Gait analysis in adolescent with idiopatic scoliosis

Introduction: Scoliosis is characterized by a deformity of the pine on the three planes of space. The purpose of this study was the evaluation of changes in he pattern of the way in subjects with severe idiopathic scoliosis efore and after they were underwent surgical correction, stabiization and spinal fusion. Materials andmethods: From 2009 to 2010 at our center were peratedon30patientswith adolescent idiopathic scoliosis correcion, spinal stabilization and fusion. For this study, were enrolled 5 patients. Patients are divided as follows: 11 females and 4 males, age 3–22 year old, average 16.2 years. Tencaseswere Lenke type1 scoliosiswith correctionof themain urve of the average 64.8%, 5 cases, 3 with Lenke type correction f the lumbar curve average of 66.5% and 60.5% of the backbone urve. The stabilization was carried out almost exclusively with edicle screws. In 3 cases, proximal hooks were used. The defority correction maneuvers were performed mainly for derotation lobal direct vertebral derotation (DVR) at theapexof thedeformity nd minimally distraction and segmental kyphosis. In 3 cases, the ertebral stabilization was performed at the dorsal level (the most roximal vertebra T4) and in 5 cases at the level of back injury (L4 ertebra most distal) [1,2]. Theevaluationswereperformedbeforeandafter2and6months fter surgery. All patients underwent the study three-dimensional ovements of the pelvis and lower limbon sagittal plane and study he kinetics during the spontaneous gait. Has been used an optolectronic system Elite BTS S.p.A., consists of 6 infrared cameras, ith acquisition frequency100Hz, 22 reflectivemarkers anda force latform. Results: We analyzed the spatial-temporal parameters, kineatics of pelvis, hip, knee and ankle sagittal and kinetics. In the re-operativeassessment, therewere small changes in timeparamters with longer duration in seconds and in percentage of the tance phase in 5 cases. Always in 5 cases pre-spinal surgery during he analysis in the spatial parameters was observed a reduction in verage gait speed. In the preoperative evaluation in the sagittal plane kinematics t the pelvis were found 5 cases with slight increase in anteverion and 5 cases with slight increase of retroversion, while in the nkles was observed in 7 cases a dorsiflexion in stance bilaterally. he kinetics on sagittal planeof anklewasmoderately impaired in 9 ases with values of the power generated above average, in 4 cases ilateral and unilateral on the right side in 3 cases. In 2 cases was bserved values below average on the left side. Themain improveents, pre and post surgery two months were: improvement in tride length-dependent increase in the average speed of thewalkncreasing speed of oscillation of the limb. In the sagittal plane inematics was shown significant improvement against the pelvis nd ankle. It reduces the anteversion and the retroversion pelvic resents throughout the gait cycle. In sagittal kinematics reduces mpaired dorsiflexion of the ankle. Two months after surgery, the inetics shows a sagittal symmetry of the power generated by the nkle on both sides. Discussion: In light of the results, although the series still limted in patients with severe idiopathic scoliosis shows “range” f the gait parameters not otherwise documented in the clinie 35 (2012) S1–S47 S5