Oral Presentation 51st International Society for the Study of the Lumbar Spine Annual Meeting 2025

Quantifying Functional Differences Between Unilateral Radiculopathy and Neurogenic Claudication Patients Utilizing 3D Gait Analysis (115734)

Haseeb Goheer 1 , Cindy Wang 1 , Paul Rubery 1 , Varun Puvanesarajah 1 , Andrew Megas 1 , Gabriel Ramirez 1 , Ashley Lynn Rogerson 1 , Ram Haddas 1
  1. University of Rochester Medical Center, Rochester, NY, United States

Introduction: Lumbar spinal degeneration (LD) is a leading cause of low back pain and a significant cause of disability in adults aged 45 or older1. Patients with LD present with altered gait patterns which contribute towards disability, reduced quality of life, and/or impairment of daily activities2. Gait analysis has been utilized to quantitatively assess patients with spinal disorders3.  There is little literature profiling the gait of LD surgical candidates, including patients with unilateral radiculopathy (UR) and neurogenic claudication (NC). The aim of this study was to evaluate the impact of UR and NC on an individual’s gait and quality of life. Further understanding of gait differences compared to healthy controls will enable clinicians to better elucidate the impact of LD on patients.

 

Methods: Eighty-five LD surgical candidates, consisting of 39 patients with UR, 46 with NC, as well as 35 healthy controls (H) were included in this study. Patient-reported outcomes measurement information system (PROMIS), Oswestry Disability Index (ODI), and Tampa Scale of Kinesiophobia (TSK) questionnaires were collected. Participants were fitted with a full-body external reflective marker set for three-dimensional analysis of their gait. Each patient completed five 10-meter over-ground walking trials at a self-selected speed. Spatiotemporal, joint patterns and range of motion, PROMIS, ODI, and TSK outcomes were compared between the cohorts using linear mixed-effects regression models.

 

Results: Patients with UR and NC demonstrated significantly decreased walking speeds (UR: 0.8 vs. NC: 1.0 vs. H: 1.2 m/s; p<0.001), cadence (UR: 95.6 vs. NC: 101.9 vs. H: 101.4 steps/min; p = 0.002), step lengths (UR: 0.5, NC: 0.6, H: 0.7 m; p<0.001), and step width (UR: 0.2, NC: 0.2, H: 0.1 m; p<0.001) compared to healthy controls. For kinematic measures, UR and NC patients presented with a statistically significant increase in ankle dorsiflexion (p<0.001) and reduced hip extension (p<0.001) during the stance phase of the gait cycle. Additionally, significantly increased lumbar spine extension and lumbar flexion (p=0.021) were observed in UR patients when compared to radiculopathy patients. Patients with UR had higher mean ODI (UR: 47.7 vs. NC:39.3), lower TSK scores (UR 42.3 vs. NC: 43.4), and similar PROMIS Physical Function, Pain Interference, and Mood scores.

 

Conclusions: This study demonstrates that patients with UR or NC have significant changes in spatiotemporal and kinematic gait pattern measures compared to healthy patients. Data from this study can serve as a baseline reference for further evaluation of gait in UR or NC lumbar spine patients. This study demonstrated that patients with LD exhibit abnormal gait patterns with abnormal spinal parameters and, consequently, exhibit altered biomechanics of the lower extremities. These findings provide patients and interdisciplinary providers with evidence-informed expectations related to their mobility and daily activities.  Identification of these key gait parameters can be used to help monitor and quantify postoperative recovery and rehabilitation protocols in LD patients. 

673a6a9c17e3c-Gait.jpg

  1. 1. Hoy D, March L, Brooks P, et al. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73(6):968-974. doi:10.1136/annrheumdis-2013-204428
  2. 2. Kramers-de Quervain IA, Müller R, Stacoff A, Grob D, Stüssi E. Gait analysis in patients with idiopathic scoliosis. Eur Spine J. 2004;13(5):449-456. doi:10.1007/s00586-003-0588-x
  3. 3. Engsberg JR, Bridwell KH, Wagner JM, Uhrich ML, Blanke K, Lenke LG. Gait changes as the result of deformity reconstruction surgery in a group of adults with lumbar scoliosis. Spine (Phila Pa 1976). 2003;28(16):1836-1844. doi:10.1097/00007632-200308150-00012
  4. 4. Haddas R, Ju KL, Belanger T, Lieberman IH. The use of gait analysis in the assessment of patients afflicted with spinal disorders. Eur Spine J. 2018;27(8):1712-1723. doi:10.1007/s00586-018-5569-1