Document Detail

Global sagittal alignment and health-related quality of life in lumbosacral spondylolisthesis.
MedLine Citation:
PMID:  23184183     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Global sagittal alignment is considered as an important aspect in the management of spinal disorders, but the evidence establishing its clinical impact in lumbosacral spondylolisthesis is still poor. This study evaluated the impact of global sagittal alignment on the health-related quality of life (HRQOL) of patients with spondylolisthesis.
METHODS: A retrospective study of 149 consecutive unoperated children and adolescents presenting with lumbosacral spondylolisthesis (117 low-grade and 32 high-grade) was performed. Two global sagittal alignment parameters were measured on standing lateral radiographs: spinal tilt (ST) and C7 plumbline deviation (C7P deviation). All patients completed the SRS-22 questionnaire to assess HRQOL. Pearson's correlations were calculated between parameters of global sagittal alignment and HRQOL. Multiple regression analyses were also undertaken to account for slip percentage and lumbosacral kyphosis (LSK).
RESULTS: Both global sagittal alignment parameters were correlated with the SRS-22 total score. When analyzed separately, the correlation was absent in patients with a low-grade slip but remained significant for patients with a high-grade slip (r = 0.35 for ST; r = -0.35 for C7P deviation). The relation was strengthened in high-grade spondylolisthesis when considering only patients with a C7P in front of the posterior corner of upper sacral endplate (r = 0.48 for ST; r = -0.48 for C7P deviation) and was also positive for the SRS-22 pain and appearance domains. For these last patients, the relationship with global sagittal alignment remained significant in the multiple regression analysis. HRQOL was particularly worse for high-grade patients with a C7P in front of the hip axis.
CONCLUSIONS: In high-grade spondylolisthesis, an increasing positive sagittal alignment was related to a poorer SRS-22 total score, especially when the C7P is in front of the hip axis. Global sagittal alignment should particularly be assessed in patients with high-grade spondylolisthesis.
Adil Harroud; Hubert Labelle; Julie Joncas; Jean-Marc Mac-Thiong
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-11-27
Journal Detail:
Title:  European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society     Volume:  22     ISSN:  1432-0932     ISO Abbreviation:  Eur Spine J     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-22     Completed Date:  2014-02-04     Revised Date:  2014-04-01    
Medline Journal Info:
Nlm Unique ID:  9301980     Medline TA:  Eur Spine J     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  849-56     Citation Subset:  IM    
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MeSH Terms
Bone Malalignment / diagnosis,  radiography*
Cohort Studies
Disability Evaluation
Lumbar Vertebrae / radiography*
Quality of Life*
Regression Analysis
Retrospective Studies
Sacrum / radiography*
Severity of Illness Index
Spondylolisthesis / radiography*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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