Does static trunk motion analysis reflect its true position during daily activities in adolescent with idiopathic...

Adolescent idiopathic scoliosis is common condition in pediatric orthopedics that is generally analyzed with standard radiographs. However, the conditions under which the radiographs are made are completely different than the position that patients use during day-to-day activities. We hypothesized that the trunk's static position differs from its dynamic one. The aim of this study was to determine differences between the trunk's static and dynamic positions using motion analysis in adolescents with idiopathic scoliosis.

This prospective, single-center study enrolled adolescents with idiopathic scoliosis who were scheduled to undergo surgical correction. The day before the surgery, radiographs were made and motion analysis was performed (static and dynamic acquisitions). Various parameters were measured on the radiographs and motion analysis, including the coronal vertical axis (CVA), sagittal vertical axis (SVA) and coronal shoulder tilt.

The study enrolled 62 patients with a mean age of 15.5 years. There was a significant correlation between the radiographic measurements and the static motion analysis results for most parameters. Conversely, dynamic measurements of CVA, SVA and coronal shoulder tilt were not correlated to their static measurements (R=0.229; 0.198 and -0.109 respectively, all p>0.05). The static coronal shoulder tilt was opposite to the one found during walking (-0.9° vs. 0.5°, p=0.031).

Our study is the first to compare the trunk's static position with its dynamic position during walking in a cohort of adolescents with idiopathic scoliosis. Motion analysis provides new information about the trunk's dynamic positions. Based on our findings, radiographic analysis only partially captures the spinal alignment and cannot be used to draw reliable conclusions about the trunk's dynamic balance.