Adult degenerative lumbar scoliosis.

Degenerative scoliosis of the lumbar spine affects a significant number of adults. Although the etiology of this condition is not clear, the most commonly implicated causes include osteoporosis and degenerative disc disease. Clinically, patients with this condition most commonly complain of axial low back pain, but they may also present with radicular complaints. This pain may be generated directly by the facet joints or may be due to nerve root impingement or traction. Imaging of this spinal deformity should include both plain radiographs and computed tomographic myelography. Nonoperative therapy is ideal, but surgery is indicated for severe radicular symptoms refractory to conservative management or for progression of the curve. Ideally, surgical treatment should consist of decompression and fusion with segmental instrumentation.