title: Principles for selecting fusion levels in adult spinal deformity with particular attention to lumbar curves and double major curves.
abstract: METHODS
  Review article.
  
  
  OBJECTIVE
  To identify decision-making principles for selecting fusion levels in adult spinal deformity, with particular attention to lumbar curves and double major curves.
  
  
  BACKGROUND
  Although numerous articles have been published on the selection of fusion levels for adolescent idiopathic scoliosis (AIS) curves, relatively less attention has been paid to the selection of fusion levels for the operative management of adult scoliosis.
  
  
  METHODS
  This is a literature review pertaining to the surgical management of adult scoliosis.
  
  
  RESULTS
  Selection of fusion levels for adult scoliosis can be difficult; however, certain biomechanical and surgical principles can consistently be applied.
  
  
  CONCLUSIONS
  An appreciation of both the coronal and sagittal plane components of spinal deformity is mandatory to achieve optimal results with surgical stabilization of adult scoliosis.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Walter Reed Army Medical Center, Washington, DC, USA.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Kuklo
mesh_terms: D000328:Adult; D000367:Age Factors; D001416:Back Pain / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods / Q000592:standards; D013121:Spinal Curvatures / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods* / Q000592:standards*; D013131:Spine / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome