• Jakub Godzik, Christopher W Frames, Smith Hussain Victoria V School of Biological and Health Systems Engineering, Biological Design Program, Arizona State University, Tempe, Arizona., Markey C Olson, U Kumar Kakarla, Juan S Uribe, Thurmon E Lockhart, and Jay D Turner.
• Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
• World Neurosurg. 2020 Sep 1; 141: e783-e791.

ObjectiveWe sought to evaluate dynamic balance and postural stability in patients with adult spinal deformity (ASD) compared with published age-matched normative data.MethodsEleven patients with ASD were prospectively enrolled. Postural stability was tested using static and dynamic posturography; patients stood on a movable platform with an integrated force plate and performed standardized sensory organization testing (SOT), evaluating the influence of sensory processing on postural stability under 6 conditions, and motor control testing, assessing reflexive postural reactions to an external perturbation. Patient performance was compared with that of published age-matched controls. Quality of life metrics included scores on the Scoliosis Research Society-22 questionnaire, SF-36, and Morse Fall Scale. Correlations between postural stability and radiographic measurements were performed.ResultsASD patients demonstrated significantly lower SOT scores (P ≤ 0.03) in 5 of 6 conditions tested and greater latency of limb movement during backward translation (P = 0.04) compared with controls. Lower SOT scores were associated with a history of falls. ASD patients who self-reported falling in the previous 6 months, when compared with nonfallers, demonstrated significantly lower SOT scores (P = 0.04) and significantly lower Scoliosis Research Society-22 self-image subscores (P = 0.003). Thoracic kyphosis and mediolateral sway (predictor of falls) were positively correlated in the eyes-open and eyes-closed conditions (P ≤ 0.04).ConclusionsASD patients demonstrated impaired postural stability, diminished sensory integration, and delayed response to external perturbations compared with normal control data. Postural stability and quality of life metrics correlated with self-reported falls. These findings suggest that ASD patients have abnormal postural stability and may be at elevated risk of falls.Copyright © 2020 Elsevier Inc. All rights reserved.

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