J Korean Med Assoc.  2023 Aug;66(8):497-505. 10.5124/jkma.2023.66.8.497.

Diagnosis and treatment of adult spinal deformity

• Hong KU
• Hyun SJ
• Lee, JK
• Kim KJ

• KMID: 2545253
• DOI: http://doi.org/10.5124/jkma.2023.66.8.497

Abstract

Background
The diagnosis rate of adult spinal deformity (ASD) is increasing with increased life expectancy and the prevalence of degenerative spinal diseases. The prevalence of ASD in adults aged >60 years has been reported to be up to 68%. ASD has significant impact on the pain, disability, and mental health. Therefore, it is necessary to establish an effective surgical plan by accumulating modern knowledge on ASD, developing surgical techniques, and improving pre- and post-operative care so as to achieve optimal surgical outcomes.
Current Concepts
ASD results from coronal and sagittal malalignments caused by degenerative diseases or iatrogenic factors. Recently, the significance of sagittal alignment correction has been emphasized, and the SRSSchwab classification of ASD is generally accepted. Individualized correction goals can be set through sufficient preoperative evaluations and imaging studies, and appropriate coronal and sagittal alignment correction can be achieved through intraoperative positioning of patient, anterior and posterior approach spine surgery, screw fixation, and osteotomies.
Discussion and Conclusion
It is necessary to establish an optimal correction target and select the appropriate surgical approach for each patient with ASD, so as to improve patients’ quality of life. Surgical interventions for ASD can be safely completed by adequately comprehending and anticipating perioperative complications.

Keyword

Spinal diseases; Spinal curvatures; Spinal fusion; Osteotomy; 척추질환; 척추변형; 척추유합술; 절골술