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Review
. 2017 Dec;10(4):547-558.
doi: 10.1007/s12178-017-9445-0.

Degenerative Scoliosis

Philip J York  1 , Han Jo Kim  2
Affiliations
Review

Degenerative Scoliosis

Philip J York et al. Curr Rev Musculoskelet Med. 2017 Dec.

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.

Keywords: Adult scoliosis; Degenerative spine; Spinal deformity; Spinal stenosis.

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Conflict of interest statement

Conflict of Interest

Philip J. York declares that he has no conflict of interest.

Han Jo Kim reports personal fees from ZimmerBiomet, K2M, and AO Spine, outside of the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Figures

Fig. 1
Fig. 1
The SRS-Schwab classification system. The system describes curve type with three sagittal modifiers. PI indicates pelvic incidence; LL, lumbar lordosis; PT, pelvic tilt; SVA, sagittal vertical axis. From Schwab et al. 2012 [•]
Fig. 2
Fig. 2
Preoperative (top) and 3-year postoperative (bottom) radiographs of a 73 year old female with debilitating back pain and progressive coronal and sagittal decompensation
Fig. 3
Fig. 3
a Preoperative (left) and 2-year postoperative (right) radiographs of a 71-year-old female who presented with debilitating right leg pain and back pain resulting in limited ambulation and decreased functional capacity for activities of daily living. b MRI of the same patient revealing L5-S1 right foraminal stenosis (blue arrow), L5-S1 isthmic spondylolisthesis, and L4–5 facet joint effusions (yellow arrows)
See this image and copyright information in PMC

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