Acta Ortopédica Mexicana

García-Ramos CL, Obil-Chavarría CA, Zárate-Kalfópulos B, Rosales-Olivares LM, Alpizar-Aguirre A, Reyes-Sánchez AA
Degenerative adult scoliosis
Acta Ortop Mex 2015; 29 (2)

Language: Español
References: 50
Page: 127-138
PDF: 315.55 Kb.

[Fulltext - PDF]

ABSTRACT

Adult scoliosis is a complex three-dimensional rotational deformity of the spine, resulting from the progressive degeneration of the vertebral elements in middle age, in a previously straight spine; a Cobb angle greater than 10o in the coronal plane, which also alters the sagittal and axial planes. It originates an asymmetrical degenerative disc and facet joint, creating asymmetrical loads and subsequently deformity. The main symptom is axial, radicular pain and neurological deficit. Conservative treatment includes drugs and physical therapy. The epidural injections and facet for selectively blocking nerve roots improves short-term pain. Surgical treatment is reserved for patients with intractable pain, radiculopathy and / or neurological deficits. There is no consensus for surgical indications, however, it must have a clear understanding of the symptoms and clinical signs. The goal of surgery is to decompress neural elements with restoration, modification of the three-dimensional shape deformity and stabilize the coronal and sagittal balance.


Key words: adult spinal deformity, degenerative spinal deformity, review, scoliosis, spine deformity.


REFERENCES

  1. Kotwal S, Pumberger M, Hughes A, Girardi F: Degenerative scoliosis: a review. HSS J. 2011; 7: 257-64.

  2. Cho KJ, Kim YT, Shin SH, Suk SI: Surgical treatment of adult degenerative scoliosis. Asian Spine J. 2014; 8(3): 371-81.

  3. Birknes JK, White AP, Albert TJ, Shaffrey CI, Harrop JS: Adult degenerative scoliosis: a review. Neurosurgery. 2008; 63: 94-103.

  4. Aebi M: The adult scoliosis. Eur Spine J. 2005; 14: 925-48.

  5. Tribus CB: Degenerative lumbar scoliosis: evaluation and management. J Am Acad Orthop Surg. 2003; 11: 174-83.

  6. Faldini C, Pagkrati S, Grandi G, Di Gennaro V, Faldini O, Giannini S: Degenerative lumbar scoliosis: features and surgical treatment. J Orthop Traumatol. 2006; 7: 67-71.

  7. Faldini C, Di Martino A, De Fine M, Miscione MT, Calamelli C, Mazzotti A, et al: Current classification systems for adult degenerative scoliosis. Musculoskelet Surg. 2013; 97: 1-8.

  8. Lowe T, Berven SH, Schwab FJ, Bridwell KH: The SRS classification for adult spinal deformity: building on the King/Moe and Lenke classification systems. Spine. 2006; 31: 119-25.

  9. Schwab F, Farcy JP, Bridwell K, et al: A clinical impact classification of scoliosis in the adult. Spine. 2006; 31: 2109-14.

  10. Schwab F, Ungar B, Blondel B, Buchowski J, Coe J, Deinlein D, et al: Scoliosis Research Society-Schwab adult spinal deformity classification: a validation study. Spine. 2012; 37: 1077-82.

  11. Ploumis A, Transfledt EE, Denis F: Degenerative lumbar scoliosis associated with spinal stenosis. Spine J. 2007; 7: 428-36.

  12. Chin KR, Furey C, Bohlman H: Rate of curve progression in degenerative scoliosis. Spine J. 2004; 4: 3S-119S.

  13. Silva EF, Lenke GL: Adult degenerative scoliosis: evaluation and management. Neurosurg Focus. 2010; 28(3): 1-10.

  14. Boissière L, Bourghli A, Vital JM, Gille O, Obeid I: The lumbar lordosis index: a new ratio to detect spinal malalignment with a therapeutic impact for sagittal balance correction decisions in adult scoliosis surgery. Eur Spine J. 2013; 22: 1339-45.

  15. Smith JS, Shaffrey C, Glassman SD, Carreon LY, Schwab FJ, Lafage V, et al: Clinical and radiographic parameters that distinguish between the best and worst outcomes of scoliosis surgery for adults. Eur Spine J. 2013; 22: 402-10.

  16. Youssef JA, Orndorff DO, Patty CA, Scott MA, Price HL, Hamlin LF, et al: Current status of adult spinal deformity. Global Spine J. 2013; 3: 51-62.

  17. Smith JS, Shaffrey CI, Berven S, Glassman S, Hamill C, Horton W, et al: Improvement of back pain with operative and nonoperative treatment in adults with scoliosis. Neurosurgery. 2009; 65: 86-94.

  18. Smith JS, Shaffrey CI, Berven S, Glassman S, Hamill C, Horton W, et al: Operative versus nonoperative treatment of leg pain in adults with scoliosis: a retrospective review of a prospective multicenter database with two-year follow-up. Spine. 2009; 34(16): 1693-8.

  19. Li G, Passias P, Kozanek M, Fu E, Wang S, Xia Q, et al: Adult scoliosis in patients over sixty-five years of age: outcomes of operative versus nonoperative treatment at a minimum two-year follow-up. Spine. 2009; 34(20): 2165-70.

  20. Shapiro GS, Taira G, Boachie-Adjei O: Results of surgical treatment of adult idiopathic scoliosis with low back pain and spinal stenosis: a study long-term clinical and radiographic outcomes. Spine. 2003; 28: 358-63.

  21. Frazier DD, Lipson SJ, Fossel AH, Katz JN: Associations between spinal deformity and outcomes after decompression for spinal stenosis. Spine. 1997; 22: 2025-9.

