Adult Scoliosis

  • Teja Karukonda
  • Steven M. Presciutti
  • Isaac L. Moss
  • Frank M. PhillipsEmail author


Adult scoliosis represents a complex three-dimensional deformity that may affect the spine in the coronal, sagittal, and axial planes. Unlike in adolescent idiopathic scoliosis, adult patients typically present with spinal deformity, stenosis, neurogenic symptoms, and significant medical comorbidities. Traditional surgical approaches to the adult patient with spinal deformity have included open posterior-only and open anterior/posterior surgical correction. These techniques have provided reliable correction of deformity; however, these traditional open procedures carry with them a significant perioperative risk profile. Minimally invasive surgery in the management of adult scoliosis has been introduced to minimize the postoperative morbidity and facilitate earlier recovery in this group of medically complicated patients. The current experience with minimally invasive techniques of adult scoliosis has rapidly evolved since their inception.


Adult scoliosis Spinal fusion Minimally invasive Sagittal balance Spinal deformity 


  1. 1.
    Aebi M. Adult scoliosis. Ther Umsch. 1987;44:757–63.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Tribus CB. Degenerative lumbar scoliosis: evaluation and management. J Am Acad Orthop Surg. 2003;11(3):174–83.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Velis KP, Healey JH, Schneider R. Osteoporosis in unstable adult scoliosis. Clin Orthop Relat Res. 1998;237:132–41.Google Scholar
  4. 4.
    Winter RB, Lonstein JE. Adult scoliosis. AAOS Instr Course Lect. 1983;32:170–91.Google Scholar
  5. 5.
    Hibbs RA. An operation for progressive spinal deformities. NY Med J. 1911;93:1013–6.Google Scholar
  6. 6.
    Hibbs RA. A report of fifty-nine cases of scoliosis treated by the fusion operation. J Bone Joint Surg. 1924;6:3–37.Google Scholar
  7. 7.
    Harrington PR. Treatment of scoliosis: correction and internal fixation by spine instrumentation. J Bone Joint Surg Am. 1962;44:591–610.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Luque ER. The anatomic basis and development of segmental spinal instrumentation. Spine. 1982;7:256–70.PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    Cotrel Y, Dubousset J. Nouvelle instrumentation pour chirurgie du rachis [a new technique for segmental spinal osteosynthesis using the posterior approach]. Rev Chir Orthop Reparatrice Appar Mot. 1984;70(6):489–94.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Hodgson AR, Stock FE. Anterior fusion for the treatment of tuberculosis of the spine: the operative findings and results of treatment in the first one hundred cases. J Bone Joint Surg Am. 1960;42:295–304.CrossRefGoogle Scholar
  11. 11.
    Dwyer AF, Newton NC, Sherwood AA. An anterior approach to scoliosis. A preliminary report. Clin Orthop Relat Res. 1969;62:192–202.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Zielke K, Berthet A. VDS- ventral derotation spondylodesis—preliminary report on 58 cases. Beitr Orthop Traumatol. 1978;25(2):85–103.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Millis MB, Hall JE, Emans JB. Short segment anterior instrumentation and fusion for progressive thoracolumbar scoliosis. Orthop Trans. 1985;9:438–9.Google Scholar
  14. 14.
    Brodner W, Yue WM, Moller HB, Hendricks KH, Burd TA, Gaines RW. Short segment bone-on-bone instrumentation for single curve idiopathic scoliosis. Spine. 2003;28(20S):S224–33.PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Okuda S, Miyauchi A, Oda T, Haku T, Yamamoto T, Iwasaki M. Surgical complications of posterior lumbar interbody fusion with total facetectomy in 251 patients. J Neurosurg Spine. 2006;4:304–9.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Carreon LY, Puno RM, Dimar JR II, Glassman SD, Johnson JR. Perioperative complications of posterior lumbar decompression and arthrodesis in older adults. J Bone Joint Surg Am. 2003;85:2089–92.PubMedCrossRefPubMedCentralGoogle Scholar
  17. 17.
    Kim YB, Lenke LG, Kim YJ, Kim YW, Blanke K, Stobbs G, Bridwell KH. The morbidity of an anterior thoracolumbar approach: adult spinal deformity patients with greater than five-year follow-up. Spine. 2009;34:822–6.PubMedCrossRefPubMedCentralGoogle Scholar
  18. 18.
