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| Effects of long segment fusion and fixation on lower limb gait in patients with degenerative scoliosis |
| GAO Shunxing WANG Fangfang WU Linlin FENG Juanjuan WANG Jun TAO Xiaobing CHEN Yanping |
| The First Department of Spinal Cord Surgery, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Hebei Province, Cangzhou 061001, China |
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Abstract Objective To analyze the effects of long segment fusion fixation surgery on lower limb gait in patients with degenerative scoliosis (DS). Methods A retrospective analysis was performed to evaluate 49 patients with DS who underwent long segment fusion fixation surgery in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Hebei Province from January 2015 to June 2017. The surgery were observed before and after treatment of measuring spatiotemporal parameters (step size, step speed and step width), and the kinematic data (hip joint motion angle, knee joint motion angle and plantar pressure distribution), and measurement of coronal plane scoliosis angle (Cobb), lumbar lordosis angle (LL), sacral slope (SS), visual analogue scale (VAS) score of lumbago and lower limb pain, lumbar Oswestry disability index (ODI) score Results Compared with the preoperative results, the postoperative step size, step speed and hip joint motion angle of DS patients all increased, while the knee joint motion angle decreased, with statistically significant differences (all P ＜ 0.05). There was no significant difference of the step width between the postoperative and the preoperative (P ＞ 0.05). The preoperative ground reaction force (GRF) of DS patients showed a high single peak curve, and the postoperative GRF changed into a low level bimodal curve. Compared with preoperative results, the postoperative Cobb angle of DS patients decreased, spinal balance parameters of LL and SS increased, VAS score and ODI score decreased, and the differences were all statistically significant (all P ＜ 0.05). Conclusion Long segment fusion fixation surgery can improve patients′ gait parameters, such as step size and step speed, by improving patients′ spinal deformity, so as to achieve the ultimate treatment of patients′ limb function and gait and improve their quality of life.
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