The Orthobullets Podcast Spine | Adult Spinal Deformity
Apr 22, 2023
Explore the complexities of Adult Spinal Deformity, from its diagnosis to treatment options and prognosis. Discover how lumbar kyphosis significantly impacts patient disability and learn about the classification standards for adult scoliosis. The discussion sheds light on surgical complications and shares insights into thoracic decompression after lumbar spinal procedures. Engage with thought-provoking insights that invite audience interaction and feedback, making this topic both informative and accessible.
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How To Differentiate Idiopathic From De Novo Adult Curves
- Distinguish idiopathic/residual curves from degenerative/de novo by curve pattern, segment count, location, and magnitude.
- Idiopathic: classic patterns, more segments, thoracic location, larger curves; degenerative: fewer segments, lumbar, smaller curves.
Symptoms Concentrate On The Concave Side
- Common symptoms include low back pain (40–90%), neurogenic claudication, and radicular pain, often worse on the concave side of the curve.
- Stenosis causing claudication is typically on the concavity; sitting may not relieve symptoms as in classic claudication.
Essential Imaging And Measurements For Planning
- Obtain full-length 36-inch standing AP and lateral scoliosis films plus side-bending views to assess flexibility and planning.
- Use C7 plumb line for coronal and sagittal balance, measure pelvic incidence as sacral slope plus pelvic tilt; get CT/MRI/DEXA as indicated.