Degenerative Scoliosis: Literature Review

The paper presents a review of the current literature concerning the problem of degenerative scoliosis, its clinical manifestations, diagnosis, classification and approaches to surgical treatment. In connection with the aging of the population, improvement of surgical techniques and advance in anesthetic support, the problem of degenerative scoliosis is increasingly viewed with regard to possible options for its surgical correction. There are several factors that contribute to the formation of de novo scoliosis. They involve the facet joint tropism, asymmetric degeneration of the intervertebral disc, osteoporosis, myopathy, and long-existing antalgic scoliosis. Conservative treatment of degenerative scoliosis includes administration of non-steroidal anti-inflammatory drugs, brace treatment, and epidural and paravertebral glucocorticosteroid injections. When conservative therapy is fully ineffective and patient’s quality of life significantly decreases, the surgical treatment decision is made individually. The main issue of surgery is the choice of optimal surgical strategy which depends on careful evaluation of clinical symptoms and their pathologic substrate, and mandatory accounting for parameters of the global spinal-pelvic balance. Positive sagittal imbalance is associated with a significant reduction in quality of life, therefore it should be, whenever possible, surgically corrected.