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Global Sagittal Angle and T9-tilt seem to be the most clinically and functionally relevant global alignment parameters in patients with Adult Spinal Deformity

Article dans une revue avec comité de lecture
Auteur
NASSIM, Nabil
301405 Université Saint-Joseph de Beyrouth [USJ]
ccMEKHAEL, Elio
301405 Université Saint-Joseph de Beyrouth [USJ]
RACHKIDI, Rami El
301405 Université Saint-Joseph de Beyrouth [USJ]
SAADE, Maria
301405 Université Saint-Joseph de Beyrouth [USJ]
AYOUB, Elma
301405 Université Saint-Joseph de Beyrouth [USJ]
ccRTEIL, Ali
301405 Université Saint-Joseph de Beyrouth [USJ]
JABER, Elena
301405 Université Saint-Joseph de Beyrouth [USJ]
ccCHAAYA, Celine
301405 Université Saint-Joseph de Beyrouth [USJ]
REHAYEM, Rami
301405 Université Saint-Joseph de Beyrouth [USJ]
ABI NAHED, Julien
KARAM, Mohamad
301405 Université Saint-Joseph de Beyrouth [USJ]
ccGHANEM, Ismat
301405 Université Saint-Joseph de Beyrouth [USJ]
ccMASSAAD, Abir
301405 Université Saint-Joseph de Beyrouth [USJ]
ASSI, Ayman
301405 Université Saint-Joseph de Beyrouth [USJ]
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]

URI
http://hdl.handle.net/10985/25221
DOI
10.1016/j.bas.2024.102805
Date
2024-04
Journal
Brain and Spine

Résumé

Introduction Radiographic analysis is necessary for the assessment and the surgical planning in adults with spinal deformity (ASD). Restoration of global alignment is key to improving patient's quality of life. However, the large number of existing global alignment parameters can be confusing for surgeons. Research question To determine the most clinically and functionally relevant global alignment parameters in ASD. Material and methods ASD and controls underwent full body biplanar X-ray to calculate global alignment parameters: odontoid to hip axis angle (OD-HA), global sagittal angle (GSA), global tilt (GT), SVA, center of auditory meatus to hip axis (CAM-HA), SSA, T1-tilt and T9-tilt. All subjects filled HRQoL questionnaires: ODI, SF-36, VAS for pain and BDI (Beck's Depression Inventory). 3D gait analysis was performed to calculate kinematic and spatio-temporal parameters. A machine learning model predicted gait parameters and HRQoL scores from global alignment parameters. Results 124 primary ASD and 47 controls were enrolled. T9 tilt predicted the most BDI (31%), hip flexion/extension during gait (36%), and double support time (39%). GSA predicted the most ODI (26%), thorax flexion/extension during gait (33%), and cadence (36%). Discussion and conclusion Among all global alignment parameters, GSA, evaluating both trunk shift and knee flexion, and T9 tilt, evaluating the shift of the center of mass, were the best predictors for most of HRQoL scores and gait kinematics. Therefore, we recommend using GSA and T9 tilt in clinical practice when evaluating ASD because they represent the most quality of life and functional kinematic of these patients.

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