1. Britspine Debate Degenerative scoliosis requires full deformity correction The case for..... Ian Harding and Sean Molloy Wednesday 4.15pm 2 nd April 2014

2. 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

3. Deformity: Imbalance v. local

4. 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

5. 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

6. 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

7. 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

8. 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