Preoperative Surgical Planning and Intraoperative Considerations for the Treatment of Adult Spinal Deformity Surgery.

Study DesignNarrative Review of published literature.ObjectiveThe objective of this article is to review the current state of treatment for patients with adult spinal deformity (ASD) with a focus on preoperative planning, optimization and intraoperative surgical techniques, including the application of current enabling technologies to spinal deformity surgery.MethodsA literature review of publications related to preoperative planning, patient optimization, intraoperative techniques, and surgical outcomes for the treatment of ASD was performed.Results/ConclusionStandardized preoperative evaluation including imaging analysis now allows patient specific planning for the planned surgical procedure. The current work on patient optimization along with understanding and mitigating the surgical insult are being utilized as appropriate and should improve patient outcomes. The intraoperative application of enabling technologies including navigation, robotics and confirmatory radiographic software will continue to assist surgeons in safe placement of instrumentation, often with less invasive surgical techniques and achievement of intraoperative alignment goals.