    Healey JH, Lane JM. Structural scoliosis in osteoporotic women. Clin Orthop Relat Res. 1985;195:216–23.Google Scholar
  19. 19.
    Schwab F, Dubey A, Gamez L, El Fegoun AB, Hwang K, Pagala M, Farcy JP. Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine. 2005;30:1082–5.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project. Nationwide inpatient sample. 2004.
  21. 21.
    Martin BI, Turner JA, Mirza SK, Lee MJ, Comstock BA, Deyo RA. Trends in health care expenditures, utilization, and health status among US adults with spine problems, 1997–2006. Spine. 2009;34:2077–84.PubMedCrossRefPubMedCentralGoogle Scholar
  22. 22.
    Sing DC, Khanna R, Shaw JD, Metz LN, Burch S, Berven S. Increasing rates of surgical management of multilevel spinal curvature in elderly patients. Spine Deform. 2016;4:365–72.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Goldstein LA, Waugh TR. Classification and terminology of scoliosis. Clin Orthop. 1973;93:10–22.CrossRefGoogle Scholar
  24. 24.
    King H, Moe J, Bradford DS, Winter RB. The selection of fusion levels in thoracic idiopathic scoliosis. J Bone Joint Surg Am. 1983;65:1302–13.PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, Blanke K. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg. 2001;83A:1169–81.CrossRefGoogle Scholar
  26. 26.
    Glassman SD, Berven S, Bridwell K, Horton W, Dimar JR. Correlation of radiographic parameters and clinical symptoms in adult scoliosis. Spine. 2005;30:682–8.PubMedPubMedCentralCrossRefGoogle Scholar
  27. 27.
    Lafage V, Schwab F, Patel A, Hawkinson N, Farcy JP. Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity. Spine. 2009;34:E599–606.PubMedCrossRefPubMedCentralGoogle Scholar
  28. 28.
    Lowe T, Berven SH, Schwab FJ, Bridwell KH. The SRS classification for adult spinal deformity: building on the King/Moe and Lenke classification systems. Spine. 2006;31(19 Suppl):S119–25.PubMedCrossRefPubMedCentralGoogle Scholar
  29. 29.
    Schwab F, Farcy JP, Bridwell K, Berven S, Glassman S, Harrast J, Horton W. A clinical impact classification of scoliosis in the adult. Spine. 2006;31:2109–14.PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Schwab FJ, Blondel B, Bess S, Hostin R, Shaffrey CI, Smith JS, Boachie-Adjei O, Burton DC, Akbarnia BA, Mundis GM, Ames CP, Kebaish K, Hart RA, Farcy JP, Lafage V. Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis. Spine. 2013;38:E803–12.PubMedCrossRefPubMedCentralGoogle Scholar
  31. 31.
    Schwab F, Ungar B, Blondel B, Buchowski J, Coe J, Deinlein D, DeWald C, Mehdian H, Shaffrey C, Tribus C, Lafage V. Scoliosis Research Society—Schwab adult spinal deformity classification—a validation study. Spine. 2012;37:1077–82.PubMedCrossRefPubMedCentralGoogle Scholar
  32. 32.
    Smith JS, Klineberg E, Schwab F, Shaffrey CI, Moal B, Ames CP, Hostin R, Fu KM, Burton D, Akbarnia B, Gupta M, Hart R, Bess S, Lafage V. Change in classification grade by the SRS-Schwab adult spinal deformity classification predicts impact on health-related quality of life measures: prospective analysis of operative and nonoperative treatment. Spine. 2013;38:1663–71.PubMedCrossRefPubMedCentralGoogle Scholar
  33. 33.
    Albert TJ, Purtill J, Mesa J, McIntosh T, Balderston RA. Health outcome assessment before and after adult deformity surgery. A prospective study discussion. Spine. 1995;20:2002–4.PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    Benner B, Ehni G. Degenerative lumbar scoliosis. Spine. 1979;4:548.PubMedCrossRefPubMedCentralGoogle Scholar
  35. 35.
    Kostuik JP, Israel J, Hall JE. Scoliosis surgery in adults. Clin Orthop Relat Res. 1973;93:225–34.CrossRefGoogle Scholar
  36. 36.
