Electromyogram and kinematic analysis of lateral bending in idiopathic scoliosis patients

In adolescent idiopathic scoliosis (AIS), surgical planning currently relies on spinal flexibility evaluation using lateral bending radiographs. The aim was to evaluate the feasibility of non-invasive dynamic analysis of trunk kinematics and muscle activity in patients with AIS before surgical correction. During various lateral trunk bending tasks, erector spinae (18 sites) and abdominal (four sites) muscle activity was sampled using surface electrodes in ten AIS patients and in ten controls. Simultaneously, the spatial displacements of infrared emitting diodes located on the trunk were sampled. Parameters considered were the heterolateral-to-homolateral root-mean-square EMG ratios R at each site and total lateral bending and thoracic and lumbar curvature angle courses. Main alterations concerned apical muscle activity during left bending tasks. ANOVA results showed a significant effect of side (p=2.1×10−9), EMG recording site (p=1.9×10−16), pathology (p=3.9×10−16) and task (p=2.2×10−11) on R ratios. The R ratio at T10 and L1 for a simple lateral bending task during left bending averaged 4.8 (SD 4.3) and 3.0 (SD 3.1) in AIS patients, and 2.3 (SD 2.8) and 1.3 (SD 0.4) in controls (p=6.4×10−4 and 2.5×10−3, LSD post hoc). This preliminary study allowed the development of a functional, noninvasive, non-irradiating dynamic tool for pre-operative evaluation in AIS.