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  • Title: Using video rasterstereography and treadmill gait analysis as a tool for evaluating postoperative outcome after lumbar spinal fusion.
    Author: Scheidt S, Endreß S, Gesicki M, Hofmann UK.
    Journal: Gait Posture; 2018 Jul; 64():18-24. PubMed ID: 29803082.
    Abstract:
    BACKGROUND: The rise in the number of patients with lumbar back pain has led to an increase in the number of spinal surgeries. To avoid unfavorable outcomes, high accuracy and reliability of indication for surgery are essential. This requires critical evaluation of postoperative outcomes with its two key dimensions pain and function. While imaging findings give details about the technical dimension of the intervention, they are prone to high inter-/intra-observer variability, with limited relation to functional outcomes. Pain improvement can be directly asked from patients or documented by questionnaires. There is abundant literature on postoperative function based on questionnaires, but quantifiable data such as gait or posture analysis are scarce. Highprecision measurement tools are available and easy to implement in a clinician's work routine. OBJECTIVE: This study evaluates whether lumbar fusion surgery changes gait and postural variables and how these changes are related to patients' descriptions of alterations in their levels of pain. METHODS: Back profiles and gait analyses were measured by video rasterstereography and treadmill gait analysis. Measurements were recorded before surgery, at discharge, after 3 months in a longitudinal (n = 30), and after 12 months in a cross-sectional group (n = 29). A reference group was formed (n = 28). The improvement on the Numeric Pain Rating Scale was documented and compared with changes in gait and posture. RESULTS: A significant reduction in kyphotic (52-43°, p = 0.014) and lordotic (28-11°, p < 0.001) angles was observed. The values again increased after 3 months, with a significant reduction in cadence (98-91 steps/min, p = 0.006). While improvements in pain were also obtained by surgery (p < 0.001), no clear correlation could be detected between 3-month alleviation in pain and changes in kyphotic/lordotic angle or cadence. CONCLUSIONS: Although both methods offer high-precision measurement, changes in gait and posture were not related with the patients' reported pain relief after lumbar fusion surgery.
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