• Spine · Jan 2020

    The Transverse Gravitational Deviation Index, a Novel Gravity Line-related Spinal Parameter, Relates to Balance Control and Health-related Quality of Life in Adults with Spinal Deformity.

    • Lieven Moke, Thomas Overbergh, Pieter Severijns, Sebastiaan Schelfaut, Pierre Moens, Kristel Van de Loock, Lore Hermans, Guy Molenaers, Ilse Jonkers, and Lennart Scheys.
    • Department of Development and Regeneration, Institute for Orthopaedic Research and Training (IORT), KU Leuven, Belgium.
    • Spine. 2020 Jan 1; 45 (1): E25-E36.

    Study DesignProspective cross-sectional case-control study design.ObjectiveThis study aims to analyze the relation between balance control as well as health-related quality of life (HRQOL) in patients with adult spinal deformity (ASD), with a novel gravity line (GL)-related 3D spinal alignment parameter, the transverse gravitational deviation index (TGDI), defined to quantify the transverse plane position of any vertebra with respect to the GL.Summary Of Background DataDemographic data and balance control have both been identified as important determinants of HRQOL in ASD patients during a preoperative setting. Therefore, a better understanding of the relation between spinal alignment and balance is required.MethodsAfter informed consent, 15 asymptomatic healthy volunteers (mean age 60.1 ± 11.6 years old) and 55 ASD patients (mean age 63.5 ± 10.1 years old) were included. Relation between performance on BESTest as well as core outcome measures index (COMI) with spinopelvic alignment was explored using General Linear Modeling (GLM). A P-value ≤0.05 was considered statistically significant.ResultsThe L3 TGDI was identified to relate to balance control in the total ASD population after correction for confounding demographic factors (P = 0.001; adjusted R = 0.500) and explained 19% of the observed variance in balance performance. In addition, COMI is related to L3 TGDI in a subgroup of ASD patients with combined coronal and sagittal malalignment of L3 (P = 0.027; slope B = 0.047), despite significant influence of age (P = 0.020).ConclusionIn ASD patients with a combined coronal and sagittal malalignment of the L3 vertebra, both the level of balance impairment as well as HRQOL are related to the distance component of the L3 TGDI, that is, the offset between the center of the L3 vertebral body and the GL in the transverse plane.Level Of Evidence2.

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