The degenerative phenomena of the spine alter vertebral biomechanics. Overtime, these alterations can cause a change in the static relationship between vertebral segments, eventually leading to deformity in either the sagittal or coronal plane. With the increase in the population’s life expectancy, an increment in the prevalence and severity of degenerative deformity has been observed.  Furthermore, the elderly population demands more and more functional requirements that were not nearly as common in past decades.  For this reason, the evaluation of patients with articular disc degeneration should be performed considering not only the present condition and the immediate effects of the pathology, but also the possible biomechanical influences across a broader time perspective.  The presence of compensatory mechanisms such as the reduction of thoracic kyphosis, pelvic retroversion, and knee flexion can hide, at least in part, the incipient deformity, but they are themselves a cause of pain.

It’s important to try to predict how the motion segment alterations might evolve by evaluating the possible influences... in the statics of the spine, ...monitoring the evolution of the spinal profile over time and selecting the appropriate and reproducible timing and strategy of an eventual intervention.

The increase in the surgical revision rate observed in recent years testifies to the lack of homogeneity and reproducibility in clinical practice and outcomes, and it demonstrates how the discord in clinical and therapeutic choices is generating enormous clinical and economic costs.

These topics represent what will be some of the major challenges in spine surgery in the near future.

With this perspective, we have created this interactive course, composed of clinical cases and short readings, with the aim of offering a comprehensive picture of the relationship between deformity and degeneration.

This course will provide the unique opportunity to meet some of the greatest exponents in the world of spine surgery. Participants will have the chance to interact with the experts in a relaxed and informal setting by discussing theories presented schematically and through clinical case discussions which will provide the basis for outlining the surgical strategies, the contribution of new minimally invasive techniques, and the still present problems of this field which bridges degeneration and deformity.

GSpine4 team