    Glassman SD, Bridwell K, Dimar JR, Horton W, Berven S, Schwab F. The impact of positive sagittal balance in adult spinal deformity. Spine. 2005;30:2024–9.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Smith JS, Fu KM, Urban P, Shaffrey CI. Neurological symptoms and deficits in adults with scoliosis who present to a surgical clinic: incidence and association with the choice of operative versus nonoperative management. J Neurosurg Spine. 2008;9:326–31.PubMedCrossRefPubMedCentralGoogle Scholar
  38. 38.
    Epstein JA, Epstein BS, Jones MD. Symptomatic lumbar scoliosis and degenerative changes in the elderly. Spine. 1979;4:542–7.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Grubb SA, Lipscomb HJ. Diagnostic findings in painful adult scoliosis. Spine. 1992;17(5):518–27.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Weinstein SL, Dolan LA, Spratt KF, Peterson KK, Spoonamore MJ, Ponseti IV. Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA. 2003;289:559–67.PubMedCrossRefPubMedCentralGoogle Scholar
  41. 41.
    Murata Y, Takahashi K, Hanaoka E, Utsumi T, Yamagata M, Moriya H. Changes in scoliotic curvature and lordotic angle during the early phase of degenerative lumbar scoliosis. Spine. 2002;27:2268–73.PubMedCrossRefPubMedCentralGoogle Scholar
  42. 42.
    Berven SH, Deviren V, Smith JA, Emami A, Hu SS, Bradford DS. Management of fixed sagittal plane deformity: results of the transpedicular wedge resection osteotomy. Spine. 2001;26:2036–43.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Legaye J, Duval-Beaupère G, Hecquet J, Marty C. Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J. 1998;7:99–103.PubMedPubMedCentralCrossRefGoogle Scholar
  44. 44.
    Protopsaltis T, Schwab F, Bronsard N, Smith JS, Klineberg E, Mundis G, Ryan DJ, Hostin R, Hart R, Burton D, Ames C, Shaffrey C, Bess S, Errico T, Lafage V. The T1 pelvic angle, a novel radiographic measure of global sagittal deformity, accounts for both spinal inclination and pelvic tilt and correlates with health-related quality of life. J Bone Joint Surg Am. 2014;96:1631–40.PubMedCrossRefPubMedCentralGoogle Scholar
  45. 45.
    Lafage R, Schwab F, Challier V, Henry JK, Gum J, Smith J, Hostin R, Shaffrey C, Kim HJ, Ames C, Scheer J, Klineberg E, Bess S, Burton D, Lafage V. Defining spino-pelvic alignment thresholds: should operative goals in adult spinal deformity surgery account for age? Spine. 2016;41:62–8.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Iyer S, Lenke LG, Nemani VM, Albert TJ, Sides BA, Metz LN, Cunningham ME, Kim HJ. Variations in sagittal alignment parameters based on age: a prospective study of asymptomatic volunteers using full-body radiographs. Spine. 2016;41:1826–36.PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Everett CR, Patel RK. A systematic review of nonsurgical treatment in adult scoliosis. Spine. 2007;32(19 Suppl):S130–4.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    Teles AR, Mattei TA, Righesso O, Falavigna A. Effectiveness of operative and nonoperative care for adult spinal deformity: systematic review of the literature. AO Spine Global Spine J. 2017;7:170–8.CrossRefGoogle Scholar
  49. 49.
    Cooper G, Lutz GE, Boachie-Adjei O, Lin J. Effectiveness of transforaminal epidural steroid injections in patients with degenerative lumbar scoliotic stenosis and radiculopathy. Pain Physician. 2004;7:311–7.PubMedPubMedCentralGoogle Scholar
  50. 50.
    van Dam BE. Nonoperative treatment of adult scoliosis. Orthop Clin North Am. 1988;19:347–51.PubMedPubMedCentralGoogle Scholar
  51. 51.
    Weiss H-R, Dallmayer R, Stephan C. First results of pain treatment in scoliosis patients using a sagittal realignment brace. Stud Health Technol Inform. 2006;123:582–5.PubMedPubMedCentralGoogle Scholar
  52. 52.
