Causes / typical injury mechanism: Adult spinal deformity, specifically adult scoliosis, has multiple causes but is most commonly attributed to age-related degeneration due to lifelong wear. As facet joints and intervertebral disks deteriorate with age, they may not support the spine's normal posture. This could result in a compensatory coronal curvature of the spine. Adult spinal deformity can also be caused by spinal injuries or complications from past surgery. The stressed, degenerated joints and/or compressed nerves are likely to cause pain.

Classic history and presentation: Patients may not experience any pain if the deformity is mild. In moderate and severe cases, patients may describe localized joint pain and/or radiating pain from nerve impingement, loss of height, shortness of breath, or a bulge or deformity on their back.

Prevalence: The prevalence of adult spinal deformity has been reported to be between 2% and 32% in patients aged 19-80 years in past studies. More recent studies suggest that the prevalence may be greater than 60% in the elderly population (patients 60 years and older).

• Age –18 years and older (but most prevalent in people 60 years and older).
• Sex / gender – Females are more likely to experience adult spinal deformity than males. Prevalence estimates are 41.2% for females and 27.5% for males.

Risk factors: The primary risk factors for adult spinal deformity are age, degenerative disks, facet joint syndrome, and arthritic changes to facet joints. Elevated body mass index has also been identified as a potential risk factor.

Pathophysiology: Adult spinal deformity, and specifically scoliosis, typically results from age-related degeneration of the spine. Degeneration of intervertebral disks and a loss of shock absorption are often the first processes observed. Pathologic degeneration of facet joints typically follows, inducing bone remodeling and joint instability.

Grade / classification system: There is no agreed-upon standard classification system. The Cobb angle is used to specify the degree of curvature in the coronal plane.