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The vertebral column or spine is a flexible column that supports the head, neck, and body and  allows for their movements. It also protects the spinal cord.
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Degenerative Spinal Deformity.

Tamir Ailon1, Justin S Smith, Christopher I Shaffrey

  • 1*Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia; ‡Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, Missouri; §Department of Orthopedics, University of Utah, Salt Lake City, Utah; ¶Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania; ‖Division of Neurosurgery and Spinal Program, University of Toronto, Toronto, Ontario, Canada; #Department of Neurosurgery, University of California San Francisco, San Francisco, California.

Neurosurgery
|September 18, 2015
PubMed
Summary
This summary is machine-generated.

Degenerative adult spinal deformity (ASD) is rising in older adults, causing pain and disability. Surgical correction, when carefully selected, offers better outcomes than nonoperative treatments for this condition.

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Area of Science:

  • Orthopedics
  • Neurosurgery
  • Geriatrics

Background:

  • Degenerative adult spinal deformity (ASD) is a growing concern in the elderly population.
  • Sagittal plane malalignment is a primary cause of pain and disability in patients with ASD.
  • This review addresses the increasing prevalence and management of ASD.

Purpose of the Study:

  • To review the current literature on the epidemiology, evaluation, management, and outcomes of degenerative adult spinal deformity (ASD).
  • To highlight the shift towards evidence-based management paradigms for ASD.
  • To provide an overview of current understanding and treatment strategies for ASD.

Main Methods:

  • This is a narrative review of recent literature.
  • The review synthesizes information on ASD epidemiology, evaluation, management, and outcomes.
  • Focus is placed on sagittal plane alignment and surgical correction goals.

Main Results:

  • ASD prevalence is increasing due to an aging population.
  • Deformity results from cumulative degenerative changes in discs and facet joints.
  • Established realignment goals include sagittal vertical axis <50 mm, pelvic tilt <22°, and lumbopelvic mismatch <±9°.
  • Operative management in selected patients yields superior outcomes compared to nonoperative strategies.

Conclusions:

  • ASD presents with pain and disability due to spinal malalignment.
  • Nonoperative management is suitable for mild, nonprogressive symptoms, but evidence is limited.
  • Surgery aims to restore alignment, decompress neural elements, and achieve fusion, offering excellent outcomes in well-selected patients.