    Liu S, Diebo BG, Henry JK, Smith JS, Hostin R, Cunningham ME, Mundis G, Ames C, Burton D, Bess S, Akbarnia B, Hart R, Passias PG, Schwab FJ, Lafage V. The benefit of nonoperative treatment for adult spinal deformity: identifying predictors for reaching a minimal clinically important difference. Spine J. 2016;16:210–8.PubMedCrossRefPubMedCentralGoogle Scholar
  53. 53.
    Berven SH, Deviren V, Smith JA, Hu SH, Bradford DS. Management of fixed sagittal plane deformity: outcome of combined anterior and posterior surgery. Spine. 2003;28:1710–5.PubMedPubMedCentralGoogle Scholar
  54. 54.
    Brown CW, Orme TJ, Richardson HD. The rate of pseudarthrosis (surgical nonunion) in patients who are smokers and patients who are nonsmokers: a comparison study. Spine. 1986;9:942–3.CrossRefGoogle Scholar
  55. 55.
    Klein J, Hey L, Yu C, Klein BB, Coufal FJ, Young EP, Marshall LF, Garfin SR. Perioperative nutrition and postoperative complications in patients undergoing spinal surgery. Spine. 1996;21(22):2672–82.CrossRefGoogle Scholar
  56. 56.
    Trief P, Grant W, Fredrickson B. A prospective study of psychological predictors of lumbar surgery outcome. Spine. 2000;25(20):2616–21.PubMedCrossRefPubMedCentralGoogle Scholar
  57. 57.
    Carreon LY, Glassman SD, Shaffrey CI, Fehlings MG, Dahl B, Ames CP, Matsuyama Y, Qiu Y, Mehdian H, Cheung KMC, Schwab FJ, Pellise F, Kebaish KM, Lenke LG. Predictors of health-related quality-of-life after complex adult spinal deformity surgery a Scoli-RISK-1 secondary analysis. Spine Deform. 2017;5:139–44.PubMedCrossRefPubMedCentralGoogle Scholar
  58. 58.
    Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am. 1999;81:519–28.PubMedCrossRefPubMedCentralGoogle Scholar
  59. 59.
    Chow DHK, Luk KDK, Evans JH, Leong JC. Effects of short anterior lumbar interbody fusion on biomechanics of neighboring unfused segments. Spine. 1994;21:549–55.CrossRefGoogle Scholar
  60. 60.
    Dekutoski MB, Schendel MJ, Ogilvie JW, Olsewski JM, Wallace LJ, Lewis JL. Comparison of in vivo and in vitro adjacent segment motion after lumbar fusion. Spine. 1994;19:1745–51.PubMedPubMedCentralCrossRefGoogle Scholar
  61. 61.
    Phillips FM, Reuben J, Wetzel FT. Intervertebral disc degeneration adjacent to a lumbar fusion. An experimental rabbit model. J Bone Joint Surg Br. 2002;84:289–94.PubMedCrossRefPubMedCentralGoogle Scholar
  62. 62.
    Kim YJ, Bridwell KH, Lenke LG, Rhim S, Cheh G. Sagittal thoracic decompensation (SThD) following adult lumbar spinal instrumentation and fusion to L5 or S1: causes, incidence, and risk factor analysis. Spine. 2006;31:2359–66.PubMedCrossRefPubMedCentralGoogle Scholar
  63. 63.
    Kim YJ, Bridwell KH, Lenke LG, Rhim S, Kim YW. Is the T9, T11, or L1 the more reliable proximal level after adult lumbar or lumbosacral instrumented fusion to L5 or S1? Spine. 2007;32(24):2653–61.PubMedCrossRefPubMedCentralGoogle Scholar
  64. 64.
    Shufflebarger H, Suk SI, Mardjetko S. Debate: determining the upper instrumented vertebra in the management of adult degenerative scoliosis: stopping at T10 versus L1. Spine. 2006;31(19S):S185–94.PubMedCrossRefPubMedCentralGoogle Scholar
  65. 65.
    Lafage R, Line BG, Gupta S, Liabaud B, Schwab F, Smith JS, Gum JL, Ames CP, Hostin R, Mundis GM, Kim HJ, Bess S, Klineberg E, Lafage V. Orientation of the upper-most instrumented segment influences proximal junctional disease following adult spinal deformity surgery. Spine. 2017;42(20):1570–7; Epub ahead of print.PubMedCrossRefPubMedCentralGoogle Scholar
  66. 66.
