Postural Balance Parameters as Objective Surgical Assessments in Low Back Disorders: A Systematic Review

in Journal of Applied Biomechanics
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Balance assessments could render useful objective performance measures to evaluate the efficacy of low back surgeries, yet these assessments have not been collectively examined to determine longitudinal sensitivity across surgical interventions. The purpose of this review was to determine sensitivity of balance measurements for disparate spinal disorders after surgical intervention. We searched PubMed, Embase, Scopus, the Cochrane Library, Web of Science, and CINAHL. Articles were selected based on: (1) sample consisted of low back disorder individuals and (2) balance measurements were obtained both pre- and postsurgery. Most of the articles addressed 2 specific low back disorders: (1) adolescent idiopathic scoliosis/spinal fusion and (2) disc herniation/decompression surgery. For scoliosis patients, body sway increased (14–97%) immediately following surgery but gradually reduced (1–33%) approaching the 1-year post spinal fusion assessment. For patients with disc herniation, sway range, sway velocity, sway area, and sway variability all decreased (19–42%) immediately postsurgery. Balance assessments for adolescents with idiopathic scoliosis who underwent surgical intervention should be performed with visual occlusion, focus on time domain parameters, and evaluated with longer follow-up times. Patients with disc herniation who underwent decompression surgery should have balance assessments with visual deprivation, test conditions specifically addressing hip strategy, and correlation with pain.

Tzu Chuan Yen is with the Department of Physiology, College of Medicine, University of Arizona, Tucson, AZ. Nima Toosizadeh, Jane Mohler, and Bijan Najafi are with the interdisciplinary Consortium on Advanced Motion Performance (iCAMP) and Southern Arizona Limb Salvage Alliance (SALSA), Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ; and the Arizona Center on Aging, University of Arizona, Tucson, AZ. Carol Howe is with the Arizona Health Sciences Library, University of Arizona, Tucson, AZ. Michael Dohm is with the Department of Orthopaedic Surgery, College of Medicine, University of Arizona, Tucson, AZ.

Address author correspondence to Nima Toosizadeh at ntoosizadeh@surgery.arizona.edu.