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. 2011 Oct;7(3):257-64.
doi: 10.1007/s11420-011-9204-5. Epub 2011 Jun 11.

Degenerative scoliosis: a review

Suhel Kotwal  1 , Matthias Pumberger, Alex Hughes, Federico Girardi
Affiliations

Degenerative scoliosis: a review

Suhel Kotwal et al. HSS J. 2011 Oct.

Abstract

Degenerative lumbar scoliosis is a coronal deviation of the spine that is prevalent in the elderly population. Although the etiology is unclear, it is associated with progressive and asymmetric degeneration of the disc, facet joints, and other structural spinal elements typically leading to neural element compression. Clinical presentation varies and is frequently associated with axial back pain and neurogenic claudication. Indications for treatment include pain, neurogenic symptoms, and progressive cosmetic deformity. Non-operative treatment includes physical conditioning and exercise, pharmacological agents for pain control, and use of orthotics and invasive modalities like epidural and facet injections. Operative treatment should be contemplated after multi-factorial and multidisciplinary evaluation of the risks and the benefits. Options include decompression, instrumented stabilization with posterior or anterior fusion, correction of deformity, or a combination of these that are tailored to each patient. Incidence of perioperative complications is substantial and must be considered when deciding appropriate operative treatment. The primary goal of surgical treatment is to provide pain relief and to improve the quality of life with minimum risk of complications.

Keywords: adult deformity; adult scoliosis; degenerative scoliosis; secondary scoliosis; spinal stenosis.

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Figures

Fig. 1
Fig. 1
a, b Antero-posterior and lateral radiographs of degenerative lumbar scoliosis
Fig. 2
Fig. 2
a, b Intraoperative AP and lateral radiographs of lumbar spine after lateral lumbar interbody fusion
Fig. 3
Fig. 3
Antero-posterior radiograph after combined anterior interbody and posterior fusion
See this image and copyright information in PMC

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