Adult scoliosis describes a spinal deformity in mature patients characterized by a Cobb angle of more than 10 degrees in the coronal plane. We can divide adult scoliosis into 3 main groups. Primary degenerative scoliosis or denovo scoliosis is the form that occurs after the age of 50 as a result of degeneration of facet and disc structures and is often accompanied by low back pain and spinal stenosis findings. Curvatures of the thoracic and/or lumbar spine, which are seen in adolescence, often continue to progress in adulthood and may result in secondary degeneration and balance disorders. It may not always be possible to distinguish these 2 forms. Secondary degenerative scoliosis may develop due to pathologies such as vertebral fractures or leg inequality, hip pathologies or lumbosacral transition anomalies, which often accompany metabolic bone diseases.
While adult scoliosis patients often present with complaints of lower back pain, leg pain or claudication, rarely cosmetic reasons may be the reason for application.
Treatment is tailored to the patient's complaints. Surgical treatments may include decompression, correction and stabilization interventions, or combinations of these. Surgical interventions are quite complex, and the management of the process is determined by the patient's age, comorbidities, length of fusion, condition of adjacent segments, lumbosacral junction, osteoporosis, previous surgical interventions, and long-standing low back pain and muscle imbalance. Fusion surgery is used to stop the progression of the curvature. Instrumentation along with fusion may be preferred to eliminate sagittal imbalance and rotational deformities. Although the size of the curvature plays an important role in surgical indications in adolescent deformities, pain and dysfunction in adults are correlated with degeneration and imbalance of the spine. While selective fusion can be applied to the curvature in cases with limited spinal pathology, the entire curvature should be included in the fusion in diffuse segment disease.
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