Crouch gait in persons with positive sagittal spine alignment resolves with surgery

Area of Science:

• Orthopedics
• Spine Surgery
• Biomechanics

Background:

• Degenerative spinal conditions can lead to positive sagittal alignment.
• This spinal malalignment may necessitate multi-segment reconstructive surgery.

Purpose of the Study:

• To investigate changes in gait kinematics before and after spinal reconstructive surgery.
• To assess the impact of surgery on gait in patients with positive sagittal alignment.

Main Methods:

• Gait analyses were performed pre- and 6 months post-operatively in 12 subjects.
• Data included standing quiet stance and self-selected walking speed.
• Subjects had positive sagittal alignment of at least 7 cm.

Main Results:

• Post-operative sagittal spine alignment significantly improved during standing and walking (p<0.0001 and p<0.0005).
• Crouch gait, characterized by reduced knee flexion, was significantly improved post-surgery (p<0.0).
• Step and stride lengths increased significantly after surgery (p<0.003 and p<0.001).

Conclusions:

• Positive sagittal alignment is associated with crouch gait.
• Multi-segment spinal reconstructive surgery effectively corrects sagittal alignment and resolves crouch gait.
• Surgical correction improves gait parameters including step and stride lengths.