• Alexander Keister, Andrew Grossbach, Nathaniel Toop, Noah Mallory, David Gibbs, David Xu, and Stephanus Viljoen.
• The Ohio State University College of Medicine, Columbus, OH.
• Spine. 2023 Feb 15; 48 (4): 240246240-246.

Background ContextAdult spinal deformity (ASD) is a prevalent condition often requiring surgical intervention. Improved outcomes among ASD patients have been shown to correlate with postoperative spinopelvic parameters, yet little is currently known about the role of postural stability and balance assessment for ASD patients.PurposeExplore early changes in postural stability following ASD correction.Study DesignProspective cohort study.Patient SampleSixteen adult patients who underwent four-level or greater posterolateral fusion to address global spinal malalignment and 14 healthy controls with no known spinal deformity nor surgery.Outcome MeasuresPostural stability parameters, spinopelvic parameters preoperatively and postoperatively.MethodsForce plate balance assessment was completed where participants and healthy controls were instructed to stand with their hands at their sides, standing still, with eyes open. Center of pressure (COP), center of gravity (COG), and cone of economy (COE) parameters were analyzed with paired and unpaired t tests with an alpha of 0.05.ResultsPreoperatively, ASD patients demonstrated more COG (P=0.0244) and sagittal and coronal head (P<0.05) sway than healthy controls. Postoperatively, ASD patients exhibited less COP (P=0.0308), COG (P=0.0276) and head (P=0.0345) sway. Compared to healthy controls, ASD patients postoperatively exhibited similar postural stability, aside from COP and COG sway amplitudes (P<0.05), and coronal head sway (P=0.0309). Pelvic incidence-lumbar lordosis and sagittal vertical axis improved from 16.2° to 4.8° (P<0.01) and 82.2 to 22.5 mm (P<0.01), respectively.ConclusionWe report a novel early improvement in postural stability, comparable to healthy controls, following ASD correction that may be related to improved spinopelvic alignment. Force plate evaluation may be a useful tool for ASD patients postoperatively. Future clinical trials assessing the impact of postural stability on clinical and radiographic outcomes are warranted.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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