  22. Cho KJ, Suk SI, Park SR, Kim JH, Jung JH: Selection of proximal fusion level for adult degenerative lumbar scoliosis. Eur Spine J. 2013; 22: 394-401.

  23. Cho KJ, Suk SI, Park SR, Kim JH, Kim SS, Lee TJ: Short fusion versus long fusion for degenerative lumbar scoliosis. Eur Spine J. 2008; 17: 650-6.

  24. Crandall DG, Revella J: Transforaminal lumbar interbody fusion versus anterior lumbar interbody fusion as an adjunct to posterior instrumented correction of degenerative lumbar scoliosis: three year clinical y radiographic outcomes. Spine. 2009; 34: 2126-33.

  25. Patel N, Regev G, Taylor W: Radiographic outcomes of the DLIF/XLIF technique in comparison to other fusion techniques for the treatment of degenerative lumbar scoliosis. Spine J. 2009; 9: 61S.

  26. Phillips F: Minimally invasive XLIF fusion in the treatment of symptomatic degenerative lumbar scoliosis. Spine J. 2005; 5: S131-2.

  27. Diaz R, Phillips F, Pimenta L: XLIF for lumbar degenerative scoliosis: outcomes of minimally invasive surgical treatment out to 3 years postoperatively. Spine J. 2006; 6: 75S.

  28. Pimenta L, Oliveira L, Coutinho E: Minimally invasive surgery for degenerative scoliosis. Spine J. 2009; 9: 131S-2S.

  29. Furey C, Emery S: Decompression and instrumented fusion for management of degenerative lumbar scoliosis. Spine J. 2006; 6: 32S.

  30. Berven S, Deviren V, Hu S, Tan V: Operative management of degenerative scoliosis: does surgical strategy predict outcome? Spine J. 2004; 4: S27-8.

  31. Matusz D, Perez O, Pateder D: Posterior only vs. combined anterior and posterior approaches to lumbar scoliosis in adults: a radiographic comparison. Spine J. 2005; 5: S62.

  32. Marchesi DG, Aebi M: Pedicle fixation devices in the treatment of adult lumbar scoliosis. Spine. 1992; 17(8): 304-9.

  33. Cheh G, Lenke L, Bridwell K: Decompression only vs. decompression and limited fusion for the treatment of degenerative lumbar scoliosis. Spine J. 2005; 5: S109.

  34. Bridwell KH: Selection of instrumentation and fusion levels for scoliosis: where to start and where to stop. J Neurosurg Spine. 2004; 1: 1-8.

  35. Kim Y, Boachie-Adjei O, Bridwell K: Selection of proximal fusion level in adult lumbar segmental instrumented fusion to L5 or S1 for degenerative lumbar scoliosis. Spine J. 2009; 96(9): 96S-7S.

  36. Kuklo TR: Principles for selecting fusion levels in adult spinal deformity with particular attention to lumbar curves and double major curves. Spine. 2006; 31(19): S132-8.

  37. Edwards CC 2nd, Bridwell KH, Patel A, Rinella AS, Jung Kim Y, Berra AB, et al: Thoracolumbar deformity arthrodesis to L5 in adults: the fate of the L5-S1 disc. Spine (Phila Pa 1976). 2003; 28: 2122-31.

  38. Tuschel A, Schenk S, Meissl M: Long instrumentation to L5 vs. S1 in degenerative lumbar scoliosis: pre-degenerated disc L5/S1. Spine J. 2009; 9(10): 96S.

  39. Crandall D, Morrison M, Baker D: Adult scoliosis correction: a comparison of techniques. Spine J. 2006; 6: 150S-1S.

  40. Kyu JC, Se-Il S, Seung-Rim P: Comparison of long fusion to L5 and the sacrum for degenerative lumbar scoliosis. Spine J. 2007; 7: 18S-9S.

  41. Liu S, Schwab F, Smith JS, Klineberg E, Ames CP, Mundis G, et al: Likelihood of reaching minimal clinically important difference in adult spinal deformity : a comparison of operative and nonoperative treatment. Ochsner J. 2014; 14: 67-77.

  42. Schwab F, Blondel B, Chay E, Demakakos J, Lenke L, Tropiano P, et al: The comprehensive anatomical spinal osteotomy classification. Neurosurgery. 2014; 74: 112-20.

  43. Diebo B, Liu S, Lafage V, Schwab F: Osteotomies in the treatment of spinal deformities: indications, classification, and surgical planning. Eur J Orthop Surg Traumatol. 2014; 24(1): 11-20.

  44. Buchowski J, Kuhns C, Lehman R: Neurologic complications of pedicle subtraction osteotomy: a ten-year review. Spine J. 2006; 6: 32S-3S.

  45. Yong-Jung, Keith B, Lawrence L: Pseudarthrosis in long adult spinal deformity instrumentation and fusions. Spine J. 2004; 4: S160.

  46. Mok JM, Cloyd JM, Bradford DS, Hu SS, Deviren V, Smith JA, et al: Reoperation after primary fusion for adult spinal deformity rate, reason, and timing. Spine. 2009; 34(8): 832-9.

  47. Avraam P, Ensor ET, Francis D: Degenerative lumbar scoliosis associated with spinal stenosis. Spine J. 2007; 7: 428-36.

  48. Transfeldt EE, Topp R, Mehbod AA, Winter RB: Surgical outcomes of decompression, decompression with limited fusion, and decompression with full curve fusion for degenerative scoliosis with radiculopathy. Spine J. 2010; 35: 1872-5.

  49. Nelson E, Villavicencio A: Correction of degenerative adult scoliosis in patients undergoing selective transforaminal lumbar interbody fusion. Spine J. 2008; 8: 138S.

  50. Sansur C, Coe J, Smith J: Scoliosis research society morbidity and mortality of adult scoliosis. Spine J. 2009; 9: 34S.