Postural Stability and Dynamic Balance in Adult Spinal Deformity: Prospective Pilot Study

• Published in: World neurosurgery Vol. 141; pp. e783 - e791
• Main Authors: Godzik, Jakub, Frames, Christopher W., Smith Hussain, Victoria, Olson, Markey C., Kakarla, U. Kumar, Uribe, Juan S., Lockhart, Thurmon E., Turner, Jay D.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2020
• Subjects: Accidental Falls; Adult spinal deformity; Aged; Balance; Dynamic stability; Falls; Female; Humans; Kyphosis; Male; Middle Aged; Pilot Projects; Postural Balance; Postural stability; Prospective Studies; Quality of life; Spinal Curvatures - complications; Spinal Curvatures - physiopathology; Kyphosis; COP; Postural stability; Adult spinal deformity; EO; Quality of life; Falls; ASD; SRS; Dynamic stability; SOT; COG; Balance; EC; MCT
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2020.06.010

We sought to evaluate dynamic balance and postural stability in patients with adult spinal deformity (ASD) compared with published age-matched normative data. Eleven patients with ASD were prospectively enrolled. Postural stability was tested using static and dynamic posturography; patients stood on a movable platform with an integrated force plate and performed standardized sensory organization testing (SOT), evaluating the influence of sensory processing on postural stability under 6 conditions, and motor control testing, assessing reflexive postural reactions to an external perturbation. Patient performance was compared with that of published age-matched controls. Quality of life metrics included scores on the Scoliosis Research Society−22 questionnaire, SF-36, and Morse Fall Scale. Correlations between postural stability and radiographic measurements were performed. ASD patients demonstrated significantly lower SOT scores (P ≤ 0.03) in 5 of 6 conditions tested and greater latency of limb movement during backward translation (P = 0.04) compared with controls. Lower SOT scores were associated with a history of falls. ASD patients who self-reported falling in the previous 6 months, when compared with nonfallers, demonstrated significantly lower SOT scores (P = 0.04) and significantly lower Scoliosis Research Society−22 self-image subscores (P = 0.003). Thoracic kyphosis and mediolateral sway (predictor of falls) were positively correlated in the eyes-open and eyes-closed conditions (P ≤ 0.04). ASD patients demonstrated impaired postural stability, diminished sensory integration, and delayed response to external perturbations compared with normal control data. Postural stability and quality of life metrics correlated with self-reported falls. These findings suggest that ASD patients have abnormal postural stability and may be at elevated risk of falls.