Reviewer’s comment on “Sagittal balance of 85 patients with a lumbar degenerative disease: a comparative study” (by Cédric Y. Barrey et al.), (ESJ-05-0488.R2)

Excerpt

In recent studies, “abnormal” sagittal balance has been shown to correlate with increased pain and decreased function in adult deformity patients both before and after surgical treatment [1‐3]. It has also been suggested as a factor in postoperative pain [5] and adjacent segment degeneration [4] after shorter lumbosacral fusions. And yet, our understanding of what constitutes “normal” or “abnormal” sagittal balance remains unclear. Furthermore, the definitions of sagittal plane indices in the literature have varied considerably with inconsistent measurement methods. The authors of the present study “ Sagittal balance of 85 patients with a lumbar degenerative disease: a comparative study” have contributed significantly to this poorly understood subject. …