Crouch gait in persons with positive sagittal spine alignment resolves with surgery

- Spinal reconstruction surgery resolved positive sagittal alignment.
- Pre-operative crouch gait resolved after spinal surgery.
- Step length and stride length increased after spinal surgery.
- No significant changes were seen in walking speed, cadence and step width.

ObjectiveDegenerative spinal conditions often result in positive sagittal alignment which may be corrected using multi-segment spinal reconstructive surgeries. The purpose of this study was to investigate gait kinematics before and after spinal reconstructive surgery in persons with positive sagittal alignment.MethodsSubjects presenting with positive sagittal alignment of greater than or equal to 7 cm who were treated with spinal reconstructive surgery were included in this study. Gait analyses were conducted pre- and 6 months post-operatively. Data were collected while subjects stood quietly for 20 s and walked at their normal self-selected walking speed.ResultsFor 12 subjects, sagittal spine alignment during standing and walking was significantly decreased post-operatively (p < 0.0001 for standing and p < 0.0005 for walking). Prior to surgery, the subjects appeared to adopt a crouch gait with the knee flexion angle at mid terminal stance decreasing significantly after surgery (p < 0.0 for the dominant lower limb and p < 0.0 for the non-dominant lower limb). Additionally, dominant step length (p < 0.003) and non-dominant step length (p < 0.001) increased significantly after surgery.ConclusionsPositive sagittal alignment resulted in crouch gait, which was resolved after multi-segment reconstructive spinal surgery that improved sagittal spinal alignment. Step and stride lengths also improved after surgical correction of the sagittal alignment.