Adult Degenerative Scoliosis
Adult degenerative scoliosis is abnormal curvature to the left or right of the spine. It can develop or become problematic in some people over age 18. Degenerative scoliosis can develop in the thoracic (mid-back) and/or lumbar (low back). Thoracic scoliosis is illustrated below.
Causes differ
Sometimes untreated childhood scoliosis progresses during adulthood. In other words, the sideward spinal curve begins to increase in size. Natural, age-related—or degenerative changes in the body can affect the spine's architecture; its structures, shape, and stability. In addition, certain diseases that affect spinal bone can contribute to the advancement of degenerative conditions that may lead to adult degenerative scoliosis.
Symptoms
Back pain is a common symptom and often the primary reason why a patient sees their doctor. Spinal nerve root compression can cause leg weakness, numbness, or tingling sensations. If the spinal cord is compressed, symptoms may include problems with coordination, balance, or difficulty walking, standing or sitting. In rare cases, low back nerve compression may cause bowel or bladder dysfunction; a medical emergency.
Degenerative changes, and time, can affect the shape of the spine and cause deformity. Some patients notice a change in their physical appearance.
- Trunk imbalance; listing to one side
- Spinal instability
- Rib prominence on either side
- Humpback
- Irregular gait caused by a discrepancy in leg length
- Spinal rigidity and stiffness
- Cardiopulmonary (heart and lung) problems
Accurate diagnosis
Spine surgeons undergo years of rigorous training and gain unique experience valuable to treating your back problem. Consult an expert about your back pain, pre-existing or changing spinal disorder. An accurate diagnosis is essential to an effective and successful treatment plan.
- Do you have a family history of scoliosis?
- Have you had previous back surgery?
- When did your symptoms start and how have they changed?
Your medical history and physical and neurological examinations are very important. You and your doctor discuss your symptoms, their severity, and treatment tried. The doctor tests your reflexes and evaluates you for muscle weakness, loss of feeling, and signs of neurological injury.
- Movement limitations
- Balance problems
- Ability to bend sideways, forward, backward at the waist
- Measure the length of each leg
Diagnostic testing may include x-rays, CT or MRI scans, or myelography to enhance the surgeon's examination of your spinal cord and nerve roots.
Treatment options
The treatment plan is dependent on you and your diagnosis. No two patients with adult degenerative scoliosis are the same. Not every patient needs treatment. Sometimes lifestyle changes; such as losing weight, eating better, smoking cessation, and regular exercise help. Non-surgical treatment may include anti-inflammatory and pain medications, bracing to help manage pain, spinal injections, and physical therapy.
Your surgeon may discuss surgical treatment when:
- Non-operative treatment fails and pain persists
- Curvature is progressive or excessive (curves greater than 45-degrees)
- Curvature causes cardiopulmonary problems (heart, lung)
You may be a candidate for a minimally invasive spine surgery. Sometimes spinal stabilization and fusion are necessary to stop the spine from moving or help alleviate progression of symptoms or deformity. |
