A comprehensive review of adult scoliosis: Advances in pathogenesis, diagnosis, and management strategies

Adult scoliosis is a three-dimensional complex deformity of the spine where the Cobb angle is over 10°. Understanding the severity of the deformity, etiology, and planning management strategies is assisted by classification systems with their emphasis on sagittal balance modifiers such as sagittal vertical axis and pelvic incidence. According to epidemiological studies, this deformity is getting more prevalent among the elderly due to progressive spinal degeneration. Adult scoliosis has a wide range of manifestations and symptoms ranging from neurogenic claudication and back pain to psychosocial effects and postural imbalance. For the overall diagnostic evaluation, actions such history-taking, physical examination, and assessing the individual's quality of life play an essential role. However, the precise diagnosis of this deformity can be significantly assisted by radiographic methods making use of sagittal modifiers and the Cobb angle, and advanced imaging systems such as computed tomography and magnetic resonance imaging. Practices such as bracing, physical therapy, and pharmacological interventions are considered conservative treatments, while surgical options are preferred for severe deformities, which include spinal fusion and osteotomies.