Matches in SemOpenAlex for { <https://semopenalex.org/work/W2000235333> ?p ?o ?g. }
- W2000235333 endingPage "948" @default.
- W2000235333 startingPage "925" @default.
- W2000235333 abstract "Adult scoliosis is defined as a spinal deformity in a skeletally mature patient with a Cobb angle of more than 10° in the coronal plain. Adult scoliosis can be separated into four major groups: Type 1: Primary degenerative scoliosis, mostly on the basis of a disc and/or facet joint arthritis, affecting those structures asymmetrically with predominantly back pain symptoms, often accompanied either by signs of spinal stenosis (central as well as lateral stenosis) or without. These curves are often classified as “de novo” scoliosis. Type 2: Idiopathic adolescent scoliosis of the thoracic and/or lumbar spine which progresses in adult life and is usually combined with secondary degeneration and/or imbalance. Some patients had either no surgical treatment or a surgical correction and fusion in adolescence in either the thoracic or thoracolumbar spine. Those patients may develop secondary degeneration and progression of the adjacent curve; in this case those curves belong to the type 3a.Type 3: Secondary adult curves: (a) In the context of an oblique pelvis, for instance, due to a leg length discrepancy or hip pathology or as a secondary curve in idiopathic, neuromuscular and congenital scoliosis, or asymmetrical anomalies at the lumbosacral junction; (b) In the context of a metabolic bone disease (mostly osteoporosis) combined with asymmetric arthritic disease and/or vertebral fractures. Sometimes it is difficult to decide, what exactly the primary cause of the curve was, once it has significantly progressed. However, once an asymmetric load or degeneration occurs, the pathomorphology and pathomechanism in adult scoliosis predominantly located in the lumbar or thoracolumbar spine is quite predictable. Asymmetric degeneration leads to increased asymmetric load and therefore to a progression of the degeneration and deformity, as either scoliosis and/or kyphosis. The progression of a curve is further supported by osteoporosis, particularly in post-menopausal female patients. The destruction of facet joints, joint capsules, discs and ligaments may create mono- or multisegmental instability and finally spinal stenosis. These patients present themselves predominantly with back pain, then leg pain and claudication symptoms, rarely with neurological deficit, and almost never with questions related to cosmetics. The diagnostic evaluation includes static and dynamic imaging, myelo-CT, as well as invasive diagnostic procedures like discograms, facet blocks, epidural and root blocks and immobilization tests. These tests may correlate with the clinical and the pathomorphological findings and may also offer the least invasive and most rational treatment for the patient. The treatment is then tailored to the specific symptomatology of the patient. Surgical management consists of either decompression, correction, stabilization and fusion procedures or a combination of all of these. Surgical procedure is usually complex and has to deal with a whole array of specific problems like the age and the general medical condition of the patient, the length of the fusion, the condition of the adjacent segments, the condition of the lumbosacral junction, osteoporosis and possibly previous scoliosis surgery, and last but not least, usually with a long history of chronified back pain and muscle imbalance which may be very difficult to be influenced. Although this surgery is demanding, the morbidity cannot be considered significantly higher than in other established orthopaedic procedures, like hip replacement, in the same age group of patients. Overall, a satisfactory outcome can be expected in well-differentiated indications and properly tailored surgical procedures, although until today prospective, controlled studies with outcome measures and pre- and post-operative patient’s health status are lacking. As patients, who present themselves with significant clinical problems in the context of adult scoliosis, get older, minimal invasive procedures to address exactly the most relevant clinical problem may become more and more important, basically ignoring the overall deformity and degeneration of the spine." @default.
- W2000235333 created "2016-06-24" @default.
- W2000235333 creator A5022317298 @default.
- W2000235333 date "2005-11-18" @default.
- W2000235333 modified "2023-10-18" @default.
- W2000235333 title "The adult scoliosis" @default.
- W2000235333 cites W1234968016 @default.
- W2000235333 cites W131833469 @default.
- W2000235333 cites W148751618 @default.
- W2000235333 cites W186556716 @default.
- W2000235333 cites W1933686193 @default.
- W2000235333 cites W1941226294 @default.
- W2000235333 cites W1966328055 @default.
- W2000235333 cites W1966718740 @default.
- W2000235333 cites W1979331872 @default.
