The Study: Global sagittal alignment and health-related quality of life in lumbosacral spondylolisthesis.

The Facts:

  1. In the management of spinal disorders global alignment is considered to be important.
  2. “This study evaluated the impact of global sagittal alignment on the health-related quality of life (HRQOL) of patients with spondylolisthesis.”
  3. They measured global sagittal alignment on standing lateral full spine radiographs.
  4. There were 149 subjects aged 13.5 years, plus or minus 7 years, who all suffered from spondylolisthesis.
  5. Out of the 149 subjects 117 had a low-grade spondylolisthesis slip which was defined as less than 50% and the other 32 had a high grade slip which was defined as a slip of over 50%.
  6. They also measured two global sagittal parameters, spinal tilt and C7 plumbline deviation (C7P).
  7. Both parameters were correlated with SRS-22 total scores which were used to assess HRQOL.
  8. The correlation was significant in those who suffered from high grade spondylolisthesis but not in those subjects with low grade spondylolisthesis.
  9. “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.”

Take Home:

In patients with high grade spondylolisthesis, poor sagittal alignment was significantly correlated to health- related quality of life as measured by the SRS-22.

Reviewer’s Comments:

The authors indicate that spinal alignment can affect quality of life. In addition, they state, “Global sagittal alignment should particularly be assessed in patients with high-grade spondylolisthesis.” Once again alignment does seem to matter.

Reviewer: Roger Coleman DC

Editor’s Comments: More research supporting the fact that spinal alignment matters. At least it matters to everyone except the 90 plus percent of chiropractors who rarely, if ever, bother to actually measure global posture on radiographs.

Editor: Mark R. Payne DC

Reference: Harroud A, Labelle H, Joncas J, Mac-Thiong JM. Global sagittal alignment and health-related quality of life in lumbosacral spondylolisthesis. Eur Spine J.  2013 Apr;22(4):849-56. doi: 10.1007/s00586-012-2591-6. Epub 2012 Nov 27.

Link to Full Text Article: