3-dimensional assessment of "Cone of Economy" and post-operative standing balance improvement in patients with spinal disorders

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K18021
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 56020:Orthopedics-related
• Research Institution: The University of Tokyo
• Principal Investigator: Kato So 東京大学, 医学部附属病院, 助教 (50822061)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 脊椎 / 3次元 / 動作解析 / 脊柱変形

Outline of Final Research Achievements

Dubousset et al. proposed that the "cone of economy" (COE) in the inverted pendulum model of human standing increases significantly in patients with balance impairment. The clinical significance of COE size measured by motion capture as a postural sway index in adult spinal deformity (ASD) patients remains unclear. In the subgroup of ASD patients with preoperative breakdown of balance compensation mechanisms leading to an increase in COE size, balance significantly influences preoperative quality of life (QOL), and the reduction of COE postoperatively indicates its utility as an evaluation scale. Conversely, in cases where balance compensation is possible from preoperative stages, capturing postoperative changes is challenging, and adverse effects of long-segment fixation are considered. COE size is a useful measure in ASD patients where the compensation mechanism for balance is compromised.

Free Research Field

脊椎

Academic Significance and Societal Importance of the Research Achievements

成人脊柱変形（ASD）患者のうち術前からバランスの代償機構が破綻しCOEサイズが増大している群では、バランスは術前QOLに影響し、術後にCOEが縮小したことから、評価尺度として有用である。一方、術前からバランスの代償が可能な症例では術後変化を捉えることは困難で、長範囲固定による悪影響が考えられる。
COEサイズはバランスの代償が破綻したASD患者において有用な尺度である。