, Volume 26, Issue 3, pp 143–148 | Cite as

La scoliosi dell’adulto: il trattamento chirurgico

  • M. Palmisani
  • E. Dema
  • S. Cervellati

Adult scoliosis: Surgical treatment


Surgical treatment of adult scoliosis still presents many points of discussion. In decision making it is mandatory to evaluate all the possible alternatives to surgery. Progression of deformity to an unacceptable degree and pain resistant to conservative treatments are the usual surgical indications in the middle-aged and older adult. For the younger adult magnitude of deformity and progression of deformity are relative indications. Correction of deformity and aesthetic improvement are only requested in young adults, while older patients require pain relief and improvement of quality of life. Posterior fusion and pedicle screws instrumentation, with lumbar osteotomies, provide a satisfactory correction. Complications and pseudoarthroses occur much more frequently in adults compared to the adolescent scoliosis patients. Surgical treatment of scoliosis in adulthood is a challenge to the experienced spinal deformity surgeon. A correct surgical indication and appropriate surgical technique con reduce the rate of complications.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Aebi M (2005) The adult scoliosis. Eur Spine J 14:925–948PubMedCrossRefGoogle Scholar
  2. 2.
    Weinstein SL, Ponseti IV (1983) Curve progression in idiopathic scoliosis. J Bone Joint Surg Am 65:447–455PubMedGoogle Scholar
  3. 3.
    Pérennou D, Marcelli C, Hérisson C, Simon L (1994) Adult lumbar scoliosis. Epidemiologic aspects in a low-back pain population. Spine 19:123–128PubMedCrossRefGoogle Scholar
  4. 4.
    Jimbo S, Kobayashi T, Aono K et al (2012) Epidemiology of degenerative lumbar scoliosis: a community based cohort study. Spine Apr 5 [Epub ahead of print]Google Scholar
  5. 5.
    Ascani E, Bartolozzi P, Logroscino CA et al (1986) Natural history of untreated idiopathic scoliosis after skeletal maturity. Spine 11:784–789PubMedCrossRefGoogle Scholar
  6. 6.
    Vanderpool DW, James JI, Wynne-Davies R (1969) Scoliosis in the elderly. J Bone Joint Surg Am 51:446–455PubMedGoogle Scholar
  7. 7.
    Benner B, Ehni G (1979) Degenerative lumbar scoliosis. Spine 4:548–552PubMedCrossRefGoogle Scholar
  8. 8.
    Briard JL, Jegou D, Cauchoix J (1979) Adult lumbar scoliosis. Spine 4:526–532PubMedCrossRefGoogle Scholar
  9. 9.
    Seo JY, Ha KY, Hwang TH et al (2011) Risk of progression of degenerative lumbar scoliosis. J Neurosurg Spine 15:558–566PubMedCrossRefGoogle Scholar
  10. 10.
    Bradford DS, Tay BK, Hu SS (1999) Adult scoliosis: surgical indications, operative management, complications and outcomes. Spine 24:2617–2629PubMedCrossRefGoogle Scholar
  11. 11.
    Jackson RP, Simmons EH, Stripinis D (1983) Incidence and severity of back pain in adult idiopathic scoliosis. Spine 8:749–756PubMedCrossRefGoogle Scholar
  12. 12.
    Savini R, Cervellati S, Boriani S et al (1987) Il trattamento chirurgico della scoliosi dell’adulto. Progressi in patologia vertebrale 9:97–11313.Google Scholar
  13. 13.
    Cho KJ, Suk SI, Park SR et al (2007) Complications in posterior fusion and instrumentation for degenerative lumbar scoliosis. Spine 32:2232–2237PubMedCrossRefGoogle Scholar
  14. 14.
    Kim YB, Lenke LG, Kim YJ et al (2008) Surgical treatment of adult scoliosis: is anterior apical release and fusion necessary for the lumbar curve? Spine 33:1125–1132PubMedCrossRefGoogle Scholar
  15. 15.
    Sansur CA, Smith JS, Coe JD et al (2011) Scoliosis research society morbidity and mortality of adult scoliosis surgery. Spine 36:E593–597PubMedCrossRefGoogle Scholar
  16. 16.
    Glassman SD, Schwab FJ, Bridwell KH et al (2007) The selection of operative versus nonoperative treatment in patients with adult scoliosis. Spine 32:93–97PubMedCrossRefGoogle Scholar
  17. 17.
    Bridwell KH, Berven S, Edwards C 2nd et al (2007) The problems and limitations of applying evidence-based medicine to primary surgical treatment of adult spinal deformity. Spine 32[19 Suppl.]:135–139CrossRefGoogle Scholar
  18. 18.
    Gennari JM, Tropiano P, Bergoin M (2010) Use of a universal clamp in the surgical treatment of lumbar scoliosis in adults. Eur Spine J 19:1610Google Scholar
  19. 19.
    O’shaughnessy BA, Bridwell KH, Lenke LG et al (2012) Does a long fusion “T3-sacrum” portend a worse outcome than a short-fusion “T10-sacrum” in primary surgery for adult scoliosis? Spine 37:884–890PubMedCrossRefGoogle Scholar
  20. 20.
    Kim YJ, Bridwell KH, Lenke LG et al (2006) Pseudoarthrosis in long adult spinal deformity instrumentation and fusion to the sacrum: prevalence and risk factor analysis of 144 cases. Spine 31:2329–2336CrossRefGoogle Scholar
  21. 21.
    White AH, von Rogov P, Zucherman J, Heiden D (1987) Lumbar laminectomy for herniated disc: a prospective controlled comparison with internal fixation fusion. Spine 12:305–307PubMedCrossRefGoogle Scholar
  22. 22.
    O’shaughnessy BA, Lenke LG, Bridwell KH et al (2012) Should symptomatic iliac screws be electively removed in adult spinal deformity patients fused to the sacrum? Spine 37:1175–1181PubMedCrossRefGoogle Scholar
  23. 23.
    Cho KJ, Suk SI, Park SR et al (2009) Arthrodesis to L5 versus S1 in long instrumentation and fusion for degenerative lumbar scoliosis. Eur Spine J 18:531–537PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • M. Palmisani
    • 1
  • E. Dema
    • 1
  • S. Cervellati
    • 1
  1. 1.Centro Scoliosi e Malattie della Colonna VertebraleHesperia HospitalModenaItaly

Personalised recommendations