Philip J York1, Han Jo Kim2. 1. Department of Orthopaedic Surgery, University of Colorado, Aurora, CO, USA. 2. Hospital for Special Surgery, New York, NY, 10021, USA. KimH@hss.edu.
Abstract
PURPOSE OF REVIEW: The purpose of this review is to provide an updated review of adult degenerative scoliosis (ADS). Epidemiology, classification, pathophysiology, and natural history are discussed along with a summary of commonly used outcome measures. Operative vs non-operative outcomes and new surgical techniques are discussed. RECENT FINDINGS: The SRS-Schwab classification (2012) combines clinical and radiographic evaluation including overall global alignment. Current evidence regarding risk factors and efficacy of non-surgical modalities are discussed. Recent studies have reported surgical management to provide superior outcomes to non-operative modalities. New surgical techniques provide promising early data in regard to decreasing perioperative morbidity. ADS is a potentially debilitating condition that occurs with asymmetric spinal degeneration. This can produce global sagittal malalignment and central and foraminal stenosis and can lead to significant impairment often necessitating surgery. The surgeon must be aware of the perioperative risks in this population and implement appropriate age-specific alignment goals to achieve the best outcome for patients.
PURPOSE OF REVIEW: The purpose of this review is to provide an updated review of adult degenerative scoliosis (ADS). Epidemiology, classification, pathophysiology, and natural history are discussed along with a summary of commonly used outcome measures. Operative vs non-operative outcomes and new surgical techniques are discussed. RECENT FINDINGS: The SRS-Schwab classification (2012) combines clinical and radiographic evaluation including overall global alignment. Current evidence regarding risk factors and efficacy of non-surgical modalities are discussed. Recent studies have reported surgical management to provide superior outcomes to non-operative modalities. New surgical techniques provide promising early data in regard to decreasing perioperative morbidity. ADS is a potentially debilitating condition that occurs with asymmetric spinal degeneration. This can produce global sagittal malalignment and central and foraminal stenosis and can lead to significant impairment often necessitating surgery. The surgeon must be aware of the perioperative risks in this population and implement appropriate age-specific alignment goals to achieve the best outcome for patients.
Authors: Frank Schwab; Benjamin Ungar; Benjamin Blondel; Jacob Buchowski; Jeffrey Coe; Donald Deinlein; Christopher DeWald; Hossein Mehdian; Christopher Shaffrey; Clifford Tribus; Virginie Lafage Journal: Spine (Phila Pa 1976) Date: 2012-05-20 Impact factor: 3.468
Authors: Justin K Scheer; Justin S Smith; Aaron J Clark; Virginie Lafage; Han Jo Kim; John D Rolston; Robert Eastlack; Robert A Hart; Themistocles S Protopsaltis; Michael P Kelly; Khaled Kebaish; Munish Gupta; Eric Klineberg; Richard Hostin; Christopher I Shaffrey; Frank Schwab; Christopher P Ames Journal: J Neurosurg Spine Date: 2015-02-20
Authors: Justin S Smith; Christopher I Shaffrey; Kai-Ming G Fu; Justin K Scheer; Shay Bess; Virginie Lafage; Frank Schwab; Christopher P Ames Journal: Neurosurg Clin N Am Date: 2013-02-21 Impact factor: 2.509