Adult

Adults can present with a progressive deformity that can get worse with time and lead to a disability. The deformities later in life can either be degenerative changes in an existing deformity from childhood or adolescent years, or can be de novo, due to asymmetric degeneration of the spinal column. The problem of being unable to stand upright is the unique common factor in many of these deformities.

Concurrence of the degenerative changes implies the associated compression of neural structures as well as the mal-alignment of the spinal column. The treatment is customized to the individual patient based on the symptoms, activity and demands as well as the expected outcomes of any treatment. Physiotherapy, injections, acupuncture should all be explored before consideration is given to surgery. Surgery is high risk and medical co-morbidities should be weighed against the expected outcomes. The general health of the person is an important guide to the extent of major surgical reconstruction that is feasible.