- W2000235333 cites W1983290219 @default.
- W2000235333 cites W1991255912 @default.
- W2000235333 cites W1996433985 @default.
- W2000235333 cites W1998224356 @default.
- W2000235333 cites W2002785419 @default.
- W2000235333 cites W2002843970 @default.
- W2000235333 cites W2004202282 @default.
- W2000235333 cites W2006686224 @default.
- W2000235333 cites W2008130421 @default.
- W2000235333 cites W2009453458 @default.
- W2000235333 cites W2013159370 @default.
- W2000235333 cites W2013837287 @default.
- W2000235333 cites W2016351247 @default.
- W2000235333 cites W2021922541 @default.
- W2000235333 cites W2025951795 @default.
- W2000235333 cites W2026495414 @default.
- W2000235333 cites W2026831320 @default.
- W2000235333 cites W2027788451 @default.
- W2000235333 cites W2032788739 @default.
- W2000235333 cites W2035601626 @default.
- W2000235333 cites W2036993965 @default.
- W2000235333 cites W2037944748 @default.
- W2000235333 cites W2040220344 @default.
- W2000235333 cites W2048042484 @default.
- W2000235333 cites W2048252293 @default.
- W2000235333 cites W2054045434 @default.
- W2000235333 cites W2055231866 @default.
- W2000235333 cites W2062844617 @default.
- W2000235333 cites W2065557724 @default.
- W2000235333 cites W2074717454 @default.
- W2000235333 cites W2078213417 @default.
- W2000235333 cites W2081280095 @default.
- W2000235333 cites W2084672729 @default.
- W2000235333 cites W2086463139 @default.
- W2000235333 cites W2087699941 @default.
- W2000235333 cites W2093355208 @default.
- W2000235333 cites W2093759967 @default.
- W2000235333 cites W2108342262 @default.
- W2000235333 cites W2164130291 @default.
- W2000235333 cites W2229618181 @default.
- W2000235333 cites W2230403283 @default.
- W2000235333 cites W2274214943 @default.
- W2000235333 cites W2323574715 @default.
- W2000235333 cites W2335577464 @default.
- W2000235333 cites W2397628087 @default.
- W2000235333 cites W2400190930 @default.
- W2000235333 cites W2409407584 @default.
- W2000235333 cites W2416585051 @default.
- W2000235333 cites W2417083580 @default.
- W2000235333 cites W2431505102 @default.
- W2000235333 cites W2463179455 @default.
- W2000235333 cites W4255591811 @default.
- W2000235333 cites W4290641737 @default.
- W2000235333 cites W4299466867 @default.
- W2000235333 cites W4301261106 @default.
- W2000235333 doi "https://doi.org/10.1007/s00586-005-1053-9" @default.
- W2000235333 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/16328223" @default.
- W2000235333 hasPublicationYear "2005" @default.
- W2000235333 type Work @default.
- W2000235333 sameAs 2000235333 @default.
- W2000235333 citedByCount "673" @default.
- W2000235333 countsByYear W20002353332012 @default.
- W2000235333 countsByYear W20002353332013 @default.
- W2000235333 countsByYear W20002353332014 @default.
- W2000235333 countsByYear W20002353332015 @default.
- W2000235333 countsByYear W20002353332016 @default.
- W2000235333 countsByYear W20002353332017 @default.
- W2000235333 countsByYear W20002353332018 @default.
- W2000235333 countsByYear W20002353332019 @default.
- W2000235333 countsByYear W20002353332020 @default.
- W2000235333 countsByYear W20002353332021 @default.
- W2000235333 countsByYear W20002353332022 @default.
- W2000235333 countsByYear W20002353332023 @default.
- W2000235333 crossrefType "journal-article" @default.
- W2000235333 hasAuthorship W2000235333A5022317298 @default.
- W2000235333 hasBestOaLocation W20002353332 @default.
- W2000235333 hasConcept C105702510 @default.
- W2000235333 hasConcept C13483470 @default.
- W2000235333 hasConcept C141071460 @default.
- W2000235333 hasConcept C151730666 @default.
- W2000235333 hasConcept C2778871979 @default.
- W2000235333 hasConcept C2779343474 @default.
- W2000235333 hasConcept C2779982284 @default.