Two major types of adult scoliosis
| Adult idiopathic scoliosis | Adult degenerative scoliosis (de novo scoliosis) |
|---|---|
| Younger age at presentation | De novo scoliosis develops in 68% of adults aged >60 yr (Schwab et al.24) |
| Can have associated congenital elements | Disk space collapse, vertebral wedging |
| Disk space height maintained | Facet degeneration |
| Thoracolumbar scoliosis (apex T12 or L1) | Lumbar scoliosis (apex L2 or below) |
| SRS definition | |
| Mechanical back pain predominates | Radiculopathy and claudication |
| Pedicular kinking and stretching of nerve roots | Direct nerve root compression from spinal stenosis (magnetic resonance imaging required) |
| Rotational deformity more pronounced | Rotary subluxation more prominent |
| Translation unusual | Spondylolisthesis and lateral subluxation particularly at L3-4 and L4-5 are characteristic |
| Coronal-plane deformity predominates | Multiplanar 3-dimensional deformity (coronal, sagittal, and transverse) |
| More apt to extend into thoracic spine | Usually confined to lumbar spine as degenerative disk disease is more extensive |
| Usually develops in absence of prior surgery | Often associated with post-laminectomy syndrome due to prior degenerative changes |
| Approach on convex side | Approach on concave side |
SRS, Scoliosis Research Society.