Among the prevalent forms of adult spinal deformity are residual adolescent idiopathic and degenerative scoliosis, kyphotic deformity, and spondylolisthesis. Clinical evaluation should include a thorough history, discussion of concerns, and a review of comorbidities. Physical examination should include assessment of the deformity and a neurologic examination. Imaging studies should include full-length standing posteroanterior and lateral spine radiographs, and measurement of pelvic parameters. Advanced imaging studies are frequently indicated to assess for neurologic compromise and for surgical planning. This article focuses on clinical and radiographic evaluation of spinal deformity in the adult population, particularly scoliosis and kyphotic deformities.
Key points
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Adult spinal deformity encompasses a broad range of conditions. The most common are scoliosis (residual adolescent idiopathic scoliosis, also called adult idiopathic scoliosis, and degenerative or de novo scoliosis), kyphotic deformities with associated positive sagittal malalignment, and spondylolisthesis.
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Clinical evaluation of the adult with spinal deformity should include a thorough history of the condition, discussion of the presenting concerns, and a review of comorbidities. The physical examination should include assessment of the deformity and a complete neurologic examination.
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Imaging studies for adult spinal deformity evaluation should include full-length standing posteroanterior and lateral spine radiographs for assessment of regional and global alignment parameters, as well as measurement of pelvic parameters.
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Advanced imaging studies, including CT, CT myelogram, and MRI, are frequently indicated to assess for neurologic compromise and for surgical planning.
Introduction
The term adult spinal deformity (ASD) refers to a broad range of spinal conditions that have in common an abnormality of physiologic spinal alignment that may lead to pain, instability, functional disability, cosmetic concerns, neurologic compromise, and/or physiologic dysfunction. A working knowledge of the basic descriptive terminology for ASD is important for those who provide spinal care for these patients. The Scoliosis Research Society (SRS) Terminology Committee and Working Group on Spinal Classification have been proactive in developing and promoting an accurate and accepted nomenclature. Table 1 is a glossary of several frequently used terms, primarily derived from the efforts of the SRS.
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