- Why do we need a separate classification for AdIS?
- Symptoms are different:
- AdIS patients complain of back and/or leg pain
- Radiological evaluation is different:
- Sagittal malalignment contributes significantly
- Curves are more rigid
- Degeneration of lumbosacral (LS) fractional curve is common
- Surgical management is different:
- Instrumentation may need to be extended to the pelvis
- Aim of the classification
- to help determine the appropriate levels of spinal arthrodesis in adult idiopathic scoliosis
- Indication
- Adult idiopathic scoliosis
- Not to be used for iatrogenic, neuromuscular, or degenerative deformities often present with significant sagittal plane malalignment that is not addressed with this classification.
- Imaging:
- Supine coronal radiographs (instead of bending radiographs)
- easier to perform → more reproducible
- Not operator dependent
- Standing long-cassettes
- Coronal
- Lateral
- Difference vs Lenke classification
- AdIS uses of supine radiographs instead of side-bending radiographs
- Therefore the definition for Structural criteria is different
- AdIS uses lumbosacral and global alignment modifers whereas Lenke uses lumbar spine modifiers
- AdIS has a global alignment modifier vs Lenke does not have
- Difference AdIS vs SRS-Schwab classification:
- SRS-Schwab takes into account the Spinopelvic parameters which has a high correlation with pain, disability, and patient-reported outcome measures
- AdIS has better inter-observer reliability
- AdIS is only for adult idiopathic scoliosis where as SRS-Schwab is for all types of adult spinal deformity
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