Adult Spinal Deformity: Current Concepts and Decision-Making Strategies for Management

被引:53
作者
Kim, Hong Jin [1 ]
Yang, Jae Hyuk [2 ]
Chang, Dong-Gune [1 ]
Suk, Se-Il [1 ]
Suh, Seung Woo [2 ]
Song, Kwang-Sup [3 ]
Park, Jong-Beom [4 ]
Cho, Woojin [5 ]
机构
[1] Inje Univ, Coll Med, Dept Orthopaed Surg, Sanggye Paik Hosp, 1342 Dongil Ro, Seoul 01757, South Korea
[2] Korea Univ, Coll Med, Dept Orthopaed Surg, Guro Hosp, Seoul, South Korea
[3] Chung Ang Univ, Chung Ang Univ Hosp, Dept Orthopaed Surg, Coll Med, Seoul, South Korea
[4] Catholic Univ Korea, Coll Med, Dept Orthopaed Surg, Seoul, South Korea
[5] Montefiore Med Ctr, Albert Einstein Coll Med, Dept Orthopaed Surg, 111 E 210th St, Bronx, NY 10467 USA
关键词
Adult spinal deformity; Sagittal imbalance; Health-related quality of life; Surgical treatment; Complications; PEDICLE SUBTRACTION OSTEOTOMY; LUMBAR DEGENERATIVE KYPHOSIS; VERTEBRAL COLUMN RESECTION; NONOPERATIVE TREATMENT; SAGITTAL ALIGNMENT; IATROGENIC FLATBACK; BACK-PAIN; SCOLIOSIS; THORACOLUMBAR; COMPLICATIONS;
D O I
10.31616/asj.2020.0568
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Adult spinal deformity (ASD) is characterized by three-dimensional abnormalities of the thoracic or thoracolumbar spine that exerts significant impacts on the health-related quality of life (HRQoL). With the important effects that deformity of the sagittal plane exerts on the HRQoL, there have been paradigm shifts in ASD evaluation and management. Loss of lumbar lordosis is recognized as a key driver of ASD followed by reducing kyphosis, pelvic retroversion, and knee flexion. The Scoliosis Research Society ( SRS)Schwab classification reflects the sagittal spinopelvic parameters that correlate pain and disability in ASD patients. Although the SRS-Schwab classification provides a realignment target framework for surgeons, a structured patient-specific systemic approach is crucial for the process of decision-making. ASD management should be focused on restoring age-specific harmonious alignment and should consider the comorbidities and risk factors of each patient to prevent catastrophic complications and enhance the HRQoL.
引用
收藏
页码:886 / 897
页数:12
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