When you think about scoliosis, if you know what it is at all, you might think it is only a spinal disorder that begins when you’re young. However, adults can develop scoliosis, too, even if they didn’t have it as a child.

What’s the difference between pediatric and adult scoliosis?

Scoliosis describes the curvature of the spine in the imaginary line that divides the front and back halves of the body. With scoliosis, it creates an S-shaped curve. You can learn more about adult scoliosis at  https://scoliosisinstitute.com/adult-scoliosis/.

Can Adults Suffer From Scoliosis?

The most common kind of scoliosis that affects children is called adolescent idiopathic scoliosis. As the name suggests, this condition is usually detected during adolescence, and we don’t yet understand why this happens. Scoliosis in this form can involve the mid-back and the low back portions of the spine. When this kind of scoliosis continues into adulthood, adult idiopathic scoliosis is one of the more common forms of scoliosis seen in adults.

The other form of scoliosis that is most commonly seen in adults is degenerative scoliosis. In this form, degeneration or aging of the joints and discs in the spine happens asymmetrically. This causes a tilting or slipping between the vertebrae. As this cascades from one level to the next, a curve of the spine can occur. This sort of scoliosis usually affects the lower back. 

If I had scoliosis surgery in my youth, is that a predictor for scoliosis in adulthood?

Surgical treatment for scoliosis involves partially straightening the curve in the spine. Then, doctors permanently link the individual vertebral bones together. Hence, they grow into a solid piece of bone. This is called spinal fusion. If this fusion is successful, the curve won’t usually progress further as you get older. However, some parts of the spine above or below the fused part of the spine could develop curvature problems. 

Will I develop a compensating curve above or below scoliosis?

This is a likely possibility. A compensating curve happens above or below the largest area of the scoliosis curve. It happens because our bodies work to keep the head centered over the pelvis. When the spine’s curvature develops in one direction in one part of the spine, it’s typical for the areas above and below to curve in the opposite direction to balance this out and keep the head over the pelvis. This can cause back pain.

What risk factors could predispose an adult to degenerative scoliosis?

Unfortunately, not much is known about the risk factors for adult degenerative scoliosis. Smoking and obesity are commonly linked to accelerated degeneration of the spine. However, it isn’t clear what factors cause the abnormal curve to develop in the first place. 

Is adult scoliosis a progressive disorder?

Idiopathic curves that start in youth that are greater than about 45 degrees can worsen during adulthood. Generally, if this does happen, the progression usually occurs at about 1 or 2 degrees a year. Scoliosis surgery is performed on children who have curves greater than the 45-degree threshold to stop the curve from worsening over time.

Besides the spine curvature, what symptoms might accompany adult scoliosis?

Beyond the actual curvature itself and the effects on your appearance, scoliosis can also have a range of other symptoms that are usually related to the degeneration of the spine.

Arthritis or disc degeneration can lead to back pain. Spinal stenosis, which is an abnormal narrowing of the spinal canal, can cause back pain when you stand or walk. This is called neurogenic claudication. Nerves can become compressed and might cause radiculopathy and sciatica with pain, numbness, tingling, or weakness in the legs.

Will wearing a special back brace correct or straighten my spine?

Braces have been known to be successful at stopping scoliosis from progressing in teenagers with adolescent idiopathic scoliosis. However, once you have stopped growing, braces aren’t effective at either straightening or preventing the curve from progressing further. A brace can help adults to manage pain. However, in some cases, it can make the pain worse by weakening the muscles that support the back. 

How are symptoms of adult scoliosis treated without surgery?

Back pain can be managed with medications, including anti-inflammatory drugs (NSAIDs) and muscle relaxers. Physical therapy might also benefit, especially for staying flexible, having intense abdominal and core muscles, and cardiovascular fitness.

You might also consider seeking chiropractic care, massage therapy, or acupuncture. If your symptoms are related to spinal stenosis or radiculopathy, you can reduce your pain with an epidural steroid injection. In many cases, lots of these nonoperative treatments are attempted before surgery is considered. 

Surgery is usually recommended for teenagers when the magnitude of the curve exceeds about 45-degrees. Surgery is done in this case to prevent the possibility of the curve progressing through adulthood.

In adults, progression or worsening of the curve is why a physician might recommend you have surgery. Another reason surgery might be suggested is if you have spinal stenosis or radiculopathy and haven’t responded to medical or other treatments over a few weeks.

In cases like this, it is essential to account for scoliosis when you’re being treated, as the surgical options for someone with scoliosis will differ compared to someone without the condition.

Another reason to consider surgery is if you start to lean more and more forward. Scoliosis is side to side bending of the spine and is better known to most people, but abnormally increased kyphosis, which bends the spine back to front, may cause more back pain and symptoms. 

What type of surgery might be needed?

The goals of surgery in scoliosis cases are to remove any significant areas of nerve compression, improve the degree of curvature, and stabilize the spine through a spinal fusion. This will usually involve placing things like screws, rods, or cages.

Surgery is usually performed over several vertebral levels. It is usually more complex than common surgeries for degenerative conditions, which are only performed over a few levels. For this reason, you should look for a surgeon who has very specialized training and experience in treating adults for scoliosis. 

In more and more cases, minimally invasive techniques are used to accomplish surgery goals. This allows patients to recover faster and with reduced risk of complications. The choice to perform open, traditional surgery instead of minimally invasive, or a hybrid of the two types, should be made based on your individual needs. It should also be based on the comfort level of the surgeon in using the various techniques available. The key is to encourage the best recovery speed while not compromising the long-term results of the surgery. 

What’s the best advice for people with adult scoliosis?

Surgery should only be considered when other treatment options have been tried but have not given the amount of improvement you want. Minimally invasive surgical options should be considered when appropriate. Work with a doctor who will help you understand your condition and the treatment options available to you. Your doctor should prepare you and your support network for what to expect during recovery.

Surgery for adult spine deformities can result in significant improvements, but it can be stressful and often has a lengthy recovery process. Working with your doctor on these issues before surgery will help build trust, decrease your worries, and improve the outcome. 

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