Cawley DT, et al. - Authors assessed the back and leg pain as a combined score in adult spinal deformity (ASD) and compared their relative and cumulative correlations with health-related quality of life (HRQOL) and sagittal parameters. Insight into the pathogenesis of ASD was provided by the distribution and intensity of pain and its correlations with clinical and radiological parameters. To the assessment of symptoms in ASD, a combined score has a simple yet valuable contribution. Three clear patterns of pain were demonstrated by the distribution of NRS20 pain scores viz, back pain only, moderate back pain with varying mild-moderate leg pain, and severe equivalent back and leg pain. For nonoperative and operative patients, similar values were noted.