Postural Stability and Dynamic Balance in Adult Spinal Deformity: Prospective Pilot Study

Jakub Godzik, Christopher W. Frames, Victoria Smith Hussain, Markey C. Olson, U. Kumar Kakarla, Juan S. Uribe, Thurmon E. Lockhart, Jay D. Turner

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Objective: We sought to evaluate dynamic balance and postural stability in patients with adult spinal deformity (ASD) compared with published age-matched normative data. Methods: Eleven 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. Results: ASD 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). Conclusions: ASD 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.

Original languageEnglish (US)
Pages (from-to)e783-e791
JournalWorld Neurosurgery
StatePublished - Sep 2020


  • Adult spinal deformity
  • Balance
  • Dynamic stability
  • Falls
  • Kyphosis
  • Postural stability
  • Quality of life

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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