Assessment of lumbosacral spinal curvatures before and after surgery using 3D posturography

Open discectomy remains the standard procedure for decompressing neural structures in cases of intervertebral disc herniation. Early postoperative rehabilitation emphasizes protecting the surgical site while restoring functional independence in daily activities. In the absence of possibilities for performing any spinal control tests within the first few days post-surgery, the dynamism of curvature changes may be the sole criterion for evaluating rehabilitation progress. This study aims to evaluate the feasibility of utilizing the non-invasive KINEOD device to measure the dynamics of lumbosacral spinal alignment parameters in the sagittal plane before and immediately after surgical intervention. The study involved 30 patients (14 women [46.67%] and 16 men [53.33%]) from the Neurosurgical Department of the Wojewódzki Szpital Specjalistyczny in Słupsk, Poland. Data were collected using a custom questionnaire and KINEOD 3D posturography to assess body posture. The following parameters were analyzed: Sagittal Inclination Angle (Sagittal IA), Kyphosis Angle (KA), Lordosis Angle (LA), Sacral Inclination Angle (Sacral IA), Lordosis Measure (LM), Inflection Point (IP), and the Angle of Acromion-Posterior Superior Iliac Spine Rotation (A-PSIS). Measurements were conducted at three stages: Stage I - one day before surgery (2:00 PM); Stage II - on the third postoperative day (7:00 AM); and Stage III - on the third postoperative day (2:00 PM). Measurements utilizing the KINEOD device revealed statistically significant changes between Stage I and Stage II for the following parameters: Sagittal IA, KA, LA, Sacral IA, LM, IP, and A-PSIS. Significant changes were also noted between Stage I and Stage III for KA, LA, Sacral IA, LM, A-PSIS, and VAS. The study highlights that the reliability of KINEOD 3D assessment diminishes when relying solely on parameters such as Sacral IA and IP for postoperative lordosis evaluation. For rapid, non-invasive assessment of the lumbosacral spine post-surgery, Sacral IA may serve as a more accurate indicator of dynamic changes in the lower lumbar region. Postoperative alterations in all sagittal plane angles are influenced by both surgical intervention and, to a lesser extent, the diurnal adaptation rhythm.