Limited Intervention in Adult Scoliosis-A Systematic Review

Area of Science:

• Spine Surgery
• Orthopedics
• Neurosurgery

Background:

• Adult scoliosis treatment traditionally involves long-segment fusion, achieving radiographic correction but with high morbidity.
• Limited surgical interventions are increasingly explored as alternatives.

Purpose of the Study:

• To systematically review the literature on limited interventions for adult scoliosis.
• To identify optimal treatment approaches for adult spinal deformity.

Main Methods:

• A systematic literature search of MEDLINE and PubMed databases.
• Inclusion of 49 articles encompassing 21,836 subjects.

Main Results:

• Long-segment interventions yield strong radiographic correction but high perioperative morbidity.
• Limited interventions, including decompression (discectomy, laminotomy, foraminotomy), benefit patients with compensated deformities and neurological symptoms.
• Short-segment fusion shows outcome improvements but risks adjacent segment disease and correctional loss.

Conclusions:

• Limited interventions provide symptomatic relief for adult spinal deformity, particularly in cases of balanced deformities and neurological pain.
• Decompression is indicated for neurologic symptoms, while fusion addresses instability and stenosis-related neurological issues.