Seminars in Spine Surgery
Volume 21, Issue 1 , Pages 16-23 , March 2009

Idiopathic Scoliosis in Adults: Classification, Indications, and Treatment Options

  • Nader M. Hebela, MD

      Affiliations

    • Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, and Penn Presbyterian Medical Center, Philadelphia, PA
    • Corresponding Author InformationAddress reprint requests to Nader M. Hebela, MD, Penn Presbyterian Medical Center, 1 Cupp Pavilion, 51 N. 39th Street, Philadelphia, PA 19104
    • ,
  • P. Justin Tortolani, MD

      Affiliations

    • Johns Hopkins Medical Institutions, Scoliosis and Spine Center of Maryland, and Towson Orthopaedic Associates, Towson, MD

References 

  1. Schwab FJ, Smith VA, Biserni M, et al. Adult scoliosis: A quantitative radiographic and clinical analysis. Spine. 2002;27:387–392
  2. Schwab F, el-Fegoun AB, Gamez L, et al. A lumbar classification of scoliosis in the adult patient: Preliminary approach. Spine. 2005;30:1670–1673
  3. Bradford DS, Tay BK, Hu SS. Adult scoliosis: Surgical indications, operative management, complications, and outcomes. Spine. 1999;24:2617–2629
  4. Vanderpool DW, James JI, Wynne-Davies R. Scoliosis in the elderly. J Bone Joint Surg Am. 1969;51:446–455
  5. Carter OD, Haynes SG. Prevalence rates for scoliosis in US adults: Results from the first national health and nutrition examination survey. Int J Epidemiol. 1987;16:537–544
  6. Weinstein SL, Dolan LA, Spratt KF, et al. Health and function of patients with untreated idiopathic scoliosis: A 50-year natural history study. JAMA. 2003;289:559–567
  7. Jackson RP, Simmons EH, Stripinis D. Incidence and severity of back pain in adult idiopathic scoliosis. Spine. 1983;8:749–756
  8. Kostuik JP, Bentivoglio J. The incidence of low-back pain in adult scoliosis. Spine. 1981;6:268–273
  9. Lowe T, Berven SH, Schwab FJ, et al. The SRS classification for adult spinal deformity: Building on the King/Moe and Lenke classification systems. Spine. 2006;31:S119–S125
  10. Goldstein LA, Waugh TR. Classification and terminology of scoliosis. Clin Orthop Relat Res June. 1973;10–22
  11. King HA, Moe JH, Bradford DS, et al. The selection of fusion levels in thoracic idiopathic scoliosis. J Bone Joint Surg Am. 1983;65:1302–1313
  12. Cummings RJ, Loveless EA, Campbell J, et al. Interobserver reliability and intraobserver reproducibility of the system of King et al. for the classification of adolescent idiopathic scoliosis. J Bone Joint Surg Am. 1998;80:1107–1111
  13. Lenke LG, Betz RR, Harms J, et al. Adolescent idiopathic scoliosis: A new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am. 2001;83A:1169–1181
  14. Richards BS, Birch JG, Herring JA, et al. Frontal plane and sagittal plane balance following Cotrel-Dubousset instrumentation for idiopathic scoliosis. Spine. 1989;14:733–737
  15. Bridwell KH, Betz R, Capelli AM, et al. Sagittal plane analysis in idiopathic scoliosis patients treated with Cotrel-Dubousset instrumentation. Spine. 1990;15:921–926
  16. Schwab F, Farcy JP, Bridwell K, et al. A clinical impact classification of scoliosis in the adult. Spine. 2006;31:2109–2114
  17. Schwab F, Lafage V, Farcy JP, et al. Surgical rates and operative outcome analysis in thoracolumbar and lumbar major adult scoliosis: Application of the new adult deformity classification. Spine. 2007;32:2723–2730
  18. Nachemson A. A long term follow-up study of non-treated scoliosis. Acta Orthop Scand. 1968;39:466–476
  19. Nilsonne U, Lundgren KD. Long-term prognosis in idiopathic scoliosis. Acta Orthop Scand. 1968;39:456–465
  20. Pehrsson K, Larsson S, Oden A, et al. Long-term follow-up of patients with untreated scoliosis (A study of mortality, causes of death, and symptoms). Spine. 1992;17:1091–1096
  21. Mayo NE, Goldberg MS, Poitras B, et al. The Ste-Justine Adolescent Idiopathic Scoliosis Cohort Study (Part III: Back pain). Spine. 1994;19:1573–1581
