Gait and Paraspinal sEMG in Degenerative Spinal Diseases (TDGKSEPDSD)

Capital Medical University

Status: Not yet enrolling

Conditions: Sagittal Imbalance; Cervical Spondylosis With Myelopathy; Sagittal Deformity; Lumbar Spinal Stenosis; Lumbar Disc Herniation; Degenerative Scoliosis; Adult Spinal Deformity; Coronal Vertical Axis

Treatments: Other: Gait analysis and surface electromyography analysis

Study type: Observational

Funder types: Other

Identifiers

NCT07309926

xuanwu_DSD

Details and patient eligibility

About

This cross-sectional observational study aims to quantitatively compare three-dimensional gait parameters, surface electromyography (EMG) patterns, and radiological parameters among patients with different degenerative spinal conditions-including lumbar disc herniation (LDH), lumbar spinal stenosis (LSS), lumbar sagittal imbalance (LSI), degenerative lumbar scoliosis (DLS), and cervical spondylotic myelopathy (CSM)-alongside a healthy control group. The analysis focuses on spatiotemporal gait characteristics (step length, stride length, cadence), lower limb kinematics and kinetics (hip/knee/ankle joint angles, moments, and powers during stance and swing phases), and surface EMG amplitudes (thoracic erector spinae, multifidus, gluteus maximus, and rectus abdominis muscles) during standardized walking tasks. Additionally, radiological parameters (e.g., pelvic incidence-lumbar lordosis mismatch, C2-C7 sagittal vertical axis, coronal Cobb angle) will be correlated with gait and muscle activation deviations. The study employs motion capture systems, force plates, and high-density EMG to objectively differentiate disease-specific movement impairments. Findings from this study may establish biomechanical and neuromuscular signatures for each degenerative condition, providing a framework for personalized rehabilitation strategies, gait retraining, and surgical outcome assessment in spinal disorders. Comparative analysis with healthy controls will further elucidate pathological alterations in gait and muscle recruitment patterns caused by degenerative spinal diseases.

Enrollment: 120 estimated patients

Sex: All

Ages: 60+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. Patients with the following single disease: degenerative scoliosis, coronal imbalance, lumbar spinal stenosis, lumbar disc herniation, spinal cord-type cervical spondylosis;
2. Age ≥ 60 years, regardless of gender;
3. Planned to undergo elective open spinal fusion surgery;
4. Voluntarily participate in the study, understand and agree to the study content, and sign the informed consent form.

Exclusion criteria

1. History of previous spinal surgery;

2. Combined with other neuromuscular diseases (such as Parkinson's disease), inflammatory diseases (such as ankylosing spondylitis), infectious diseases (such as spinal tuberculosis), sepsis, tumors, or lower limb joint diseases that may cause low back and lower limb pain, affecting physical activity;

3. Suffering from severe cardiovascular, cerebral, liver, or kidney disease;

4. Suffering from mental illness, dementia, or unable to cooperate to complete clinical research.

   • Skin rupture in the waist;

Trial design

120 participants in 6 patient groups

Degenerative Scoliosis Group

Description:

This group comprised elderly patients (\>60 years old) diagnosed with degenerative lumbar scoliosis (DLS) (Cobb angle \>20°). Patients were excluded if they had concurrent neurological disorders, other spinal pathologies, or lower limb conditions that could influence gait mechanics. Additionally, individuals with a history of spinal or lower limb surgery were also excluded to minimize confounding factors.

Treatment:

Other: Gait analysis and surface electromyography analysis

Sagittal Imbalance Group

Description:

This group comprised elderly patients (\>60 years old) diagnosed with sagittal imbalance (PI-LL \>20° , SVA \> 4cm or PT \> 20°). Patients were excluded if they had concurrent neurological disorders, other spinal pathologies, or lower limb conditions that could influence gait mechanics. Additionally, individuals with a history of spinal or lower limb surgery were also excluded to minimize confounding factors.

Treatment:

Other: Gait analysis and surface electromyography analysis

lumbar spinal stenosis Group

Description:

This group comprised elderly patients (≥60 years old) clinically diagnosed with lumbar spinal stenosis (LSS) through radiographic findings and symptomatology. Exclusion criteria encompassed: (1) concurrent neurological disorders (e.g., peripheral neuropathy, cerebrovascular disease); (2) comorbid spinal pathologies (e.g., degenerative scoliosis, spondylolisthesis); (3) lower extremity conditions potentially impacting gait biomechanics (e.g., severe osteoarthritis, prior arthroplasty); and (4) any history of spinal or lower limb surgical interventions, thereby minimizing potential confounders.

Treatment:

Other: Gait analysis and surface electromyography analysis

Lumbar disc herniation Group

Description:

This group comprised elderly patients (≥60 years old) clinically diagnosed with Lumbar disc herniation (LDH) through radiographic findings and symptomatology. Exclusion criteria encompassed: (1) concurrent neurological disorders (e.g., peripheral neuropathy, cerebrovascular disease); (2) comorbid spinal pathologies (e.g., degenerative scoliosis, spondylolisthesis); (3) lower extremity conditions potentially impacting gait biomechanics (e.g., severe osteoarthritis, prior arthroplasty); and (4) any history of spinal or lower limb surgical interventions, thereby minimizing potential confounders.

Treatment:

Other: Gait analysis and surface electromyography analysis

Cervical Spondylosis with Myelopathy Group

Description:

This group comprised elderly patients (≥60 years old) clinically diagnosed with Cervical Spondylosis with Myelopathy Group through radiographic findings and symptomatology. Exclusion criteria encompassed: (1) concurrent neurological disorders (e.g., peripheral neuropathy, cerebrovascular disease); (2) comorbid spinal pathologies (e.g., degenerative scoliosis, spondylolisthesis); (3) lower extremity conditions potentially impacting gait biomechanics (e.g., severe osteoarthritis, prior arthroplasty); and (4) any history of spinal or lower limb surgical interventions, thereby minimizing potential confounders.

Treatment:

Other: Gait analysis and surface electromyography analysis

Healthy Volunteer Group

Description:

This group comprised healthy elderly patients (≥60 years old) . Exclusion criteria encompassed: (1) concurrent neurological disorders (e.g., peripheral neuropathy, cerebrovascular disease); (2) comorbid spinal pathologies (e.g., degenerative scoliosis, LSS, LDH, spondylolisthesis); (3) lower extremity conditions potentially impacting gait biomechanics (e.g., severe osteoarthritis, prior arthroplasty); and (4) any history of spinal or lower limb surgical interventions, thereby minimizing potential confounders.

Treatment:

Other: Gait analysis and surface electromyography analysis