Gait and Stability Analysis of People After Osteoporotic Spinal Fractures Treated with Minimally Invasive Surgery

骨质疏松性脊柱骨折患者接受微创手术治疗后的步态和稳定性分析

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Abstract

Background: Osteoporotic vertebral fractures in the thoracic-lumbar spine are common in older adults and can lead to pain, kyphotic posture, impaired postural control, and altered gait. These changes increase the risk of falls and reduce functional mobility, highlighting the need for effective assessment and intervention strategies. Objectives: To analyze stability and gait in patients who sustained a thoracic-lumbar spinal fracture and underwent minimally invasive surgery. Methods: Seventeen patients participated in this study (women = 11, age 68.36 ± 6.15 years, body weight 68.18 ± 12.8 kg, height 161.45 ± 5.26 cm; men = 6, age 62.67 ± 4.41 years, body weight 78.5 ± 20.36 kg, height 176.67 ± 12.64 cm). All participants had undergone minimally invasive spinal surgery using percutaneous screws reinforced with bone cement 12 months prior. Each patient underwent two assessments: postural stability measurement and biomechanical gait analysis. Statistical analysis was performed using Statistica software (StatSoft, PL), with significance set at p < 0.05. Results: In the stability test, seven participants could not complete the measurement due to falls (FRT = 6.45 ± 2.43), six performed within the normal range (FRT = 2.41 ± 0.9), and four were below the normal range for their age group (FRT = 2.22 ± 1.7). Patients exhibited slower walking speed, shorter stride length, and reduced hip extension during the stance phase (approximately 5° less) due to a forward-leaning posture and cautious gait. Foot placement was flat rather than heel-first, likely as a compensatory strategy to enhance safety. Conclusions: Patients after osteoporotic thoracic-lumbar vertebral fractures treated with minimally invasive surgery demonstrate shorter, wider, and slower steps, along with reduced postural stability, indicating a persistent risk of forward falls.

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