Effects of Lateral Trunk Support on Scoliotic Spinal Alignment in Persons With Spinal Cord Injury: A Radiographic Study

Abstract

Mao H-F, Huang S-L, Lu T-W, Lin Y-S, Liu H-M, Wang Y-H, Wang T-M. Effects of lateral trunk support on scoliotic spinal alignment in persons with spinal cord injury: a radiographic study. Objective To develop a radiographic method for measuring the spinal alignment of a person in a seated position and with which to investigate the effects of lateral trunk supports (LTS) in special seating on the frontal and sagittal spinal alignment in persons with spinal cord injury (SCI). Design Before-after trial. Setting University-based research laboratory. Participants Ten men and 7 women who had SCI with scoliosis (age, 35.4±9.4y; injury level, C5-T11) voluntarily participated. Intervention An adjustable seating system with LTS. Main Outcome Measures Radiographs of the spine in the anteroposterior (AP) and lateral directions were taken while sitting on an adjustable seating system without and with LTS. The Cobb angles and scoliotic indices based on the AP radiographic images and the angles of the thoracic and lumbar spine based on lateral were calculated. The relative change in angle (RCA) with LTS in terms of the percentage reduction of the Cobb angles was also obtained. Results The Cobb angles and scoliotic indices while sitting with LTS were significantly smaller than those without, the mean difference of Cobb angles ± standard error (SE) being 9.12°±1.64° ( P<.001) and those for the scoliotic indices being .09±.04 ( P=.027). The mean RCA ± SE was 26.16%±4.23%. The RCA correlated weakly with the original Cobb angles ( r=−.347, P=.172). The LTS caused a significant reduction in the lumbar angles ( P<.001), but no significant effects on the thoracic angles were found. Conclusions The radiographic findings demonstrate improved scoliotic spinal alignment in the frontal plane and reduced lumbar angles in the sagittal plane in persons with SCI when seated in a special seat and using LTS.