Definition
Lateral deviation of the spine that develops after the age of 50
- minimal structural vertebral deformity
Lower lumbar
- convex left
Aetiology
Unknown
- only very weak links to osteoporosis and degenerative disc disease
NHx
Progression
- larger curves > 30o
- increased rotation
- lateral lithesis > 6mm
- inter-crest line through or below L4/5 space
Larger curves more likely to have pain
Symptoms
LBP
Neurogenic claudication
Radiculopathy
- nerve roots compressed in concavity
X-ray
MRI
Myelopathy
Decreased height of nerve foramina
Management
Non Operative
Epidural Steroids
Operative
Technique
Multilevel decompression and posterior instrumented fusion
- laminectomy / foraminotomy
- +/- interbody cages to increase foraminal size
Deformity correction rare