Correlation of Radiographic Parameters and Clinical Symptoms in Adult Scoliosis

By S. Glassman, S. Berven, K. Bridwell, W. Horton, J. Dimar. Spine, 2005

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The Impact of Positive Sagittal Balance in Adult Spinal Deformity (2005, background): “In a recent multicenter study of 298 adults with spinal deformity, positive sagittal balance was identified as the radiographic parameter most highly correlated with adverse health status outcomes.(14) Positive sagittal balance was defined as an anterior deviation of the C7 plumb line measurement.”
Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. (2015, background): “Sagittal balance and lumbar lordosis correction have become important goals as these indicators have been shown to significantly improve outcomes (81).”
Cervical spine alignment, sagittal deformity, and clinical implications: a review. (2013, background): “In fact, both Glassman et al. 27 and Mac-Thiong et al. 69 concluded that positive sagittal malalignment, defined as a C-7 plumb line greater than 50 mm anterior to the posterosuperior aspect of the sacrum, is associated with a deterioration of quality of life in patients with adult spinal deformity.”