Correlation analysis of gait characteristics and X-ray parameters in patients with degenerative scoliosis

English Keywords:Degenerative scoliosis  Gait motion analysis  Dynamic evaluation

English Abstract:

  【Abstract】 Objectives: To analyze the gait characteristics of patients with degenerative scoliosis(DS) and explore the relationship between the gait characteristics and image parameters on X-ray. Methods: 9 DS patients of 67.7±3.1 years old(63-73 years) were included in the study. The three-dimensional gait motion of the patients was analyzed with a SMART-D 400 infrared motion capture system, including spatiotemporal parameters(stride length, stance time, swing time, stance cycle, swing cycle, single limb support cycle, double limb support cycle, absolute velocity, relative velocity, step frequency, step length, and step width), gait deviation index(GDI), and spinal balance parameters[thoracic-whole spine coronal angles(TS-CA) of the first 5m and the last 5m, the dynamic pelvic tilt in motion cycle(PTM)]. The thoracic kyphosis angle(T5/T12 Cobb), lumbar lordosis(LL) angle(L1/L5 Cobb), sacral slope(SS), pelvic incidence(PI), pelvic tilt(PT), difference between PI angle and LL angle(PI-LL), sagittal vertical axis(SVA), degenerative scoliosis segments and angles were measured on the full-length X-ray. The patient′s GDI values were counted whether within the normal range(>100), and then paired T-test was used to compare the spinal balance parameters of the first 5m with those of the last 5m. The gait characteristics of DS patients were summarized. Spearman correlation analysis was used to examine the relationship between spatiotemporal parameters and radiographic parameters. Results: The spatiotemporal parameters of the patients were: the stride duration 1.16±0.21s, the support duration 0.79±0.15s, the swing duration 0.37±0.07s, the support period (67.98±2.14)%, the swing period (32.02±2.41)%, the single foot support period (54.32±5.12)%, and the double foot support period (45.68±5.12)%, the absolute velocity 0.73±0.17m/s, the relative velocity 45.33±11.20(%height/s), the step length is 0.41±0.09m, the step width 0.09±0.03m, the step frequency 106.66±17.59 times/min. Abnormal gait existed in all the patients(GDI of the right and left lower extremities were 82.3±7.4 and 85.1±7.3, respectively). The TS-CA, TS-SA, and PTM of the last 5m were all greater than those of the first 5m(P<0.05). The correlation analysis showed that absolute velocity and relative velocity were positively correlated with LL, with correlation coefficients of 0.707(P=0.033) and 0.795(P=0.010), respectively. And PI-LL was stronly positively correlated with TS-SA, with a coefficient of 0.703(P=0.035). The swing time was strongly negatively correlated with LL with a correlation coefficient of -0.703(P=0.035). SS was strongly negatively correlated with step width, with a correlation coefficient of -0.868(P=0.002), but no significant correlation with other parameters. Conclusions: DS patients have significant gait abnormalities, and spinal imbalance increases significantly during walking. The abnormal gait of patients is significantly related to spinal imbalance (reduced LL and PI-LL, and increased SS).