Degenerative Adult Onset Scoliosis

Grubb, Stephen A.; Lipscomb, Hester J.; Coonrad, Ralph W.

doi:10.1097/00007632-198803000-00004

Cited by 179 publications

(77 citation statements)

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“…5,6,29,30,32 Many of the patients may be elderly or frail due to associated medical conditions. 1,6,12,[29][30][31] Compared with patients with adolescent idiopathic scoliosis, patients with adult scoliosis often complain of back pain. 1,[12][13][14]16,20,21,24,31,32 As a result of these significant differences between adolescent and adult scoliosis, the therapeutic goals become different.…”

Section: Discussionmentioning

confidence: 99%

“…1,6,12,[29][30][31] Compared with patients with adolescent idiopathic scoliosis, patients with adult scoliosis often complain of back pain. 1,[12][13][14]16,20,21,24,31,32 As a result of these significant differences between adolescent and adult scoliosis, the therapeutic goals become different. In adolescents, the curves typically do not cause pain, and surgery is indicated to prevent a curve from progressing to a point at which it induces pain, causes significant cardiopulmonary compromise, and for the purposes of cosmesis.…”

Section: Discussionmentioning

confidence: 99%

“…12,18,19,21,23,24,29,33,34 The disease often progresses over time and can lead to cosmetic and psychological problems, back pain, radiculopathy, spinal claudication, and ultimately spinal instability and cardiopulmonary compromise. [5][6][7][8]12,14,[16][17][18]21,22,24,27,[29][30][31][32]36,37 Although primary treatment is conservative, including spinal orthoses, physical rehabilitation, and pain control, these measures often fail, or patients may not be candidates for such therapy. 5,6,15,18,19,21,22,[29][30][31][32]36 In such cases, surgery is recommended.…”

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confidence: 99%

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Correction of adult scoliosis via a posterior-only approach

Lippman¹,

Spence²,

Youssef³

et al. 2003

FOC

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Object Adult scoliosis is a pathologically different entity from adolescent idiopathic scoliosis. The curves are more rigid, and rotational deformity and multilevel sagittal vertebral slippages compound the coronal malalignment. To correct these deformities, a surgical anterior release procedure is usually required, as well as posterior instrumentation-assisted fusion. This exposes the patient to the risks of a second procedure and of a thoracotomy or laparotomy. To decrease these risks, the authors have performed an anterior release, posterior release, and reduction via a posterior-only approach. The purpose of this study was to analyze quantitatively the degree of pre- and postoperative coronal deformity, the extent of correction, and related complications. Methods Data obtained in 20 patients with adult scoliosis were retrospectively studied. Patients presented with persistent back or lower-extremity pain, progressive deformity, or progressive neurological deficit. Sixteen patients underwent Gill-type laminectomy, radical discectomy (including fracture of any anterior and lateral osteophytes), and posterior lumbar interbody fusion (PLIF) of all apical and adjacent segments. One to four anterior release procedures were performed in each patient. Posterior instrumentation was placed over three to 15 levels. Autograft was obtained from the laminectomy sites and posterior iliac crest for fusion. There were no deaths; all patients were followed for a minimum of 1 year. The mean coronal Cobb angle improved from 36° to 14.7°. All spondylolisthetic lesions were reduced to at least Grade I. At the most recent follow-up examination, evidence of fusion was demonstrated in all patients. Reoperation for adjacent-segment failure, cephalad to the highest level of fusion, was required in two cases. Conclusions In many cases of adult scoliosis, a satisfactory multiplanar correction may be obtained via a single posterior approach and by using extended PLIF techniques. Cephalad adjacent-segment failure remains a significant problem in patients with osteoporosis, and routine extension of posterior instrumentation to the upper thoracic spine should be considered in these cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Correction of adult scoliosis via a posterior-only approach

Lippman¹,

Spence²,

Youssef³

et al. 2003

FOC

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“…Also available are provocative discography, articular surface blocks, nerve root blocks and epidural blocks [4,5,10].…”

Section: Pathomechanismmentioning

confidence: 99%

Degenerative scoliosis in the lumbosacral spine

Adamski¹

2018

Chir. Narzadow Ruchu Ortop. Pol.

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Degenerative scoliosis of the lumbosacral region occurs in 6% of the population over 50 years of age. It is often accompanied by low back pain resulting from fibular (in the majority of patients) or frontal decompensation. Radicular pain is common, radiating to one (more often) or both (less often) lower limbs and is most often caused by lateral stenosis. Key words: degenerative scoliosis, lumbosacral spine StreszczenieSkolioza zwyrodnieniowa zlokalizowana w części lędźwiowo-krzyżowej występuje u 6% populacji powyżej 50 roku życia. Towarzyszy jej często ból mechaniczny grzbietu (low back pain) wynikający z dekompensacji strzałkowej (u większości chorych) lub czołowej. Ból korzeniowy (radicular pain) występuje powszechnie, promieniując do jednej (częściej) lub obu (rzadziej) kończyn dolnych i wynika najczęściej ze stenozy bocznej.Słowa kluczowe: skolioza zwyrodnieniowa, kręgosłup lędźwiowo-krzyżowy

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“…Adult onset degenerative scoliosis often presents in the sixth decade [9,10] with stenotic symptoms [9] from mechanical compression [11,12], low back pain [10,13] spondylolisthesis [14], rotational subluxation [14][15][16][17] and lumbar hypolordosis [14,18]. The majority of adult onset degenerative scoliosis occurs in patients with no history of non-degenerative scoliosis [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Abnormalities of the lumbar spine in the coronal plane on plain abdominal radiographs

Kilshaw¹,

Baker²,

Gardner³

et al. 2010

Eur Spine J

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The main objective of this study is to determine the prevalence of coronal abnormalities of the lumbar spine in a large population of patients with respect to their age and sex. Lumbar degenerative disease is associated with degenerative scoliosis. Degenerative scoliosis and lateral listhesis are important features to identify before decompressive surgery as deformity may not be seen on magnetic resonance imaging scans. Scoliosis and lateral listhesis may be important in the development of symptoms especially in an ageing population. All abdominal and plain kidney-ureter-bladder radiographs performed over a 10-month period were reviewed. 2,765 radiographs were assessed for scoliosis (Cobb angle greater then 10°), lateral listhesis and evidence of osteoarthritis. The prevalence of scoliosis, lateral listhesis and osteoarthritis of the lumbar spine increased with age. Scoliosis and lateral listhesis were significantly more prevalent in women. Deformity starts to occur after the age of 50 and steadily increases with age. By the ninth decade nearly a quarter of patients have evidence of scoliosis and lateral listhesis. As the adult lumbar spine ages, the prevalence of lateral listhesis and degenerative scoliosis increases. It is important to appreciate these coronal abnormalities in patients undergoing decompressive surgery for spinal stenosis. This increase in deformity may have a greater impact as the population continues to age.

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Degenerative Adult Onset Scoliosis

Cited by 179 publications

References 0 publications

Correction of adult scoliosis via a posterior-only approach

Correction of adult scoliosis via a posterior-only approach

Degenerative scoliosis in the lumbosacral spine

Abnormalities of the lumbar spine in the coronal plane on plain abdominal radiographs

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