Degenerative scoliosis of the spine: diagnosis, classification and surgical approach in older patients

Abstract

Adult scoliosis is a deformity of the spine with an angle of more than 10 (according to Cobb) in people with a fully formed bone system. Due to the aging of the population, the improvement of surgical techniques, the appearance of new implants and the improvement of anesthetic aids, the problem of degenerative scoliosis is increasingly being considered from the point of view of the possibilities of surgery. There are many theories that contribute to the formation of degenerative scoliosis. Conservative therapy of degenerative scoliosis includes non-steroidal anti-inflammatory drugs, corset therapy, epidural and paravertebral injections with glucocorticosteroids, physical therapy, and physical therapy. With complete ineffectiveness of conservative therapy and with a significant decrease in the quality of life of the patient, the question of performing surgical intervention is individually decided. Currently, the question of the role and scope of surgical intervention in individuals with this pathology remains debatable. The choice of surgical intervention depends on a thorough assessment of clinical symptoms, neurological status, data of instrumental methods of examination and mandatory consideration of the parameters of the global vertebral-pelvic balance. Therefore, in this article, special attention is paid to the algorithms of surgical treatment based on the choice of the type of decompression and the length of the fusion. The paper describes the generally accepted criteria for selecting the level of spondylosynthesis. Special attention is paid to the risk factors for surgical treatment. As well as the complications associated with surgical treatment are described.