Abstract
Abstract Radiography of the spine makes it possible to assess disorders in the global sagittal balance of the spine only in statics. Therefore, the assessment of the dynamic sagittal balance according to the data of three-dimensional (3D) gait analysis including the balance of the trunk in general (in the sagittal and frontal planes) and the lumbosacral area, in particular, and determination of the compensatory mechanisms employed by the patient while walking due to the body segments and limbs, is getting more topical. Foreign publications on these topics in the last decade in the search resources of PubMed, e-Library, Cochrane Library and Scholar Google are not numerous, and there are no domestic ones at all, that, in turn, requires an independent detailed study. Purpose Primary analysis of the literature with the identification of methods and criteria for assessing the dynamic balance of the body. Materials and Methods In preparation of the review, the search and information resources of PubMed, eLibrary, Cochrane Library and Scholar Google were used. In the resources of the scientific e-Llibrary, there are no publications on the sagittal dynamic balance, that, in turn, requires an independent detailed analysis. Results and Discussion The postural model that considers the trajectory of movement of the center of mass (CoP) below foot was used to assess the dynamic sagittal balance. It is possible to evaluate the compensatory mechanisms for maintenance of dynamic sagittal balance basing only on the data of three-dimensional (3D) analysis of gait motions. Compensated / decompensated condition of the dynamic balance was defined according to the data of the ground reaction in 3 planes, the motions of the chest with regards to the pelvis, and according to the evaluation of the frontal vertical alignment (CVA-G) and sagittal vertical alignment (SVA-G). Conclusion The standard medical block for 3D gait analysis allows to perform quantitative estimation of compensatory mechanisms for sagittal imbalance, such as in-phase / antiphase coordination pattern of the trunk with regards to the pelvis; the compensated / decompensated condition of the dynamic balance according to the Ground Reaction data in three planes; and compensatory mechanisms, manifested in the parameters of the kinetics and kinematics of the lower limb joints. Assessment of dynamic sagittal balance is carried out in laboratories, where there is a software with an additional calculation option. Two main directions were proposed for its formation, taking into account either the maximum approximation to the X-ray criterion, or to the anatomical position of the center of mass.
Highlights
The transition to upright posture in humans was carried out through morphological adaptation of the skeleton in ontophylogenesis, in particular, of the lower extremities, pelvis and spine [1]
The parameters of the global spine balance are usually considered in the context of the “cone of economy” (COE) proposed in 1994 by J
The optimal balance of the spinal column allows you to maintain the position of the trunk within the boundaries of the base of support (BOS), the designated cone without additional energy consumption
Summary
The transition to upright posture in humans was carried out through morphological adaptation of the skeleton in ontophylogenesis, in particular, of the lower extremities, pelvis and spine [1]. Spinal curves allow maintaining neutral vertical alignment of the spine in the sagittal plane to reduce stress loads on the musculoligamentous structures - sagittal balance [3, 4, 5]. Spine alignment is postural radiographic information currently assessed on static radiographs, which serve as the basis for preoperative and postoperative evaluation of patients. From the standpoint of assessing the sagittal balance by the method of 3D video analysis of movements, two aspects of the biomechanics of the spine are considered: the problems of the balance of the trunk in general (in the sagittal and frontal planes) and the lumbosacral region in particular. There are not many international publications on these topics in the last decade in the PubMed, e-Library, Cochrane Library, Scholar Google, and there are no Russian publications at all, which, in turn, requires an independent detailed analysis
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