Importance of pelvic compensation in posture and motion after posterior spinal fusion using CD instrumentation for idiopathic scoliosis.

Abstract:

STUDY DESIGN:Posture and motion analysis after a Cotrel-Dubousset instrumentation. OBJECTIVES:To investigate the compensation role of pelvis. SUMMARY OF BACKGROUND DATA:Few existing studies found no compensation at the lower unfused level but did not investigate the pelvis. METHODS:Thirty patients were analyzed before surgery then at short-, medium-, and long-term postoperative follow-up. Calibrated x-rays with three-dimensional reconstruction yielded quantification of pelvic parameters. Noninvasive optoelectronic system allowed analyzing subjects first in standing position, then during flexion-extension, lateral bending, and axial rotation. Skin markers were used to quantify three-dimensional orientation of the shoulders, trunk and pelvis, and their range of motion (ROM). RESULTS:Ten patients among 21 had after surgery more than 5 degrees change of pelvic incidence. In flexion, global ROM decreased from preoperative to postoperative phase (P < 0.05). Global ROM variation was not correlated to that of lower unfused segment, while it was highly correlated to pelvic ROM variation (r = 0.78 at medium follow-up). CONCLUSION:This study underlines the central role of pelvis in balance and motion of the patients before and after surgery.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Skalli W,Zeller RD,Miladi L,Bourcereau G,Savidan M,Lavaste F,Dubousset J

doi

10.1097/01.brs.0000219402.01636.87

subject

Has Abstract

pub_date

2006-05-20 00:00:00

pages

E359-66

issue

12

eissn

0362-2436

issn

1528-1159

pii

00007632-200605200-00027

journal_volume

31

pub_type

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