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Surgical Treatment of Adult Degenerative Scoliosis

The rapid increase of elderly population has resulted in increased prevalence of adult scoliosis. Adult scoliosis is divided into adult idiopathic scoliosis and adult degenerative scoliosis. These two types of scoliosis vary in patient age, curve pattern and clinical symptoms, which necessitate diff...

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Autores principales: Cho, Kyu-Jung, Kim, Young-Tae, Shin, Sang-hyun, Suk, Se-Il
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Spine Surgery 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4068860/
https://www.ncbi.nlm.nih.gov/pubmed/24967054
http://dx.doi.org/10.4184/asj.2014.8.3.371
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author Cho, Kyu-Jung
Kim, Young-Tae
Shin, Sang-hyun
Suk, Se-Il
author_facet Cho, Kyu-Jung
Kim, Young-Tae
Shin, Sang-hyun
Suk, Se-Il
author_sort Cho, Kyu-Jung
collection PubMed
description The rapid increase of elderly population has resulted in increased prevalence of adult scoliosis. Adult scoliosis is divided into adult idiopathic scoliosis and adult degenerative scoliosis. These two types of scoliosis vary in patient age, curve pattern and clinical symptoms, which necessitate different surgical indications and options. Back pain and deformity are major indications for surgery in adult idiopathic scoliosis, whereas radiating pain to the legs due to foraminal stenosis is what often requires surgery in adult degenerative scoliosis. When selecting a surgical method, major symptoms and underlying medical diseases should be carefully evaluated, not only to relieve symptoms but also to minimize postoperative complications. Surgical options for adult degenerative scoliosis include: decompression alone; decompression and limited short fusion; and decompression coupled with long fusion and correction of deformity. Decompression and limited short fusion can be applied to patients with a small Cobb's angle and normal sagittal imbalance. For those with a large Cobb's angle and positive sagittal imbalance, long fusion with correction of deformity is required. When long fusion is applied, a careful decision regarding the extent of fusion level should be made when selecting L5 or S1 as the distal fusion level and T10 or the thoracolumbar junction as the proximal fusion level. For the fusion extending to the sacrum, restoration of sagittal balance and rigid fixation with additional iliac screws should be considered. Any surgical procedures for adult degenerative scoliosis are known to have relatively high occurrences of complications; therefore, risks and benefits should be meticulously considered before selecting a surgical procedure.
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spelling pubmed-40688602014-06-25 Surgical Treatment of Adult Degenerative Scoliosis Cho, Kyu-Jung Kim, Young-Tae Shin, Sang-hyun Suk, Se-Il Asian Spine J Review Article The rapid increase of elderly population has resulted in increased prevalence of adult scoliosis. Adult scoliosis is divided into adult idiopathic scoliosis and adult degenerative scoliosis. These two types of scoliosis vary in patient age, curve pattern and clinical symptoms, which necessitate different surgical indications and options. Back pain and deformity are major indications for surgery in adult idiopathic scoliosis, whereas radiating pain to the legs due to foraminal stenosis is what often requires surgery in adult degenerative scoliosis. When selecting a surgical method, major symptoms and underlying medical diseases should be carefully evaluated, not only to relieve symptoms but also to minimize postoperative complications. Surgical options for adult degenerative scoliosis include: decompression alone; decompression and limited short fusion; and decompression coupled with long fusion and correction of deformity. Decompression and limited short fusion can be applied to patients with a small Cobb's angle and normal sagittal imbalance. For those with a large Cobb's angle and positive sagittal imbalance, long fusion with correction of deformity is required. When long fusion is applied, a careful decision regarding the extent of fusion level should be made when selecting L5 or S1 as the distal fusion level and T10 or the thoracolumbar junction as the proximal fusion level. For the fusion extending to the sacrum, restoration of sagittal balance and rigid fixation with additional iliac screws should be considered. Any surgical procedures for adult degenerative scoliosis are known to have relatively high occurrences of complications; therefore, risks and benefits should be meticulously considered before selecting a surgical procedure. Korean Society of Spine Surgery 2014-06 2014-06-09 /pmc/articles/PMC4068860/ /pubmed/24967054 http://dx.doi.org/10.4184/asj.2014.8.3.371 Text en Copyright © 2014 by Korean Society of Spine Surgery http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Cho, Kyu-Jung
Kim, Young-Tae
Shin, Sang-hyun
Suk, Se-Il
Surgical Treatment of Adult Degenerative Scoliosis
title Surgical Treatment of Adult Degenerative Scoliosis
title_full Surgical Treatment of Adult Degenerative Scoliosis
title_fullStr Surgical Treatment of Adult Degenerative Scoliosis
title_full_unstemmed Surgical Treatment of Adult Degenerative Scoliosis
title_short Surgical Treatment of Adult Degenerative Scoliosis
title_sort surgical treatment of adult degenerative scoliosis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4068860/
https://www.ncbi.nlm.nih.gov/pubmed/24967054
http://dx.doi.org/10.4184/asj.2014.8.3.371
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