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Existing adult spinal deformity (ASD) classification systems are based on radiological parameters but management of ASD patients requires a holistic approach. A comprehensive clinically oriented patient profile and classification of ASD that can guide decision-making and correlate with patient outcomes is lacking. To perform a systematic review to determine the purpose, characteristic, and methodological quality of classification systems currently used in ASD. A systematic literature search was conducted in MEDLINE, EMBASE, CINAHL, and We