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Review
. 2024 Feb 11;13(4):1030.
doi: 10.3390/jcm13041030.

Limited Intervention in Adult Scoliosis-A Systematic Review

Zuhair Jameel Mohammed  1 , John Worley  1 , Luke Hiatt  1 , Sakthivel Rajan Rajaram Manoharan  1 , Steven Theiss  1
Affiliations
Review

Limited Intervention in Adult Scoliosis-A Systematic Review

Zuhair Jameel Mohammed et al. J Clin Med. .

Abstract

Background/objectives: Adult scoliosis is traditionally treated with long-segment fusion, which provides strong radiographic correction and significant improvements in health-related quality of life but comes at a high morbidity cost. This systematic review seeks to examine the literature behind limited interventions in adult scoliosis patients and examine the best approaches to treatment.

Methods: This is a MEDLINE- and PubMed-based literature search that ultimately included 49 articles with a total of 21,836 subjects.

Results: Our search found that long-segment interventions had strong radiographic corrections but also resulted in high perioperative morbidity. Limited interventions were best suited to patients with compensated deformity, with decompression best for neurologic symptoms and fusion needed to treat neurological symptoms secondary to up-down stenosis and to provide stability across unstable segments. Decompression can consist of discectomy, laminotomy, and/or foraminotomy, all of which are shown to provide symptomatic relief of neurologic pain. Short-segment fusion has been shown to provide improvements in patient outcomes, albeit with higher rates of adjacent segment disease and concerns for correctional loss. Interbody devices can provide decompression without posterior element manipulation. Future directions include short-segment fusion in uncompensated deformity and dynamic stabilization constructs.

Conclusions: Limited interventions can provide symptomatic relief to adult spine deformity patients, with indications mostly in patients with balanced deformities and neurological pain.

Keywords: deformity; degenerative; limited intervention; scoliosis.

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Conflict of interest statement

Zuhair Mohammed, John Worley, and Luke Hiatt declare no conflicts of interest. Sakthivel Rajaram declares educational grants from AO Spine North America and K2M, along with travel and consulting fees from Cerapedics. Steven Theiss declares education grants from AO Spine North America. The funders had no role in the design of the study, in the collection, analysis, or interpretation of data, in the writing of the manuscript, or in the decision to publish the results. All authors have read and agreed to the published version of the manuscript.

Figures

Figure 1
Figure 1
Systematic review flow diagram.
See this image and copyright information in PMC

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