Adult Spinal Deformity
Symptoms

What are the problems related to adult deformity? As noted, the expression of adult scoliosis is varied and relates to the segmental, regional, and global aspects of deformity. On a segmental level, spondylolisthesis or spinal stenosis may lead to lower extremity pain, weakness or neurogenic claudication (Figure 4). On a regional level increased kyphosis can cause digestive or respiratory troubles. Significant postural imbalance will lead to difficulty in comfortable walking and standing. Much more energy is required to stand and function in the setting of marked imbalance and leads to increased fatigue. Regardless of the region (thoracic or lumbar) or direction of postural imbalance (coronal or sagittal) back pain and the reduction in functional capabilities are important components in the patient's symptoms (Figure 5). It has been reported that scoliosis exceeding 70 degrees in the thoracic spine can cause compression of the lungs and eventually, with much larger curves (greater than 100 degrees) heart and lung dysfunction. However, in most patients even mild curves can cause marked reduction in activities of daily living when associated with a listhesis (loss of lordosis and global sagittal imbalance).