  22. Weinstein SL. Natural history. Spine. 1999;24:2592–2600
  23. Ascani E, Bartolozzi P, Logroscino CA, et al. Natural history of untreated idiopathic scoliosis after skeletal maturity. Spine. 1986;11:784–789
  24. Drummond DS. A perspective on recent trends for scoliosis correction. Clin Orthop Relat Res Mar. 1991;90–102
  25. Potter BK, Lenke LG, Kuklo TR. Prevention and management of iatrogenic flatback deformity. J Bone Joint Surg Am. 2004;86A:1793–1808
  26. Cobb JR. The problem of the primary curve. J Bone Jt Surg Am. 1960;42A:1413–1425
  27. Kittleson AC, Lim LW. Measurement of scoliosis. Am J Roentgenol Radium Ther Nucl Med. 1970;108:775–777
  28. Carman DL, Browne RH, Birch JG. Measurement of scoliosis and kyphosis radiographs (Intraobserver and interobserver variation). J Bone Joint Surg Am. 1990;72:328–333
  29. Morrissy RT, Goldsmith GS, Hall EC, et al. Measurement of the Cobb angle on radiographs of patients who have scoliosis (Evaluation of intrinsic error). J Bone Joint Surg Am. 1990;72:320–327
  30. Kuklo TR, Potter BK, Polly DW, et al. Reliability analysis for manual adolescent idiopathic scoliosis measurements. Spine. 2005;30:444–454
  31. Benoist M. Natural history of the aging spine. Eur Spine J. 2003;12(suppl 2):S86–S89
  32. Glassman SD, Alegre GM. Adult spinal deformity in the osteoporotic spine: Options and pitfalls. Instr Course Lect. 2003;52:579–588
  33. Grubb SA, Lipscomb HJ. Diagnostic findings in painful adult scoliosis. Spine. 1992;17:518–527
  34. Warner MA, Offord KP, Warner ME, et al. Role of preoperative cessation of smoking and other factors in postoperative pulmonary complications: A blinded prospective study of coronary artery bypass patients. Mayo Clin Proc. 1989;64:609–616
  35. Silcox DH, Daftari T, Boden SD, et al. The effect of nicotine on spinal fusion. Spine. 1995;20:1549–1553
  36. Wing KJ, Fisher CG, O'Connell JX, et al. Stopping nicotine exposure before surgery (The effect on spinal fusion in a rabbit model). Spine. 2000;25:30–34
  37. Klein JD, Hey LA, Yu CS, et al. Perioperative nutrition and postoperative complications in patients undergoing spinal surgery. Spine. 1996;21:2676–2682
  38. Hu SS, Berven SH. Preparing the adult deformity patient for spinal surgery. Spine. 2006;31:S126–S131
  39. Albert TJ, Purtill J, Mesa J, et al. Health outcome assessment before and after adult deformity surgery (A prospective study). Spine. 1995;20:2002–2004discussion, 2005
  40. Akbarnia BA, Ogilvie JW, Hammerberg KW. Debate: Degenerative scoliosis: To operate or not to operate. Spine. 2006;31:S195–S201
  41. Frazier DD, Lipson SJ, Fossel AH, Katz JN. Associations between spinal deformity and outcomes after decompression for spinal stenosis. Spine. 1997;22:2025–2029
  42. Ozgur BM, Aryan HE, Pimenta L, et al. Extreme lateral interbody fusion (XLIF): A novel surgical technique for anterior lumbar interbody fusion. Spine J. 2006;6:435–443
  43. Shen FH, Samartzis D, Khanna AJ, et al. Minimally invasive techniques for lumbar interbody fusions. Orthop Clin North Am. 2007;38:373–386abstract:vi
  44. Kuklo TR. Principles for selecting fusion levels in adult spinal deformity with particular attention to lumbar curves and double major curves. Spine. 2006;31:S132–S138
  45. Bridwell KH. Selection of instrumentation and fusion levels for scoliosis: Where to start and where to stop (Invited submission from the Joint Section Meeting on Disorders of the spine and peripheral nerves, March 2004). J Neurosurg Spine. 2004;1:1–8
  46. Polly DW, Klemme WR, Cunningham BW, et al. The biomechanical significance of anterior column support in a simulated single-level spinal fusion. J Spinal Disord. 2000;13:58–62

PII: S1040-7383(08)00091-9

doi: 10.1053/j.semss.2008.11.003

Seminars in Spine Surgery
Volume 21, Issue 1 , Pages 16-23 , March 2009

Article Tools

* Image Usage & Resolution