title: Prospective evaluation of trunk range of motion in adolescents with idiopathic scoliosis undergoing spinal fusion surgery.
abstract: METHODS
  Prospective evaluation of spinal range of motion in patients with adolescent idiopathic scoliosis undergoing a spinal fusion.
  
  
  OBJECTIVE
  Evaluate changes in triplanar spine range of motion following spinal fusion.
  
  
  BACKGROUND
  Preoperative and postoperative radiographs have been the major form of outcome analysis of adolescent idiopathic scoliosis fusions. Although the radiographs document static positions of the skeletal system, they do not document dynamic changes.
  
  
  METHODS
  Thirty patients with adolescent idiopathic scoliosis undergoing an instrumented spinal fusion underwent triplanar range of motion tests before surgery and at 12 and 24 months after surgery. Videography with reflective surface markers was used to capture the motions. A fused region, unfused regions above and below the fusion, and a global spinal measure were used to assess changes.
  
  
  RESULTS
  Results indicated a loss of motion in the coronal and sagittal planes for the fused and unfused spinal regions and a loss of motion in the coronal, sagittal, and transverse planes for the global measurements. Results also indicated preoperative and continued postoperative right and left lateral flexion asymmetries. No significant correlations were found between the total fused levels and changes in range of motion. No significant correlations were found between the lowest instrumented vertebra and changes in range of motion.
  
  
  CONCLUSIONS
  Whereas range of motion was reduced in the fused regions of the spine, it was also reduced in unfused regions. The lack of compensatory increase in motion at unfused regions contradicts current theory and suggests early postoperative range of motion therapy to facilitate motion in unfused regions.
authors.affiliation: Human Performance Laboratory, Barnes-Jewish Hospital, Department of Orthopaedic Surgery, Washington University School of Medicine, Shrine Hospitals for Children, St. Louis Unit, St. Louis, Missouri, USA. jr36264@bjc.org
authors.forename: Jack R
authors.initials: JR
authors.lastname: Engsberg
authors.forename: Lawrence G
authors.initials: LG
authors.lastname: Lenke
authors.forename: Angela K
authors.initials: AK
authors.lastname: Reitenbach
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Hollander
authors.forename: Keith H
authors.initials: KH
authors.lastname: Bridwell
authors.forename: Kathy
authors.initials: K
authors.lastname: Blanke
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D016059:Range of Motion, Articular; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods*; D013131:Spine / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome