Transcript Ian-Harding-first speaker

Britspine Debate
Degenerative scoliosis requires full
deformity correction
The case for.....
Ian Harding and Sean Molloy
Wednesday 4.15pm 2nd April 2014
Evidence: It is common
Prevalence rates for scoliosis in US adults: Results from the first
National Health and Nutrition Examination Survey.
Carter OD, Haynes SG.
Int J Epidemiol. 1987;16:537–544
The adult scoliosis.
Aebi M.
Eur Spine J. 2005;14(10):925–948
Abnormalities of the lumbar spine in the coronal plane on plain
abdominal radiographs
RPBaker, M Kilshaw, R Gardner, S Charosky, and IJHarding
Eur Spine J. 2011 Mar;20(3):429-33
Overall 5-70% with >30% over 70s
Deformity: Imbalance v. local
Evidence: Deformity matters
A Clinical Impact Classification of Scoliosis in the Adult
Frank Schwab MD, Jean-Pierre Farcy MD, Keith Bridwell MD, Sigurd
Berven MD, Steven Glassman MD, John Harrast MS, William Horton MD.
Spine. 2006;31(18):2109–2114
The impact of positive sagittal balance in adult spinal deformity.
Glassman SD, Bridwell K, Dimar JR, Horton W, Berven S, Schwab F
Spine. 2005;30(18):2024–2029.
Lumbar disc degeneration below a long arthrodesis (performed for
scoliosis in adults) to L4 or L5
Harding IJ, Charosky S, Vialle R, Chopin DH
Eur Spine J. 2008 Feb;17(2):250-4
Evidence: Spinal shape
Radiographic analysis of the sagittal alignment and balance of the
spine in asymptomatic subjects
Vialle R, Levassor N, Rillardon L, Templier A, Skalli W, Guigui P
J Bone Joint Surg Am. 2005 Feb;87(2):260-7
Evidence: Ageing and deformity
The effect of age on sagittal plane profile of the lumbar spine
according to standing, supine, and various sitting positions
Lee ES, Ko CW, Suh SW, Kumar S, Kang IK, Yang JH.
J Orthop Surg Res. 2014 Feb 27;9(1):11
Evidence: assessment and risk
Complications and risk factors of primary adult scoliosis surgery: a multicenter study
of 306 patients.
Charosky S, Guigui P, Blamoutier A, Roussouly P, Chopin D; Study Group on
Scoliosis
Spine (Phila Pa 1976). 2012 Apr 15;37(8):693-700
The case for
“Full deformity correction”
Full = for the particular individual with
particular functional needs at a
particular time of life, nothing more
nothing less