The Scoliosis Research Society Classification for Adult Spinal Deformity

ArticleinNeurosurgery clinics of North America 18(2):207-13 · May 2007with13 Reads
DOI: 10.1016/j.nec.2007.03.002 · Source: PubMed
Abstract
The management of adult spinal deformity is characterized by significant variability in operative and nonoperative approaches. Adult spinal deformity encompasses a broad spectrum of disorders of the spine, and the disparity observed in reported clinical outcomes of operative and nonoperative care reflects the heterogeneity of the cases studied. A classification of spinal deformity in adults is important in providing a framework for comparison of similar cases and for reporting outcomes on well-defined disorders. Existing classifications of scoliosis are limited in their applicability to adult deformity because they do not include parameters of lumbar degenerative change and regional sagittal alignment that are critical to decision making in surgical care of the adult. The Scoliosis Research Society classification for adult deformity is presented in this article. The purpose of this classification is to provide a framework for reporting similar cases and to contribute to the development of an evidence-based approach to the management of adult spinal deformity.
    • "In an effort to halt the detrimental and disabling sequelae, fusion of the concerned spinal segments coupled with/without decompression is a reasonable surgical option. In more recent published literature, a combination of decompression and fusion using fixation devices yields good results in terms of pain relief, walking ability, and patient satisfaction [6, 9, 10,29303132333435. If back pain is a leading symptom, with or without leg pain, a fusion is usually indicated. "
    [Show abstract] [Hide abstract] 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.
    Full-text · Article · Oct 2011
  • Article · Jan 2009
  • [Show abstract] [Hide abstract] ABSTRACT: Spinal deformities affect a considerable number of individuals of all ages. The etiological spectrum is broad and in cases of severe deformities a surgical treatment may be required. In addition to clinical evaluation, full spine radiographs constitute a fundamental tool, both in the diagnostic process as well as in the therapeutic follow-up of these patients. The aim of this paper is to provide a comprehensive overview on radiological assessment of spinal deformities, with an emphasis on scoliosis, by summarizing classical concepts and incorporating new ideas being developed in recent years, mainly due to the improvement and increased complexity of surgical management.
    Article · Jan 2009
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