Limited trunk motion and posterior pelvic tilting in ambulatory children treated with bilateral rib to pelvis implants for spinal deformity control. Issue 1 (January 2022)

• Record Type: Journal Article
• Authors: Tsaknakis, Konstantinos; Schmalz, Thomas; Freslier, Marie; Tsaknakis, Birgit; Lorenz, Heiko M.; Braunschweig, Lena; Hell, Anna K.
• Is Part Of: Journal of pediatric orthopedics. Volume 31:Issue 1(2022)
• Publication Date: 2022-01
• Subjects: bilateral growth-friendly spinal implants -- gait analysis -- gait pattern -- kinematic parameters -- spatiotemporal; Pediatric orthopedics -- Periodicals; 618.927005
• DOI: 10.1097/BPB.0000000000000858
• Languages: English
• ISSNs: 1060-152X

Abstract

Abstract : In young children, growth-friendly spinal implants with bilateral rib to pelvis fixation are used to control progressive spinal deformity. Whereas curve progression, complications and side-effects have been extensively studied in this patient population, no data are available on gait pattern changes and postural body adjustments. Our study evaluates whether gait pattern changed for ambulatory children treated with bilateral rib to pelvis implants compared to age-matched healthy children. In this small cohort study, gait analysis was performed using spatiotemporal and kinematic parameters of four ambulatory children with severe scoliosis and growth-friendly spinal implants using the bilateral rib to pelvis fixation. Data were statistically analyzed and compared to seven healthy age-matched children. Between both groups, no differences were seen in walking speed, cadence and stride length. The treated patients showed a lower range of motion of the pelvic obliquity and of the trunk obliquity and rotation, but a higher knee flexion. Growth-friendly spinal implants with bilateral rib to pelvis fixation are commonly used in wheelchair children and rarely indicated in ambulatory patients. The presented data show reduced trunk and pelvis motion using this implant construct. These findings help to understand body postural adjustments and add valuable information for families and care providers when considering this surgery. Level of evidence: Therapeutic level IV.