La scoliosi dell’adulto: il trattamento chirurgico

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.