Curve location influences spinal balance in coronal and sagittal planes but not transversal trunk motion in adolescents with idiopathic scoliosis: a prospective observational study.
PURPOSE
In adolescent idiopathic scoliosis (AIS), spinal deformity can be seen in the thoracic or in the lumbar area. Although differences according to curve location are well described on standard radiographs, dynamic consequences of such difference remain unclear. Our objective was to explore the differences in dynamic spinal balance according to curve location in AIS patients using gait analysis METHODS: We prospectively included 22 females with AIS planned for surgical correction (16.3 years old, 81% Risser ≥ 4). Patients were divided into two matched cohorts, according to major curve location [right thoracic (Lenke 1) or left lumbar (Lenke 5)]. Gait analysis was performed the day before surgery. Global balance was analyzed as the primary outcome. Local curves parameters (dynamic Cobb angles) were defined as the secondary outcome.


RESULTS
In coronal plane, Lenke 5 patients had a left trunk shift, whereas trunk was shifted to the right in Lenke 1 patients (- 20.7 vs 6.3, p = 0.001). In the sagittal plane, the main difference between the two groups was T12 position that remained over the pelvis during gait in Lenke 5 patients, whereas it was anterior to the pelvis in Lenke 1 patients. In the transversal plane, Lenke 5 and Lenke 1 patients presented the same gait abnormalities, with a global trunk rotation to the left (- 4.8 vs - 7.6, p = 0,165).


CONCLUSION
This is the first study to provide the results of a direct comparison between Lenke 1 and Lenke 5 patients during gait. Curve location influenced coronal and sagittal balance, but abnormalities of transversal trunk motion were the same, wherever the curve was located. These slides can be retrieved under Electronic Supplementary Material.
['Pesenti|Sébastien|S|', 'Pomero|Vincent|V|', 'Prost|Solène|S|', 'Severyns|Mathieu|M|', 'Authier|Guillaume|G|', 'Roscigni|Lionel|L|', 'Viehweger|Elke|E|', 'Blondel|Benjamin|B|', 'Jouve|Jean Luc|JL|']
D000293:Adolescent D005260:Female D006801:Humans D007738:Kyphosis D008159:Lumbar Vertebrae D012189:Retrospective Studies D012600:Scoliosis D013123:Spinal Fusion D013904:Thoracic Vertebrae D060726:Torso D016896:Treatment Outcome
Adolescent idiopathic scoliosis Right thoracic Left lumbar Transversal plane Sagittal balance Trunk balance