Principles of deformity correction

Spinal deformity can be defined as malalignment of the spine in the coronal, sagittal, and/or axial planes. It is a common condition with a great clinical impact on health-related quality of life and the cost of care. Appropriate management may encompass a wide range of options including nonoperative care, limited decompression, limited fusion, and complex spinal realignment. Complex spinal realignment involves application of a broad spectrum of techniques for deformity correction and is often characterized by significant variability in surgical approach between providers. The presence of variability reflects an absence of an evidence-based approach to care and the need for guiding principles. The purpose of this chapter is to describe the impact of spinal deformity on health status and to detail principles of deformity correction that can guide clinicians in selecting appropriate surgical plans to maximize patient benefit while minimizing the risks and costs of care.