Successful detection of postoperative improvement of dynamic sagittal balance with a newly developed three-dimensional gait motion analysis system in a patient with iatrogenic flatback syndrome: A case report
Successful detection of postoperative improvement of dynamic sagittal balance with a newly developed three-dimensional gait motion analysis system in a patient with iatrogenic flatback syndrome: A case report
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DOI：
10.1016/j.jocn.2018.04.051
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发表时间：
2018-07-01
影响因子：
2
通讯作者：
Yamazaki, Masashi
中科院分区：
文献类型：
--
作者：
Miura, Kousei;Koda, Masao;Yamazaki, Masashi
一名患有帕金森病的 75 岁日本女性主诉因医源性平背综合症而出现腰痛和步态障碍。术前整体脊柱参数如下：C7SVA，168 mm； TK，52度； LL，-0.8 度； PI，57度； PT，55 度； TPA，60 度。我们使用 VICON 系统进行 3D 步态分析并计算动态 SVA。术前，她的屈曲畸形在行走过程中逐渐进展。动态参数逐渐增加如下：胸廓SVA，216-241 mm；腰椎 SVA，53-69 毫米；脊柱 SVA，270-311 毫米。我们进行了两阶段矫正手术。她的腰痛和步态障碍明显改善。术后整体脊柱参数如下：C7SVA，1 mm； TK，47 度；法学学士，61 度； P1，52度； PT，20度； TPA，13 度。我们使用 VICON 的 3D 步态分析检测到的动态 SVA 如下：胸部 SVA，128 毫米；腰椎 SVA，4.9 毫米；脊柱 SVA，133 毫米。术后动态SVA在步行过程中没有变化。这是首例医源性平背综合征患者术后动态脊柱矢状面排列的改善，我们利用新开发的3D步态分析系统成功检测到该患者的动态变化，使我们能够根据患者连续长距离步态的实际行走来分析SVA的动态变化。我们的 3D 步态分析对于评估医源性平背综合征的术后矢状平衡具有潜在的用途。 (C) 2018 年由爱思唯尔有限公司出版。
A 75-year-old Japanese woman with Parkinson's disease complained of lower back pain and gait disturbance because of iatrogenic flatback syndrome. The preoperative global spinal parameters were as follows: C7SVA, 168 mm; TK, 52 degrees; LL, -0.8 degrees; PI, 57 degrees; PT, 55 degrees; TPA, 60 degrees. We performed 3D gait analysis using a VICON System and calculated the dynamic SVA. Preoperatively, her flexion deformity gradually progressed during walking. The dynamic parameters gradually increased as follows: thoracic SVA, 216-241 mm; lumbar SVA, 53-69 mm; spinal SVA, 270-311 mm. We performed two-stage corrective surgery. Her lower back pain and gait disturbance significantly improved. The postoperative global spinal parameters were as follows: C7SVA, 1 mm; TK, 47 degrees; LL, 61 degrees; P1, 52 degrees; PT, 20 degrees; TPA, 13 degrees. Dynamic SVA detected by our 3D gait analysis using VICON were as follows: thoracic SVA, 128 mm; lumbar SVA, 4.9 mm; and spinal SVA, 133 mm. The postoperative dynamic SVA did not change during walking.This is the first report of a patient with iatrogenic flatback syndrome whose postoperative improvement of dynamic spinal sagittal alignment was successfully detected with a newly developed 3D gait analysis system that enabled us to analyze a dynamic change of SVA based on the patient's actual walking with a continuous long-distance gait. Our 3D gait analysis has potential usefulness for evaluating postoperative sagittal balance for iatrogenic flatback syndrome. (C) 2018 Published by Elsevier Ltd.