The Scoliosis Research Society Classification for Adult Spinal Deformity

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The management of adult spinal deformity is characterized by significant variability in operative and nonoperative approaches. Adult spinal deformity encompasses a broad spectrum of disorders of the spine, and the disparity observed in reported clinical outcomes of operative and nonoperative care reflects the heterogeneity of the cases studied. A classification of spinal deformity in adults is important in providing a framework for comparison of similar cases and for reporting outcomes on well-defined disorders. Existing classifications of scoliosis are limited in their applicability to adult deformity because they do not include parameters of lumbar degenerative change and regional sagittal alignment that are critical to decision making in surgical care of the adult. The Scoliosis Research Society classification for adult deformity is presented in this article. The purpose of this classification is to provide a framework for reporting similar cases and to contribute to the development of an evidence-based approach to the management of adult spinal deformity.

Section snippets

Distinction of adult deformity from adolescent idiopathic deformity

Existing classification systems for spinal deformity have significant limitations and do not include parameters that are important considerations in deformity of the adult spine. The King/Moe classification is an ordinal classification system for thoracic idiopathic scoliosis that was intended to provide guidance for treatment of thoracic deformity [15]. The authors demonstrated that the classification has significant value in determining the appropriate levels for fusion for thoracic

Value of a classification for adult spinal deformity

Classification systems are important and valuable to the physician who cares for patients with spinal disorders because they serve to characterize a disorder accurately, to guide treatment and decision making, and to form a basis for the uniform reporting of results of care that may lead to an evidence-based approach to care [25]. A classification system for spinal deformity has four main purposes:

  • 1.

    Systematic categorization of similar disorders

  • 2.

    Prognosis regarding natural history and outcomes of

Scoliosis Research Society adult deformity classification system

The proposed classification is based on standing full-length radiographs in the coronal and sagittal planes [28]. Global balance, regional deformity patterns, and focal degenerative changes within the deformity are the parameters considered in the classification. The classification also includes primary sagittal deformity, which is commonly related to degenerative disc disease; developmental pathologic change, including Scheuermann's kyphosis; trauma; primary myopathies; and osteoporosis in

Summary

The SRS adult deformity classification offers an important framework for the establishment of a comprehensive description of adult spinal deformity. The terminology and definitions adopted by the SRS were applied in categorization of apical level, and thus curve types. Further modifiers offer important descriptors relevant to surgical decision making. Adult spinal deformity is distinct from adolescent deformity because of the predominance of lumbar degenerative conditions, regional loss of

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