The relationship between gait profile and spino-pelvic alignment in patients with adolescent idiopathic scoliosis of Lenke type 1 and 5

Minjun Choi; Tae Sik Goh; Jung Sub Lee

doi:10.1016/j.jocn.2025.111444

The relationship between gait profile and spino-pelvic alignment in patients with adolescent idiopathic scoliosis of Lenke type 1 and 5

J Clin Neurosci. 2025 Jul 1:139:111444. doi: 10.1016/j.jocn.2025.111444. Online ahead of print.

Authors

Minjun Choi¹, Tae Sik Goh², Jung Sub Lee³

Affiliations

¹ Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University, Busan, Korea.
² Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University, Busan, Korea. Electronic address: taesikgoh@pusan.ac.kr.
³ Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University, Busan, Korea. Electronic address: jungsublee@pusan.ac.kr.

PMID: 40602273
DOI: 10.1016/j.jocn.2025.111444

Abstract

Adolescent idiopathic scoliosis (AIS) is a complex three-dimensional structural deformity of the spine. While studies have reported gait abnormalities in AIS patients and their impact on patients' quality of life, the interrelationship between the sagittal spino-pelvic alignment and gait kinematics has not yet been elucidated. The purpose of this study is to investigate the association between gait profile and sagittal alignment in AIS patients, especially with Lenke type 1 and 5 curve deformities. The study group consisted of 111 AIS patients and sixty healthy controls. Standing spinal radiographs and gait analysis were performed for all participants. Gait parameters included gait speed, step length, stance phase, cadence, single leg support, double legs support, gait asymmetry (GA), and phase coordination index (PCI). Radiographic parameters included pelvic tilt (PT), sacral slope (SS), pelvic incidence (PI), thoracic kyphosis (TK), lumbar lordosis (LL), Cobb's major curve angle, sagittal vertical axis (SVA), and coronal balance (CB). There were statistically significant differences between the AIS group and the control in gait speed, step length, cadence, single leg support, double legs support, GA, PT, TK, SVA, and CB. However, no significant difference was observed between the groups in stance phase, PCI, SS, PI, and LL (p > 0.05). In addition, correlation analysis revealed significant relationships between the following pairs of gait and sagittal alignment parameters in the AIS patients; step length was related with SS, PT, and LL, PCI with CB, GA with TK and CB. Multiple regression analysis of gait and sagittal profile also indicated that PT and SS are accurate predictors of step length and CB is a predictor of GA. In conclusion, our findings demonstrated that there are significant differences in gait kinematics and sagittal spino-pelvic alignment between the AIS patients and healthy population and that these parameters are closely correlated in the AIS patients.

Keywords: Adolescent idiopathic scoliosis; Gait; Sagittal alignment; Spinal alignment.