Pelvic Obliquity During Standing and Walking in Adolescent Idiopathic Scoliosis with Lumbar Curvature
10.12290/xhyxzz.2023-0447
- VernacularTitle:存在腰弯的青少年特发性脊柱侧凸患者站立位及步行中骨盆冠状面倾斜程度分析
- Author:
Weihong SHI
1
;
Lixia CHEN
1
;
Wangshu YUAN
1
;
Yuhang ZHANG
1
;
Houqiang ZHANG
1
;
Huiling ZHANG
1
;
Yuying YANG
1
;
Jiandong LU
2
Author Information
1. Department of Rehabilitation Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
2. Tianjin Binhai Vocational Institute of Automotive Engineering, Tianjin 300352, China
- Publication Type:Journal Article
- Keywords:
adolescent idiopathic scoliosis;
lumbar curvature;
pelvic obliquity;
biomechanics
- From:
Medical Journal of Peking Union Medical College Hospital
2024;15(1):124-129
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the severity and features of pelvic coronal plane tilt in individuals with adolescent idiopathic scoliosis (AIS) who had lumbar curvature during the gait cycle. Methods AIS patients with lumbar curvature and patients with microcurvature (Cobb Angle less than 10 degrees) treated in Peking Union Medical College Hospital from September 2020 to February 2023 were retrospectively included. According to PUMC conservative classification system and Spinal Full-length Standing X-ray, AIS patients with lumbar curvature were enrolled. The bilateral iliac crest was used as the bony marker of the pelvic coronal surface, and the bilateral iliac crest height and its changes were measured during the standing position and walking cycle, so as to evaluate the degree of pelvic coronal tilt in AIS patients with lumbar curvature. Results A total of 209 AIS patients with lumbar curvature and 36 patients with microcurvature who met the inclusion and exclusion criteria were enrolled. The proportion of AIS patients with lumbar curvature who had a "congruent" relationship between the higher iliac crest and the convex side of the spine in standing position (iliac crest lower on the convex side than on the concave side) was significantly higher in AIS patients with lumbar curvature than patients with microcurvature(58.9% vs. 30.6%, P=0.002). AIS patients with lumbar curvature had statistically different bilateral iliac crest height change values throughout the gait cycle (including minimum, maximum, swing phase minimum, and swing phase maximum) (all P < 0.001), and the iliac crest height change values on the convex side were significantly higher than those on the concave side (all P < 0.05), whereas the patients with microcurvature did not have any statistically significant bilateral iliac crest height change values throughout the gait cycle (all P > 0.05). Conclusion The height of the iliac crest on the convex side of the lumbar spine is lower than that on the concave side in the standing position of AIS patients with lumbar curvature, and the value of the change of the iliac crest on the convex side of the pelvis is greater than that on the concave side in walking to maintain the balance of the body, which may provide a new direction for the intervention in the clinical rehabilitation treatment of AIS patients with lumbar curvature.
