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Review
. 2022 Mar;8(1):139-148.
doi: 10.21037/jss-21-91.

Analysing gait patterns in degenerative lumbar spine diseases: a literature review

Pragadesh Natarajan  1   2   3 , R Dineth Fonseka  1   2   3 , Sihyong Kim  1   2   3 , Callum Betteridge  1   2   3 , Monish Maharaj  1   2   3 , Ralph J Mobbs  1   2   3
Affiliations
Review

Analysing gait patterns in degenerative lumbar spine diseases: a literature review

Pragadesh Natarajan et al. J Spine Surg. 2022 Mar.

Abstract

Objectives: To collate the current state of knowledge and explore differences in the spatiotemporal gait patterns of degenerative lumbar spine diseases: lumbar spinal stenosis (LSS), lumbar disc herniation (LDH) and low back pain (LBP).

Background: LBP is common presenting complaint with degenerative lumbar spine disease being a common cause. In particular, the gait patterns of LSS, LDH and mechanical-type (facetogenic and discogenic) LBP is not established.

Methods: A search of the literature was conducted to determine the changes in spatial and temporal gait metrics involved with each type of degenerative lumbar spine disease. A search of databases including Medline, Embase and PubMed from their date of inception to April 18th, 2021 was performed to screen, review and identify relevant studies for qualitative synthesis. Seventeen relevant studies were identified for inclusion in the present review. Of these, 5 studies investigated gait patterns in LSS, 10 studies investigated LBP and 2 studies investigated LDH. Of these, 4 studies employed wearable accelerometry in LSS (2 studies) and LBP (2 studies).

Conclusions: Previous studies suggest degenerative diseases of the lumbar spine have unique patterns of gait deterioration. LSS is characterised by asymmetry and variability. Spatiotemporal gait deterioration in gait velocity, cadence with increased double-support duration and gait variability are distinguishing features in LDH. LBP involves marginal abnormalities in temporal and spatial gait metrics. Previous studies suggest degenerative diseases of the lumbar spine have unique patterns of gait deterioration. Gait asymmetry and variability, may be relevant metrics for distinguishing between the gait profiles of lumbar spine diseases.

Keywords: Degenerative disease; disc herniation; lumbar spine, gait patterns; spinal stenosis.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jss.amegroups.com/article/view/10.21037/jss-21-91/coif). The series “Objective Monitoring and Wearable Technologies including Sensor-Based Accelerometers and Mobile Health Applications for the Spine Patient” was commissioned by the editorial office without any funding or sponsorship. RJM served as the unpaid Guest Editor of the series and serves as the Editor-in-Chief of Journal of Spine Surgery. RDF and PN served as the unpaid Guest Editors of the series and serve as unpaid Assistant Managing Editors of Journal of Spine Surgery. The authors have no other conflicts of interest to declare.

Figures

Figure 1
Figure 1
Gait phases for one gait cycle of right (shaded) leg illustrating stance, swing, single-limb support, double-limb support.
See this image and copyright information in PMC

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