Nailed It Ortho OITE/ Boards Review: Spine 13- Adult Spine Deformity
Jul 31, 2022
Dr. Spencer Woolwine, an expert in adult spinal deformity, joins the discussion to delve into the nuances of assessing and treating spinal issues. They highlight how many patients remain asymptomatic until advanced stages, with family members often spotting early signs. The conversation covers critical imaging techniques, including sagittal plane measurements, and stresses the importance of pelvic incidence in spinal alignment. Surgical options and indications are also explored, emphasizing the restoration of lumbar lordosis for optimal patient outcomes.
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Adults Often Present Late And Initially Asymptomatic
- Most adult spinal deformity patients present after a long, gradual course and are often asymptomatic initially.
- Progressive changes (e.g., kyphosis worsening over years) or new myelopathy/radiculopathy—often with neuromuscular disease—signal symptomatic presentation.
Get Standing 36 Inch Films For Full Alignment
- Obtain standing 36-inch AP and lateral radiographs from clavicles to iliac crest to assess whole-spine alignment.
- Use the lateral to measure C7 sagittal vertical axis, lumbar lordosis, and T1 pelvic angle as primary sagittal assessment tools.
Sagittal Balance Drives Disability And Surgical Goals
- Sagittal balance correlates most with disability, often quantified by C7 sagittal vertical axis (SVA) within 5 cm of posterior S1.
- Also evaluate lumbar lordosis and T1 pelvic angle (goal <14 degrees) to plan correction.