title: Preoperative gait comparisons between adults undergoing long spinal deformity fusion surgery (thoracic to L4, L5, or sacrum) and controls.
abstract: METHODS
  This investigation compared the gait of revision and primary spinal deformity patients about to undergo surgical reconstruction with that of a group of able-bodied controls.
  
  
  OBJECTIVE
  The hypothesis of the study was that both patient groups would have significantly compromised gait, spine motion, and gait endurance compared with the able-bodied group.
  
  
  BACKGROUND
  There is a population of adults with degenerative changes superimposed on idiopathic scoliosis who present for reconstructive spinal surgery (primary patients). There is another group of adults who have already had spinal deformity surgery and present for revision surgery (revision patients).
  
  
  METHODS
  Twenty-seven women were recruited (8 primary, 13 revision, 6 able-bodied controls). A typical gait analysis was performed. Walking endurance was estimated from a submaximal graded treadmill exercise test. Three motion variables describing the orientation of the shoulders with respect to the pelvis in the three principal planes of the body were determined. Also, gait speed, stride length, cadence, and step width were calculated. The variable for the endurance test was the length of time walked on the treadmill.
  
  
  RESULTS
  Results for the revision group indicated a slower walking speed, greater sagittal plane trunk flexion, reduced range of motion in the coronal and transverse planes, and poorer endurance relative to age-matched controls. The primary group demonstrated a slower walking speed relative to age-matched controls. The revision group had poorer endurance scores relative to the primary group.
  
  
  CONCLUSIONS
  This investigation is an objective report describing the compromised gait and walking endurance of adult patients with spinal deformity before spinal fusion surgery. Results supported subjective observations regarding the preoperative gait of these patients and presented results difficult to observe in a clinical setting. The techniques appear useful in providing objective information regarding the gait abilities of these patients.
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA. bridwellk@msnotes.wustl.edu
authors.forename: J R
authors.initials: JR
authors.lastname: Engsberg
authors.forename: K H
authors.initials: KH
authors.lastname: Bridwell
authors.forename: A K
authors.initials: AK
authors.lastname: Reitenbach
authors.forename: M L
authors.initials: ML
authors.lastname: Uhrich
authors.forename: C
authors.initials: C
authors.lastname: Baldus
authors.forename: K
authors.initials: K
authors.lastname: Blanke
authors.forename: L G
authors.initials: LG
authors.lastname: Lenke
mesh_terms: D000328:Adult; D000368:Aged; D005080:Exercise Test; D005260:Female; D005684:Gait; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008875:Middle Aged; D010807:Physical Endurance; D011446:Prospective Studies; D012086:Reoperation; D012447:Sacrum / Q000601:surgery*; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000601:surgery*; D016138:Walking / Q000502:physiology