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Review
. 2017 Dec 20;1(2):56-60.
doi: 10.22603/ssrr.1.2016-0036. eCollection 2017.

Surgical treatment for adult spinal deformity: Conceptual approach and surgical strategy

Yukihiro Matsuyama  1
Affiliations
Review

Surgical treatment for adult spinal deformity: Conceptual approach and surgical strategy

Yukihiro Matsuyama. Spine Surg Relat Res. .

Abstract

Planning of surgical treatment requires determination of whether osteoarthritis of the spine with lumbar pain should be treated as spinal canal stenosis with or without deformity or as lumbar degenerative scoliosis and clarification of whether treatment should be provided for both. When sagittal spinal alignment is not appropriate, symptoms of adult spinal deformity may be observed. To correct this deformity, appropriate pelvic tilt should be obtained similar to that in healthy adults, and, especially, the retroversion of the pelvis should be corrected.

Keywords: adult spinal deformity; lumbar kyphoscoliosis; pathology; strategy; surgical treatment.

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Conflict of interest statement

Conflicts of Interest: The authors declare that there are no conflicts of interest.

Figures

Figure 1.
Figure 1.
SRS-Schwab Adult Spinal Deformity Classification: A Validation Study based on evaluation of PI-LL (PI: pelvic incidence, LL: lumbar lordosis), SVA (sagittal vertical axis), and PT (pelvic tilt) for sagittal plane alignment, in addition to scoliotic deformity of the coronal plane with a Cobb angle ≥30°. PI-LL ≤10°, SVA <40 mm, and PT <20° were defined as the normal values to maintain quality of life (QOL).
Figure 2.
Figure 2.
Hole spine alignment. SVA: Sagittal vertical axis, PI: Pelvic incidence, PT: Pelvic tilt, SS: Sacral slope. Spinal alignment based on frontal and lateral views of the hole spine in a standing position.
Figure 3.
Figure 3.
The Schwab osteotomy classification. Selection of the osteotomy method. In this classification, osteotomy is anatomically classified into six levels based on the level of vertebral excision.
See this image and copyright information in PMC

References

    1. Takemitsu Y, Harada Y, Iwahara T, et al. Lumbar degenerative kyphosis: Clinical, radiological and epidemiological studies. Spine. 1988; 13(11): 1317-26. - PubMed
    1. Glassman SD, Berven S, Bridwell K, et al. Correlation of radiographic parameters and clinical symptoms in adult scoliosis. Spine. 2005; 30(6): 682-8. - PubMed
    1. Schwab F, Lafage V, Shaffrey CI, et al. The Schwab-SRS adult spinal deformity classification: assessment and clinical correlations based on a prospective operative and non-operative cohort. Neurosurgery. 2012; 71(2): E556. - PubMed
    1. Aebi M. The adult scoliosis. Eur Spine. 2005; J14(10): 925-48. - PubMed
    1. Toyama Y. Spinal deformity and degenerative scoliosis. In: Toyama Y (ed): Lumbar Vertebra in Clinical Practice, Medical View Co., 210-5, 2001.

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