(iii) Adult degenerative scoliosis

In an ageing population adult degenerative scoliosis, a subset of adult scoliosis, is a growing problem. The spinal curves, unlike those of idiopathic scoliosis, are predominantly lumbar. Patients usually complain of axial pain, neurogenic claudication and radicular symptoms. Initial conservative management is indicated. If that fails, surgical treatment may be indicated, which requires careful patient selection, pre-operative assessment and pre-optimization to reduce the incidence of complications. Surgery is aimed at correcting the deformity, achieving adequate decompression, while obtaining solid spinal fusion and restoration of adequate coronal and sagittal balance.