Evidence map›Paper›PMID 30826876›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2019

ISSLS PRIZE IN BIOENGINEERING SCIENCE 2019: biomechanical changes in dynamic sagittal balance and lower limb compensatory strategies following realignment surgery in adult spinal deformity patients.

Jeannie F Bailey, Robert P Matthew, Sarah Seko, Patrick Curran, Leslie Chu, Sigurd H Berven, Vedat Deviren, Shane Burch, Jeffrey C Lotz

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.4field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 16 citations in OpenAlex.

  1. Article
  2. Evaluation of lumbar paraspinal muscles degeneration and fatty infiltration in dynamic sagittal imbalance based on magnetic resonance imaging.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024
    Article
  3. Article
  4. Compensatory biomechanics and spinal loading during dynamic maneuvers in patients with chronic low back pain.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022
    Article
  5. Article
  6. Alteration of the Sitting and Standing Movement in Adult Spinal Deformity.Frontiers in bioengineering and biotechnology · 2021
    Article
  7. Characteristics and treatment of dynamic sagittal imbalance in adult spinal deformity.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2020
    Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Jeannie F BaileyDepartment of Orthopaedic Surgery, University of California, San Francisco, USA.
Robert P MatthewDepartment of Electrical Engineering and Computer Science, University of California, Berkeley, USA.
Sarah SekoDepartment of Electrical Engineering and Computer Science, University of California, Berkeley, USA.
Patrick CurranDepartment of Orthopaedic Surgery, University of California, San Francisco, USA.
Leslie ChuDepartment of Orthopaedic Surgery, University of California, San Francisco, USA.
Sigurd H BervenDepartment of Orthopaedic Surgery, University of California, San Francisco, USA.
Vedat DevirenDepartment of Orthopaedic Surgery, University of California, San Francisco, USA.
Shane BurchDepartment of Orthopaedic Surgery, University of California, San Francisco, USA.
Jeffrey C LotzDepartment of Orthopaedic Surgery, University of California, San Francisco, USA. Jeffrey.Lotz@ucsf.edu.ORCID http://orcid.org/0000-0002-9654-0647
University of California, San Francisco · USUniversity of California, Berkeley · US

Funding

A Clinical 3D Movement Analysis System for Assessing Lower Extremity Injury Risk and Recovery in AthletesR41AR068202 · NIAMS · BIONIKS, INC. · PI LOTZ, JEFFREY C. · 2016 to 2016
$216k
NIH HHS 5TL1TR001871-02NIH HHS R41AR068202
6 · The paper itself

Abstract

STUDY

designA longitudinal cohort study.

objectiveTo define a set of objective biomechanical metrics that are representative of adult spinal deformity (ASD) post-surgical outcomes and that may forecast post-surgical mechanical complications. Current outcomes for ASD surgical planning and post-surgical assessment are limited to static radiographic alignment and patient-reported questionnaires. Little is known about the compensatory biomechanical strategies for stabilizing sagittal balance during functional movements in ASD patients.

methodsWe collected in-clinic motion data from 15 ASD patients and 10 controls during an unassisted sit-to-stand (STS) functional maneuver. Joint motions were measured using noninvasive 3D depth mapping sensor technology. Mathematical methods were used to attain high-fidelity joint-position tracking for biomechanical modeling. This approach provided reliable measurements for biomechanical behaviors at the spine, hip, and knee. These included peak sagittal vertical axis (SVA) over the course of the STS, as well as forces and muscular moments at various joints. We compared changes in dynamic sagittal balance (DSB) metrics between pre- and post-surgery and then separately compared pre- and post-surgical data to controls.

resultsStandard radiographic and patient-reported outcomes significantly improved following realignment surgery. From the DSB biomechanical metrics, peak SVA and biomechanical loads and muscular forces on the lower lumbar spine significantly reduced following surgery (- 19 to - 30%, all p < 0.05). In addition, as SVA improved, hip moments decreased (- 28 to - 65%, all p < 0.05) and knee moments increased (+ 7 to + 28%, p < 0.05), indicating changes in lower limb compensatory strategies. After surgery, DSB data approached values from the controls, with some post-surgical metrics becoming statistically equivalent to controls.

conclusionsLongitudinal changes in DSB following successful multi-level spinal realignment indicate reduced forces on the lower lumbar spine along with altered lower limb dynamics matching that of controls. Inadequate improvement in DSB may indicate increased risk of post-surgical mechanical failure. These slides can be retrieved under Electronic Supplementary Material.

Indexed as

Adaptation, PhysiologicalAdultBiomechanical PhenomenaCase-Control StudiesCohort StudiesFemaleHip JointHumansImaging, Three-DimensionalKnee JointLongitudinal StudiesLumbar VertebraeMaleMiddle AgedModels, BiologicalPostural BalanceAdult spinal deformityCompensatory mechanismsPost-surgical outcomesProximal junctional kyphosisSagittal balanceSit-to-standSpinal biomechanics

Identifiers

PMID30826876
PMCPMC6536471
OpenAlexW2920404144

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.