    Lafage R, Schwab F, Challier V, Henry JK, Gum J, Smith J, Hostin R, Shaffrey C, Kim HJ, Ames C, Scheer J, Klineberg E, Bess S, Burton D, Lafage V. Defining spino-pelvic alignment thresholds: should operative goals in adult spinal deformity account for age? Spine. 2016;41:62–8.PubMedCrossRefPubMedCentralGoogle Scholar
  67. 67.
    Edwards CC II, Bridwell KH, Patel A, Rinella AS, Berra A, Lenke LG. Long adult deformity fusions to L5 and the sacrum- a matched cohort analysis. Spine. 2004;29(18):1996–2005.PubMedCrossRefPubMedCentralGoogle Scholar
  68. 68.
    Bridwell KH. Selection of instrumentation and fusion levels for scoliosis: where to start and where to stop. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004. J Neurosurg Spine. 2010;1:1–8.CrossRefGoogle Scholar
  69. 69.
    Lafage R, Obeid I, Liabaud B, et al. Location of correction within the lumbar spine impacts acute adjacent segment kyphosis. 23rd International Meeting on Advanced Spine Techniques; 13–16 July 2016; Washington, DC, USA.Google Scholar
  70. 70.
    Kelleher M, Timlin M, Persaud O, Rampersaud YR. Success and failure of minimally invasive decompression for focal lumbar spinal stenosis in patients with without deformity. Spine. 2010;35(19):E981–7.PubMedCrossRefPubMedCentralGoogle Scholar
  71. 71.
    Transfeldt E, Topp R, Mehbod A, Winter RB. Surgical outcomes of decompression, decompression with limited fusion, and decompression with full curve fusion for degenerative scoliosis with radiculopathy. Spine. 2010;35(20):1872–5.PubMedCrossRefPubMedCentralGoogle Scholar
  72. 72.
    Hamilton DK, Kanter AS, Bolinger BD, Mundis GM, Nguyen S, Mummaneni PV, Anand N, Fessler RG, Passias PG, Park P, La Marca F, Uribe JS, Wang MY, Akbarnia BA, Shaffrey CI, Okonkwo DO. Reoperation rates in minimally invasive, hybrid, and open surgical treatment for adult spinal deformity with minimum 2-year follow-up. Eur Spine J. 2016;25:2605–11.PubMedCrossRefPubMedCentralGoogle Scholar
  73. 73.
    Charosky S, Guigui P, Blamoutier A, Roussouly P, Chopin D. Complications and risk factors of primary adult scoliosis surgery: a multicenter study of 306 patients. Spine. 2012;37(8):693–700.PubMedCrossRefPubMedCentralGoogle Scholar
  74. 74.
    Passias PG, Soroceanu A, Yang S, Schwab F, Ames C, Boniello A, Smith J, Shaffrey C, Boachie-Adjei O, Mundis G, Burton D, Klineberg E, Hart R, Hamilton DK, Sciubba DM, Bess S, Lafage V. Predictors of revision surgical procedure excluding wound complications in adult spinal deformity and impact on patient-reported outcomes and satisfaction. J Bone Joint Surg Am. 2016;98:536–43.PubMedCrossRefPubMedCentralGoogle Scholar
  75. 75.
    Weistroffer J, Perra J, Lonstein J, Schwender JD, Garvey TA, Transfeldt EE, Ogilvie JW, Denis F, Winter RB. Complications in long fusions to the sacrum for adult scoliosis: minimum five-year analysis of fifty patients. Spine. 2008;33(13):1478–83.PubMedCrossRefPubMedCentralGoogle Scholar
  76. 76.
    Zimmerman R, Mohamed A, Skolasky R, Robinson MD, Kebaish KM. Functional outcomes and complications after primary spinal surgery for scoliosis in adults aged forty years or older: a prospective study with minimum two-year follow-up. Spine. 2010;35(20):1861–6.PubMedCrossRefPubMedCentralGoogle Scholar
  77. 77.
    Kang DG, Baldus C, Glassman SD, Shaffrey CI, Lurie JD, Bridwell KH. Neurologic deficits have a negative impact on patient-related outcomes in primary presentation adult symptomatic lumbar scoliosis surgical treatment at one-year follow-up. Spine. 2017;42(7):479–89.PubMedPubMedCentralCrossRefGoogle Scholar
  78. 78.
