Scoliosis is a curvature of the spine that occurs most often in adolescents, but adults develop the condition too. An estimated 60 percent of the older population has what is known as adult scoliosis. As people live longer and are more active, this number is expected to increase.
Adult scoliosis is most common in people between the ages of 50 and 80. It is characterized by a side-to-side curvature of the spine caused by degeneration of the spine’s facet joints, which act as hinges to help the spine bend.
What to look for
Mid to lower back pain and back stiffness are often the first symptoms of degenerative adult scoliosis.
Other symptoms include:
- Curved posture
- Difficulty sitting or standing
- Difficulty walking due to loss of leg muscle coordination
- Humpback
- Leaning towards one side
- Nerve damage, causing weakness, numbness and pain in legs and feet
- Protruding rib
- Reduction in height due to a curved spine
- Shortness of breath and fatigue, caused by an upper spine curve
Spinal stiffness
Tests
To make a diagnosis, a spine specialist will record your medical history, including information about your symptoms, previous treatments and family history of scoliosis.
A physical examination will include tests to measure your range of motion, balance, reflexes, muscle strength, sensation and neurologic function.
Standing X-rays, from the front and side, will be taken to document the curvature of your spine and to determine how fast the curve is progressing.
Treatment
Treatment usually begins with physical therapy and medications, including:
- Anti-inflammatory medications and occasional mild narcotics for pain relief
- Epidural steroid injections to relieve leg pain
- Physical therapy to stabilize the spine
Surgery
For patients whose back or leg pain doesn’t respond to medication and physical therapy, surgery may be considered. Spinal surgery to treat adult scoliosis is complex, considering the average patient’s age and the possibility of other medical conditions, such as osteoporosis, but a patient’s age should not rule out surgery.
Research has shown that age is not as important as a person’s health in determining the success of the surgery and rate of recovery. Patients considering surgery are encouraged to adapt a healthy diet and weight, and participate in an exercise regimen before and after surgery.
Spinal Fusion Surgery
Spinal Fusion surgery may be recommended for patients who have pain despite other treatments.
Fusion surgery is performed to fuse the vertebrae so the spine can’t bend. This stabilizes the spine, preventing excessive motion and collapse. Surgery also corrects the deformity, when needed. The goal is to correct the curve by 50 percent or more.
