Assessment of dynamic balance during walking in patients with adult spinal deformity
Article dans une revue avec comité de lecture
Purpose: To assess dynamic postural alignment in ASD during walking using a subject-specific 3D approach. Methods: 69 ASD (51 ± 20 years, 77%F) and 62 controls (34 ± 13 years, 62%F) underwent gait analysis along with full-body biplanar Xrays and filled HRQoL questionnaires. Spinopelvic and postural parameters were computed from 3D skeletal reconstructions, including radiographic odontoid to hip axis angle (ODHA) that evaluates the head's position over the pelvis (rODHA), in addition to rSVA and rPT. The 3D bones were then registered on each gait frame to compute the dynamic ODHA (dODHA), dSVA, and dPT. Patients with high dODHA (> mean + 1SD in controls) were classified as ASD-DU (dynamically unbalanced), otherwise as ASD-DB (dynamically balanced). Between-group comparisons and relationship between parameters were investigated. Results: 26 patients were classified as ASD-DU having an average dODHA of 10.4° (ASD-DB: 1.2°, controls: 1.7°), dSVA of 112 mm (ASD-DB: 57 mm, controls: 43 mm), and dPT of 21° (ASD-DB: 18°, controls: 14°; all p < 0.001). On static radiographs, ASD-DU group showed more severe sagittal malalignment than ASD-DB, with more altered HRQoL outcomes. The ASD-DU group had an overall abnormal walking compared to ASD-DB & controls (gait deviation index: 81 versus 93 & 97 resp., p < 0.001) showing a reduced flexion/extension range of motion at the hips and knees with a slower gait speed and shorter step length. Dynamic ODHA was correlated to HRQoL scores. Conclusion: Dynamically unbalanced ASD had postural malalignment that persist during walking, associated with kinematic alterations in the trunk, pelvis, and lower limbs, making them more prone to falls. Dynamic-ODHA correlates better with HRQoL outcomes than dSVA and dPT.
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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 ...
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 ...
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 ...
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 ...
Gait kinematic alterations in subjects with adult spinal deformity and their radiological determinants Article dans une revue avec comité de lectureKAWKABANI, Georges; SALIBY, Renée Maria; MEKHAEL, Mario; RACHKIDI, Rami; MASSAAD, Abir; GHANEM, Ismat; KHARRAT, Khalil; KREICHATI, Gaby; SAAD, Eddy; LAFAGE, Virginie; LAFAGE, Renaud; SKALLI, Wafa; ASSI, Ayman (Elsevier BV, 2021)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 ...