Gait kinematic alterations in subjects with adult spinal deformity and their radiological determinants
Article dans une revue avec comité de lecture
Background: Adults with spinal deformity (ASD) are known to have postural malalignment affecting their quality of life. Classical evaluation and follow-up are usually based on full-body static radiographs and health related quality of life questionnaires. Despite being an essential daily life activity, formal gait assessment lacks in clinical practice. Research Question: What are the main alterations in gait kinematics of ASD and their radiological determinants? Methods: 52 ASD and 63 control subjects underwent full-body 3D gait analysis with calculation of joint kinematics and full-body biplanar X-rays with calculation of 3D postural parameters. Kinematics and postural parameters were compared between groups. Determinants of gait alterations among postural radiographic parameters were explored. Results: ASD had increased sagittal vertical axis (SVA:34 ± 59 vs −5 ± 20 mm), pelvic tilt (PT:19 ± 13 vs 11 ± 6°) and frontal Cobb (25 ± 21 vs 4 ± 6°) compared to controls (all p < 0.001). ASD displayed decrease walking speed (0.9 ± 0.3 vs 1.2 ± 0.2 m/s), step length (0.58 ± 0.11 vs 0.64 ± 0.07 m) and increased single support (0.45 ± 0.05 vs 0.42 ± 0.04 s). ASD walked with decreased hip extension in stance (−3 ± 10 vs −7 ± 8°), increased knee flexion at initial contact and in stance (10 ± 11 vs 5 ± 10° and 19 ± 7 vs 16 ± 8° respectively), and decreased knee flexion/extension ROM (55 ± 9 vs 59 ± 7°). ASD had increased trunk flexion (12 ± 12 vs 6 ± 11°) and reduced dynamic lumbar lordosis (−11 ± 12 vs −15 ± 7°, all p < 0.001). Sagittal knee ROM, walking speed and step length were negatively determined by SVA; lack of lumbar lordosis during gait was negatively determined by radiological lumbar lordosis. Significance: Static compensations in ASD persist during gait, where they exhibit a flexed attitude at the trunk, hips and knees, reduced hip and knee mobility and loss of dynamic lordosis. ASD walked at a slower pace with increased single and double support times that might contribute to their gait stability. These dynamic discrepancies were strongly related to static sagittal malalignment.
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Toward understanding the underlying mechanisms of pelvic tilt reserve in adult spinal deformity: the role of the 3D hip orientation Article dans une revue avec comité de lectureMEKHAEL, Mario; KAWKABANI, Georges; SALIBY, Renée Maria; SKALLI, Wafa; SAAD, Eddy; JABER, Elena; RACHKIDI, Rami; KHARRAT, Khalil; KREICHATI, Gaby; GHANEM, Ismat; LAFAGE, Virginie; ASSI, Ayman (Springer Science and Business Media LLC, 2021)Purpose: To explore 3D hip orientation in standing position in subjects with adult spinal deformity (ASD) presenting with different levels of compensatory mechanisms. Methods: Subjects with ASD (n = 159) and controls ...
Article dans une revue avec comité de lectureSAAD, Eddy; SEMAAN, Karl; KAWKABANI, Georges; MASSAAD, Abir; SALIBY, Renée Maria; MEKHAEL, Mario; FAKHOURY, Marc; KARAM, Krystel Abi; JABER, Elena; GHANEM, Ismat; LAFAGE, Virginie; SKALLI, Wafa; RACHKIDI, Rami; ASSI, Ayman (Elsevier BV, 2022)Adults with spinal deformity (ASD) are known to have spinal malalignment affecting their quality of life and daily life activities. While walking kinematics were shown to be altered in ASD, other functional activities are ...
Alterations of gait kinematics depend on the deformity type in the setting of adult spinal deformity Article dans une revue avec comité de lectureSEMAAN, Karl; RACHKIDI, Rami; SAAD, Eddy; MASSAAD, Abir; KAWKABANI, Georges; SALIBY, Renée Maria; MEKHAEL, Mario; ABI KARAM, Krystel; FAKHOURY, Marc; JABER, Elena; GHANEM, Ismat; SKALLI, Wafa; LAFAGE, Virginie; ASSI, Ayman (Springer Science and Business Media LLC, 2022-08)Purpose : To evaluate 3D kinematic alterations during gait in Adult Spinal Deformity (ASD) subjects with different deformity presentations. Methods : One hundred nineteen primary ASD (51 ± 19y, 90F), age and ...
Article dans une revue avec comité de lectureEL RACHKIDI, Rami; MASSAAD, Abir; SAAD, Eddy; KAWKABANI, Georges; SEMAAN, Karl; ABI NAHED, Julien; GHANEM, Ismat; LAFAGE, Virginie; SKALLI, Wafa; ASSI, Ayman (Springer Nature, 2022-08)Purpose To describe spinopelvic adaptations in the standing and sitting positions in patients with adult spinal deformity (ASD). Methods Ninety-five patients with ASD and 32 controls completed health-related quality ...
Article dans une revue avec comité de lectureASSI, Ayman; REBEYRAT, Guillaume; EL RACHKIDI, Rami; SEMAAN, Karl; SAAD, Eddy; MEKHAEL, Elio; NASSIM, Nabil; MASSAAD, Abir; LAFAGE, Virginie; GHANEM, Ismat; PILLET, Hélène; SKALLI, Wafa (Elsevier BV pour le compte d'EANS (European Association of Neurosurgical Societies) et d'Eurospine (The Spine Society of Europe), 2023-05)Introduction: It was hypothesized that pelvic retroversion in Adult Spinal Deformity (ASD) can be related to an increased hip loading explaining the occurrence of hip-spine syndrome. Research question: How pelvic ...