal imbalance. METHODS: In this age- and sex-matched case control study, a total of 40 patients, each 20 subjects with either ASD or LSS who were scheduled to undergo surgery were included. Both clinical outcomes and sagittal spinopelvic parameters, including sagittal vertical axis (SVA), lumbar lordosis (LL), pelvic tilt (PT), sacral slope (SS), and pelvic incidence (PI) were measured. In motion analysis during walking, the angle of anterior pelvic tilt and the angles of the pelvis, hip, and knee were estimated. The correlation between variables was analyzed. RESULTS: On standing lateral x-rays, SVA, PT, and PI - LL were significantly higher in the ASD group while SS and LL were significantly lower in the ASD group. However, on motion analysis, the average mean anterior pelvic tilt ± SD values in the ASD group were 8.3 ± 10.7 and 8.5 ± 10.7 on the right and left, respectively, and were not different from matched values in the LSS group. A Bland-Altman plot demonstrated a good agreement between the SS in the x-ray and anterior pelvic tilt in the motion analysis. In the ASD group, SS and SVA showed a significant positive correlation with mean anterior pelvic tilt in motion analysis during gait. CONCLUSION: The present study showed that the failure of pelvic compensation would likely occur in patients with severe positive sagittal imbalance during walking.3.",
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Failure of Pelvic Compensation in Patients With Severe Positive Sagittal Imbalance : Comparison Between Static Radiographs and Gait Analysis of Spinopelvic Parameters in Adult Spinal Deformity and Lumbar Stenosis. / Kim, Ho Joong; Shen, Feng; Kang, Kyoung Tak; Chun, Heoung Jae; Kim, Sung Taeck; Chang, Bong Soon; Lee, Choon Ki; Yeom, Jin S.

In: Spine, Vol. 44, No. 13, 01.07.2019, p. E759-E765.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Failure of Pelvic Compensation in Patients With Severe Positive Sagittal Imbalance

T2 - Comparison Between Static Radiographs and Gait Analysis of Spinopelvic Parameters in Adult Spinal Deformity and Lumbar Stenosis

AU - Kim, Ho Joong

AU - Shen, Feng

AU - Kang, Kyoung Tak

AU - Chun, Heoung Jae

AU - Kim, Sung Taeck

AU - Chang, Bong Soon

AU - Lee, Choon Ki

AU - Yeom, Jin S.

PY - 2019/7/1

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N2 - STUDY DESIGN: Case-control study for motion analysis. OBJECTIVE: To compare spinopelvic parameters using static radiographs with the values obtained using motion analysis during gait between adult spinal deformity (ASD) or lumbar spinal stenosis (LSS). SUMMARY OF BACKGROUND DATA: It is still unclear whether measurement of radiological parameters using static radiographs can reflect natural sagittal balance during gait in the patients with severe positive sagittal imbalance. METHODS: In this age- and sex-matched case control study, a total of 40 patients, each 20 subjects with either ASD or LSS who were scheduled to undergo surgery were included. Both clinical outcomes and sagittal spinopelvic parameters, including sagittal vertical axis (SVA), lumbar lordosis (LL), pelvic tilt (PT), sacral slope (SS), and pelvic incidence (PI) were measured. In motion analysis during walking, the angle of anterior pelvic tilt and the angles of the pelvis, hip, and knee were estimated. The correlation between variables was analyzed. RESULTS: On standing lateral x-rays, SVA, PT, and PI - LL were significantly higher in the ASD group while SS and LL were significantly lower in the ASD group. However, on motion analysis, the average mean anterior pelvic tilt ± SD values in the ASD group were 8.3 ± 10.7 and 8.5 ± 10.7 on the right and left, respectively, and were not different from matched values in the LSS group. A Bland-Altman plot demonstrated a good agreement between the SS in the x-ray and anterior pelvic tilt in the motion analysis. In the ASD group, SS and SVA showed a significant positive correlation with mean anterior pelvic tilt in motion analysis during gait. CONCLUSION: The present study showed that the failure of pelvic compensation would likely occur in patients with severe positive sagittal imbalance during walking.3.

AB - STUDY DESIGN: Case-control study for motion analysis. OBJECTIVE: To compare spinopelvic parameters using static radiographs with the values obtained using motion analysis during gait between adult spinal deformity (ASD) or lumbar spinal stenosis (LSS). SUMMARY OF BACKGROUND DATA: It is still unclear whether measurement of radiological parameters using static radiographs can reflect natural sagittal balance during gait in the patients with severe positive sagittal imbalance. METHODS: In this age- and sex-matched case control study, a total of 40 patients, each 20 subjects with either ASD or LSS who were scheduled to undergo surgery were included. Both clinical outcomes and sagittal spinopelvic parameters, including sagittal vertical axis (SVA), lumbar lordosis (LL), pelvic tilt (PT), sacral slope (SS), and pelvic incidence (PI) were measured. In motion analysis during walking, the angle of anterior pelvic tilt and the angles of the pelvis, hip, and knee were estimated. The correlation between variables was analyzed. RESULTS: On standing lateral x-rays, SVA, PT, and PI - LL were significantly higher in the ASD group while SS and LL were significantly lower in the ASD group. However, on motion analysis, the average mean anterior pelvic tilt ± SD values in the ASD group were 8.3 ± 10.7 and 8.5 ± 10.7 on the right and left, respectively, and were not different from matched values in the LSS group. A Bland-Altman plot demonstrated a good agreement between the SS in the x-ray and anterior pelvic tilt in the motion analysis. In the ASD group, SS and SVA showed a significant positive correlation with mean anterior pelvic tilt in motion analysis during gait. CONCLUSION: The present study showed that the failure of pelvic compensation would likely occur in patients with severe positive sagittal imbalance during walking.3.

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