    Smith JS, Shaffrey CI, Bess S, Shamji MF, Brodke D, Lenke LG, Fehlings MG, Lafage V, Schwab F, Vaccaro AR, Ames CP. Recent and emerging advances in spinal deformity. Neurosurgery. 2017;80:S70–85.PubMedCrossRefPubMedCentralGoogle Scholar
  79. 79.
    Zdeblick TA, Ulschmid S, Dick JC. The surgical treatment of L5–S1 degenerative disc disease. A prospective randomized study. 10th annual meeting, North American Spine Society, Washington, 18–21 Oct 1995.Google Scholar
  80. 80.
    Reagan JJ, Yuan H, McAfee PC. Laparoscopic fusion of the lumbar spine: minimally invasive spine surgery. A prospective multicenter study evaluating open and laparoscopic lumbar fusion. Spine. 1999;24(4):402–11.CrossRefGoogle Scholar
  81. 81.
    Reagan JJ, McAfee PC, Guyer RD, Aronoff RJ. Laparoscopic fusion of the lumbar spine in a multicenter series of the first 34 consecutive patients. Surg Laparosc Endosc Percutan Tech. 1996;6(6):459–68.CrossRefGoogle Scholar
  82. 82.
    Fantini GA, Pawar AY. Access related complications during anterior exposure of the lumbar spine. World J Orthop. 2013;4(1):19–23.PubMedPubMedCentralCrossRefGoogle Scholar
  83. 83.
    Wood KB, Devine J, Fischer D, Dettori JR, Janssen M. Vascular injury in elective anterior lumbosacral surgery. Spine. 2010;35(9 Suppl):S66–75.PubMedCrossRefPubMedCentralGoogle Scholar
  84. 84.
    Lindley EM, McBeth ZL, Henry SE, Cooley R, Burgery EL, Cain CM, Patel VV. Retrograde ejaculation after anterior lumbar spine surgery. Spine. 2012;37(20):1785–9.PubMedCrossRefPubMedCentralGoogle Scholar
  85. 85.
    Johnson JR, Holt RT. Combined use of anterior and posterior surgery for adult scoliosis. Orthop Clin North Am. 1988;19:361–70.PubMedPubMedCentralGoogle Scholar
  86. 86.
    Bridwell KH. Normalization of the coronal and sagittal profile in idiopathic scoliosis: options of treatment. J Orthop Sci. 1998;3:125–34.PubMedCrossRefPubMedCentralGoogle Scholar
  87. 87.
    Floman Y, Micheli LJ, Penny JN, Riseborough EJ, Hall JE. Combined anterior and posterior fusion in seventy-three spinally deformed patients: indications, results and complications. Clin Orthop Relat Res. 1982;164:110–22.Google Scholar
  88. 88.
    Lapp MA, Bridwell KH, Lenke LG, Riew DK, Linville DA, Eck KR, Ungacta FF. Long-term complications in adult spinal deformity patients having combined surgery: a comparison of primary to revision patients. Spine. 2001;26:973–83.PubMedCrossRefPubMedCentralGoogle Scholar
  89. 89.
    Ozgur BM, Aryan HE, Pimenta L, Taylor WR. Extreme lateral interbody fusion (XLIF): a novel surgical technique for anterior lumbar interbody fusion. Spine J. 2006;6:435–43.CrossRefGoogle Scholar
  90. 90.
    Phillips FM, Diaz R, Pimenta L. Minimally invasive fusion (XLIF) in the treatment of symptomatic degenerative lumbar scoliosis. 12th international meeting on advanced spine techniques, Banff, July 2005.Google Scholar
  91. 91.
    Regev GJ, Chen L, Dhawan M, Lee YP, Garfin SR, Kim CW. Morphometric analysis of the ventral nerve roots and retroperitoneal vessels with respect to the minimally invasive lateral approach in normal and deformed spines. Spine. 2009;34:1330–5.PubMedPubMedCentralCrossRefGoogle Scholar
  92. 92.
