Adult Degenerative Scoliosis: A Literature Review of Current Concepts and New Trends

Abstract

Background Data: Degenerative scoliosis in adults is a growing health problem due to the steady increase in lifespans globally. It is a benign health problem, but it develops slowly in nature. Purpose: To review the available data about degenerative scoliosis in adults and the recent concepts and treatment options. Study Design: A narrative literature review. Patients and Methods: The author reviewed the English literature published through the last two decades for recent and relevant data about the pathogenesis, presentation, and management of adult degenerative scoliosis. A PubMed search was conducted using both phrase searching and combined searching using Boolean operators. The most relevant articles according to the study aim and spine surgeon’s practice were extracted. Results: Adult degenerative scoliosis is a triplanar deformity affecting coronal and sagittal parameters and axial spinal dimensions. The condition starts with age-related disc degeneration and progresses slowly over the years with worsening back pain and neurological deficits in advanced stages. Selected stable patients with early deformities can be managed nonsurgically through various pharmacological, physical, and interventional measures. However, most cases with degenerative scoliosis are best treated surgically via various open or minimally invasive procedures, reserving the conservative measures for nonsurgical candidates or as preoperative palliation. Conclusion: Adult degenerative scoliosis is best managed by a multidisciplinary team of neurosurgeons and orthopedic surgeons in a patient-specific manner. Further studies are required for comparing and identifying the best surgical strategies in a patient-specific approach. (2021ESJ249)