Journal
NEUROSURGERY CLINICS OF NORTH AMERICA
Volume 28, Issue 3, Pages 341-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.nec.2017.03.002
Keywords
Adult spinal deformity; Treatment strategies; Decompression alone; Decompression with limited fusion; Multilevel fusion; Appropriate use criteria; Clinical outcomes
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The management of adult deformity varies significantly. Options range from nonoperative care to limited decompression to decompression with limited or extensive fusion. The appropriate surgical management is the approach that optimizes the likelihood of improvement in health-related quality of life, while limiting risks of complications and costs. Decompression alone is unreliable in the setting of significant deformity contributing to radiculopathy. Decompression with limited fusion is most appropriate for patients with age-appropriate global alignment of the spine, and decompression with more extensive fusion is most appropriate for patients with progressive deformity or with global sagittal or coronal malalignment.
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