    Makanji HS, Le H, Wood KB, Jenis LG, Cha TD. Morphometric analysis of the retroperitoneal vessels with respect to lateral access surgery in adult scoliosis. Clin Spine Surg. 2017;30:E1010–4.PubMedCrossRefPubMedCentralGoogle Scholar
  93. 93.
    Mundis G, Akbarnia B, Phillips F. Adult deformity correction through minimally invasive lateral approach techniques. Spine. 2010;35(26 Suppl):S312–21.PubMedCrossRefPubMedCentralGoogle Scholar
  94. 94.
    Isaacs RE, Hyde J, Goodrich JA, Rodgers WB, Phillips FM. A prospective, non-randomized, multicenter evaluation of extreme lateral interbody fusion for the treatment of adult degenerative scoliosis: perioperative outcomes and complications. Spine. 2010;35(26 Suppl):S322–30.PubMedPubMedCentralCrossRefGoogle Scholar
  95. 95.
    Dakwar E, Cardona RF, Smith DA, Uribe JS. Early outcomes and safety of the minimally invasive, lateral retroperitoneal transpsoas approach for adult degenerative scoliosis. Neurosurg Focus. 2010;28(3):E8.PubMedPubMedCentralCrossRefGoogle Scholar
  96. 96.
    Diaz R, Phillips F, Pimenta L. XLIF for lumbar degenerative scoliosis: outcomes of minimally invasive surgical treatment out to 3 years postoperatively. Spine J. 2006;6(5):75S.CrossRefGoogle Scholar
  97. 97.
    Akbarnia BA, Mundis GM, Bagheri R, Salari P. Is the less invasive far lateral approach a safe way to reconstruct the anterior spinal column in advanced adult deformity surgery? A minimum 2-year follow-up study. Presented at: the 17th international meeting on advanced spine techniques (IMAST), Toronto, 21–24 July 2010.Google Scholar
  98. 98.
    Oliveria L, Marchi L, Coutinho E, Pimenta L. A radiographic assessment of the ability of the extreme lateral interbody fusion procedure to indirectly decompress the neural elements. Spine. 2010;35(26 Suppl):S331–7.CrossRefGoogle Scholar
  99. 99.
    Sembrano JN, Horazdovsky RD, Sharma AK, Yson SC, Santos ERG, Polly DW. Do lordotic cages provide better segmental lordosis versus nonlordotic cages in lateral lumbar interbody fusion (LLIF)? Clin Spine Surg. 2017;30:E338–43.PubMedCrossRefPubMedCentralGoogle Scholar
  100. 100.
    Anand N, Cohen RB, Cohen J, Kahndehroo B, Kahwaty S, Baron E. The influence of lordotic cages on creating sagittal balance in the CMIS treatment of adult spinal deformity. Int J Spine Surg. 2017;11:183–92.CrossRefGoogle Scholar
  101. 101.
    Philips FM, Isaacs RE, Rodgers WB, Khajavi K, Tohmeh AG, Deviren V, Peterson MD, Hyde J, Kurd MF. Adult degenerative scoliosis treated with XLIF. Spine. 2013;38(21):1853–61.CrossRefGoogle Scholar
  102. 102.
    Akbarnia BA, Mundis GM, Moazzaz P, Kabirian N, Bagheri R, Eastlack R, Pawelek J. Anterior column realignment (ACR) for focal kyphotic spinal deformity using a lateral transpsoas approach and ALL release. J Spinal Disord Tech. 2014;27:29–39.PubMedPubMedCentralCrossRefGoogle Scholar
  103. 103.
    Saigal R, Mundis GM, Eastlack R, Uribe JS, Philips FM, Akbarnia BA. Anterior column realignment (ACR) in adult sagittal deformity correction. Spine. 2016;41(8S):S66–73.PubMedPubMedCentralGoogle Scholar
  104. 104.
    Luhmann SJ, Lenke LG, Kim YJ, Bridwell KH, Schootman M. Thoracic adolescent idiopathic scoliosis curves between 70° and 100°: is anterior release necessary? Spine. 2005;30:2061–7.PubMedCrossRefPubMedCentralGoogle Scholar
  105. 105.
    Dobbs MB, Lenke LG, Kim YJ, Luhmann SJ, Bridwell KH. Anterior/posterior spinal instrumentation versus posterior instrumentation alone for the treatment of adolescent idiopathic scoliotic curves more than 90 degrees. Spine. 2006;31:2386–91.PubMedCrossRefPubMedCentralGoogle Scholar
  106. 106.
