Researchers Identify Better Classification System for Adult Idiopathic Scoliosis
Researchers have designed a new X-ray classification system for adult idiopathic scoliosis that can more precisely define which parts of the spine need correction, an achievement that could enhance treatment, communication, and analysis of spinal deformities affecting older patients, according to a study published in Spine Deformity in August.
The team of researchers, led by James D. Lin, MD, MS, a spine surgeon at The Mount Sinai Hospital and Assistant Professor of Orthopedic Surgery at the Icahn School of Medicine at Mount Sinai, said their modern approach to the X-ray classification system could provide a more universal and standard assessment of adult scoliosis.
“This classification system provides a new language for clinicians and researchers, helping us reliably categorize and communicate the radiographic features of adult idiopathic scoliosis, in order to more effectively facilitate treatment and further analysis,” said Dr. Lin. “This will help researchers and surgeons scrutinize past results from prior surgeries and refine future treatment.”
Scoliosis is a sideways curvature of the spine, a condition that affects an estimated six million people in the United States. Many develop it in adolescence, but only a small percentage of adolescent cases require surgery. While adult scoliosis can be the natural progression of adolescent scoliosis, adults can also develop it for the first time; those cases are called adult degenerative scoliosis. The symptoms and surgical treatment can differ significantly for older patients; for example, adults often experience more pain from the condition.
The new method builds on the Lenke classification system for adolescent idiopathic scoliosis, which is widely used to define six curve types but is not applicable to adults. The new three-component method maintains the curve types from the Lenke classification and introduces assessments of the global alignment and lumbosacral curve, two features that more commonly deteriorate in older patients.
In the study, 12 spine surgeons used the new classification system to grade 30 cases twice, which resulted in near-perfect agreement in the assessment of the patients. This latest method to classify adult scoliosis could improve treatment options because it helps define the different areas of the spine that need to be corrected and fused, and there is currently no widely accepted X-ray classification system for the complex condition.
“The development of a new classification system, led by Dr. Lin, strengthens our efforts at the Spine Center at The Mount Sinai Hospital to provide innovative and customized treatment for patients with spinal disorders and injuries,” said Andrew Hecht, MD, Chief of Spine Surgery for the Mount Sinai Health System and The Mount Sinai Hospital, and Director of the Spine Center at Mount Sinai. “The new method ensures that we have a more exhaustive, thorough, and rigorous benchmark in how we analyze and treat adults with spinal conditions throughout the Mount Sinai Health System, but also for our colleagues throughout the entire orthopedic community, helping us all to provide exceptional care.”
Dr. Lin authored the study with doctors from the Departments of Orthopedic Surgery and Neurological Surgery at Columbia University, and the Department of Orthopaedic Surgery at Washington University.
About the Mount Sinai Health System
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, over 400 outpatient practices, nearly 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is one of three medical schools that have earned distinction by multiple indicators: It is consistently ranked in the top 20 by U.S. News & World Report's "Best Medical Schools," aligned with a U.S. News & World Report "Honor Roll" Hospital, and top 20 in the nation for National Institutes of Health funding and top 5 in the nation for numerous basic and clinical research areas. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.