Degenerative scoliosis and stenosis—Surgical management

Adult degenerative scoliosis affects the growing elderly population and is an expanding challenge for spine surgeons. The etiology and natural history of this disease are imperfectly understood; however, it is accepted that degenerative spinal curvature is likely to progress. Severe deformity, particularly in the sagittal plane, is poorly tolerated. Treatment is complicated in this population where comorbid or mimicking diseases are the norm. Where appropriate, surgery is undertaken only after a thorough assessment of each patient’s spinal geometry. Guidelines aid in selecting among or combining surgical procedures. Increased potential for correction generally involves increased risk. Complications are common after surgery for adult degenerative scoliosis and their management should be anticipated.