    Watanabe K, Lenke LG, Bridwell KH, Kim YJ, Watanabe K, Kim YW, Kim YB, Hensley M, Stobbs G. Comparison of radiographic outcomes for the treatment of scoliotic curves greater than 100 degrees: wires versus hooks versus screws. Spine. 2008;33:1084–109.PubMedCrossRefPubMedCentralGoogle Scholar
  107. 107.
    Lippman CR, Spence CA, Youssef S, Cahill DW. Correction of adult scoliosis via a posterior-only approach. Neurosurg Focus. 1992;14:1–6.CrossRefGoogle Scholar
  108. 108.
    Marchesi DG, Aebi M. Pedicle fixation devices in the treatment of adult lumbar scoliosis. Spine. 1992;17:304–9.CrossRefGoogle Scholar
  109. 109.
    Pateder DB, Kebaish KM, Cascio BM, Neubaeur P, Matusz DM, Kostuik JP. Posterior only versus combined anterior and posterior approaches to lumbar scoliosis in adults: a radiographic analysis. Spine. 2007;32:1551–4.PubMedCrossRefPubMedCentralGoogle Scholar
  110. 110.
    Wang MY, Bordon G. Mini-open pedicle subtraction osteotomy as a treatment for severe adult spinal deformities: case series with initial clinical and radiographic outcomes. J Neurosurg Spine. 2016;24(5):769–76.PubMedCrossRefPubMedCentralGoogle Scholar
  111. 111.
    Silva FE, Lenke LG. Adult degenerative scoliosis: evaluation and management. Neurosurg Focus. 2010;28(3):E1.PubMedCrossRefPubMedCentralGoogle Scholar
  112. 112.
    Mummaneni PV, Shaffrey CI, Lenke LG, Park P, Wang MY, La Marca F, Smith JS, Mundis GM, Okonkwo DO, Moal B, Fessler RG, Anand N, Uribe JS, Kanter AS, Akbarnia B, Fu KM. The minimally invasive spinal deformity surgery algorithm: a reproducible rational framework for decision making in minimally invasive spinal deformity surgery. Neurosurg Focus. 2014;36(5):E6.PubMedPubMedCentralCrossRefGoogle Scholar
  113. 113.
    Anand N, Baron EM, Thaiyananthan G, Khalsa K, Goldstein TB. Minimally invasive multilevel percutaneous correction and fusion for adult lumbar degenerative scoliosis: a technique and feasibility study. J Spinal Disord Tech. 2008;21(7):459–67.PubMedCrossRefPubMedCentralGoogle Scholar
  114. 114.
    Anand N, Rosemann R, Khalsa B, Baron EM. Mid-term to long-term clinical and functional outcomes of minimally invasive correction and fusion for adults with scoliosis. Neurosurg Focus. 2010;28(3):E6.PubMedCrossRefPubMedCentralGoogle Scholar
  115. 115.
    Phan K, Huo YR, Hogan JA, Xu J, Dunn A, Cho SK, Mobbs RJ, McKenna P, Rajagopal T, Altaf F. Minimally invasive surgery in adult degenerative scoliosis: a systematic review and meta-analysis of decompression, anterior/lateral and posterior lumbar approaches. J Spine Surg. 2016;2(2):89–104.PubMedPubMedCentralCrossRefGoogle Scholar
  116. 116.
    Kanter AS, Tempel ZJ, Ozpinar A, Okonkwo DO. A review of minimally invasive procedures for the treatment of adult spinal deformity. Spine. 2016;41(8S):S59–65.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Teja Karukonda
    • 1
  • Steven M. Presciutti
    • 2
  • Isaac L. Moss
    • 3
  • Frank M. Phillips
    • 4
    Email author
  1. 1.Department of Orthopaedic SurgeryUniversity of ConnecticutFarmingtonUSA
  2. 2.Department of Orthopaedic SurgeryEmory UniversityAtlantaUSA
  3. 3.Department of Orthopaedic SurgeryUConn HealthFarmingtonUSA
  4. 4.Department of Orthopedic SurgeryRush University Medical CenterChicagoUSA

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