Pelvic Kinematics during Gait Following Long-Segment Spinal Fusion Due to Adult Spinal Deformity: An Analysis Using a...

Area of Science:

• Orthopedics
• Biomechanical Engineering
• Spinal Surgery

Background:

• Adult spinal deformity (ASD) corrective surgery involves long-segment fusion from the thoracic spine to the pelvis.
• Postoperative gait changes, particularly in pelvic kinematics, may influence the development or progression of hip osteoarthritis.
• Understanding these gait alterations is crucial for patient outcomes.

Purpose of the Study:

• To analyze and characterize postoperative pelvic kinematics in patients with ASD after long-segment fusion surgery.
• To investigate the relationship between spinal fusion and gait patterns using advanced wearable technology.

Main Methods:

• Utilized smartphone-integrated inertial measurement units (IMUs) to record sacral acceleration and angular velocity during gait in 21 ASD patients and 20 healthy controls.
• Applied gradient boosting machine learning to classify gait patterns based on 20 key features derived from 1043 gait parameters.

Main Results:

• Achieved a high classification accuracy of 96.7% and an F1-score of 0.968 between the ASD and control groups.
• Identified suppressed variance in pelvic rotation angular velocity in the horizontal plane during the gait cycle as the primary distinguishing feature for the ASD group.

Conclusions:

• Patients with ASD who have undergone long-segment thoracic to pelvic fusion exhibit a characteristic gait pattern.
• This gait style is marked by significantly reduced pelvic rotation in the horizontal plane compared to healthy individuals.