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Author Spotlight: Developing Low-Tech Balance Assessment Methods for Broad-Spectrum Healthcare Applications
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Does improved radiographic alignment truly enhance dynamic functional balance?

Ram Haddas1, Stanley Kisinde2, Damon Mar2

  • 1Texas Back Institute, 6020 West Parker Road, Plano, TX, 75093, USA. rhaddas@texasback.com.

Spine Deformity
|February 18, 2020
PubMed
Summary
This summary is machine-generated.

Realignment surgery for adult degenerative scoliosis (ADS) improved radiographic alignment and functional balance, measured by the cone of economy (CoE). Improved spinal alignment correlated with better CoE balance post-surgery.

Keywords:
Adult degenerative scoliosisFunctional balanceRadiographic alignment

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Area of Science:

  • Spine surgery
  • Orthopedics
  • Biomechanical analysis

Background:

  • Adult degenerative scoliosis (ADS) presents a significant healthcare challenge, particularly in the elderly population.
  • Current assessment of ADS relies on radiographic alignment and patient-reported outcomes, with limited functional balance evaluation.
  • The relationship between radiographic parameters and functional balance (cone of economy - CoE) in ADS patients is not well understood.

Purpose of the Study:

  • To determine the correlation between radiographic alignment and functional CoE measurements before and after realignment surgery in ADS patients.
  • To investigate the impact of surgical intervention on both radiographic and functional balance parameters in ADS.
  • To explore the potential of CoE as a novel measure for assessing surgical outcomes in ADS.

Main Methods:

  • Prospective concurrent cohort study involving 29 ADS patients undergoing realignment surgery.
  • Patients were assessed 1 week pre-surgery and 3 months post-surgery, including radiographic imaging and functional balance tests (CoE).
  • Patient-reported outcomes (pain, disability, function) were collected; statistical analyses included paired t tests and Pearson correlations.

Main Results:

  • Significant improvements were observed in patient-reported outcomes, radiographic measures (Cobb angle, pelvic tilt, lordosis, kyphosis), and CoE measures post-surgery.
  • Improvements in scoliosis Cobb angle, pelvic tilt, lumbar lordosis, and thoracic kyphosis correlated significantly with CoE sway and total distance.
  • These correlations were observed for both center of mass and center of head measurements.

Conclusions:

  • Improved radiographic alignment after ADS realignment surgery is significantly associated with enhanced functional balance (CoE).
  • Integrating CoE measurements with radiographic data offers a more sensitive and robust assessment of postoperative outcomes in ADS patients.
  • Cone of economy (CoE) balance may serve as a valuable new metric for evaluating the effectiveness of surgical interventions for ADS.