Adolescent idiopathic scoliosis : functional impacts of natural evolution, orthopaedic and surgical treatments on gait

(eng) Thoracolumbar and lumbar curves in adolescent idiopathic scoliosis (AIS) induce pelvic structural abnormalities. The pelvis is an important determinant of normal gait. Consequently, thoracolumbar/lumbar AIS may be associated with abnormal gait. Orthotic and surgical treatments, by reducing spinal mobility, could be more deleterious to gait. This work aimed to quantitatively and objectively assess gait, including kinematics, electromyography, mechanical work and energy consumption. The studied population was adolescent girls with thoracolumbar or lumbar main scoliosis curves and normal subjects. The results of our studies are very surprising. Overall, scoliosis does not disturb body motion during gait, except that there is a prolonged EMG timing activity of the lumbo-pelvic muscles and excessive energy consumption. We found no effect of severity or asymmetry on gait. Both orthotic and surgical treatments partially correct the pelvis and hip motions as well as mechanical muscular work. Prolonged bilateral EMG activities of the lumbo-pelvic muscles and energy cost remain excessive before and after treatment.