Surgical treatment for adult spinal deformity: Conceptual approach and surgical strategy

Planning of surgical treatment requires determination of whether osteoarthritis of the spine with lumbar pain should be treated as spinal canal stenosis with or without deformity or as lumbar degenerative scoliosis and clarification of whether treatment should be provided for both. When sagittal spinal alignment is not appropriate, symptoms of adult spinal deformity may be observed. To correct this deformity, appropriate pelvic tilt should be obtained similar to that in healthy adults, and, especially, the retroversion of the pelvis should be corrected.