RESUMEN
In adolescent idiopathic scoliosis (AIS), surgical planning currently relies on spinal flexibility evaluation using lateral bending radiographs. The aim was to evaluate the feasibility of non-invasive dynamic analysis of trunk kinematics and muscle activity in patients with AIS before surgical correction. During various lateral trunk bending tasks, erector spinae (18 sites) and abdominal (four sites) muscle activity was sampled using surface electrodes in ten AIS patients and in ten controls. Simultaneously, the spatial displacements of infrared emitting diodes located on the trunk were sampled. Parameters considered were the heterolateral-to-homolateral root-mean-square EMG ratios R at each site and total lateral bending and thoracic and lumbar curvature angle courses. Main alterations concerned apical muscle activity during left bending tasks. ANOVA results showed a significant effect of side (p = 2.1 x 10(-9)), EMG recording site (p = 1.9 x 10(-16)), pathology (p = 3.9 x 10(-16)) and task (p = 2.2 x 10(-11)) on R ratios. The R ratio at T10 and L1 for a simple lateral bending task during left bending averaged 4.8 (SD 4.3) and 3.0 (SD 3.1) in AIS patients, and 2.3 (SD 2.8) and 1.3 (SD 0.4) in controls (p = 6.4 x 10(-4) and 2.5 x 10(-3), LSD post hoc). This preliminary study allowed the development of a functional, non-invasive, non-irradiating dynamic tool for pre-operative evaluation in AIS.
Asunto(s)
Músculo Esquelético/fisiopatología , Escoliosis/fisiopatología , Columna Vertebral/fisiopatología , Adolescente , Adulto , Electromiografía , Estudios de Factibilidad , Femenino , Humanos , Masculino , Movimiento , Escoliosis/cirugíaRESUMEN
Lateral bending test is a common evaluation of AIS patients prior to their surgical correction. Traditionally this evaluation is made by the assessment of the curve's flexibility from side-bending radiographs. As a complement to this static test, dynamic bending was experimented while simultaneously quantifying muscular and kinematic behavior of the spine. The biggest contribution to total EMG output was 36% from lumbar muscles in healthy and 35% from abdominal muscles in scoliotic subjects. Continuous measuring of kinematics and muscle activation patterns throughout lateral bending could be an evaluation tool for distinguishing pathological from normal behavior.