Paraplegic patients: how to measure balance and what is normal or functional? View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-02

AUTHORS

Kaku Barkoh, Joshua W. Lucas, Larry Lee, Patrick C. Hsieh, Jeffrey C. Wang, Kevin Rolfe

ABSTRACT

PURPOSE: To review the current understanding and data of sagittal balance and alignment considerations in paraplegic patients. METHODS: A PubMed literature search was conducted to identify all relevant articles relating to sagittal alignment and sagittal balance considerations in paraplegic and spinal cord injury patients. RESULTS: While there are numerous studies and publications on sagittal balance in the ambulatory patient with spinal deformity or complex spine disorders, there is paucity of the literature on "normal" sagittal balance in the paraplegic patients. Studies have reported significantly alterations of the sagittal alignment parameters in the non-ambulatory paraplegic patients compared to ambulatory patients. The variability of the alignment changes is related to the differences in the level of the spinal cord injury and their differences in the activations of truncal muscles to allow functional movements in those patients, particularly in optimizing sitting and transferring. Surgical goal in treating paraplegic patients with complex pathologies should not be solely directed to achieve the "normal" radiographic parameters of sagittal alignment in the ambulatory patients. The goal should be to maintain good coronal balance to allow ideal sitting position and to preserve motion segment to optimize functions of paraplegia patients. CONCLUSION: Current available literature data have not defined normal sagittal parameters for paraplegic patients. There are significant differences in postural sagittal parameters and muscle activations in paraplegic and non-spinal cord injury patients that can lead to differences in sagittal alignment and balance. Treatment goal in spine surgery for paraplegic patients should address their global function, sitting balance, and ability to perform self-care rather than the accepted radiographic parameters for adult spinal deformity in ambulatory patients. More... »

PAGES

109-114

References to SciGraph publications

  • 2011-09. Sagittal spino-pelvic balance is a crucial analysis for normal and degenerative spine in EUROPEAN SPINE JOURNAL
  • 2012-04. Postural bipedance in paraplegics under neuromuscular electrical stimulation: Is it possible to improve it based on sagittal spinal alignment? in SPINAL CORD
  • 2010-03. Sagittal spinal alignment in paraplegics: a new paradigm for the rehabilitation under neuromuscular electrical stimulation in SPINAL CORD
  • 2016-11. Normative values for the spine shape parameters using 3D standing analysis from a database of 268 asymptomatic Caucasian and Japanese subjects in EUROPEAN SPINE JOURNAL
  • 2014-10. Sitting imbalance cause and consequence of post-traumatic Charcot spine in paraplegic patients in EUROPEAN SPINE JOURNAL
  • 2014-12. The effect of age on sagittal plane profile of the lumbar spine according to standing, supine, and various sitting positions in JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
  • 2009-06. Thoracolumbar burst fracture with complete paraplegia: rationale for second-stage anterior decompression and fusion regarding functional outcome in JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY
  • 2012-11. Sagittal lumbar and pelvic alignment in the standing and sitting positions in JOURNAL OF ORTHOPAEDIC SCIENCE
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  • 1998-05. Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves in EUROPEAN SPINE JOURNAL
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00586-018-5471-x

    DOI

    http://dx.doi.org/10.1007/s00586-018-5471-x

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1100894682

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/29423886


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