FAQ’s on Adult Scoliosis
Our spine is a column of bones that tends toward a normal S-shaped curvature. However, there are some cases when the spine presents with a sideways bend. This condition is called scoliosis, and it can be a barely noticeable tilt in the shoulders, or a severe deformity that requires surgery.
This may or may not be associated with back pain, although those with larger curves may occasionally experience discomfort. This may present during childhood, or even later on during adulthood.
What causes adult scoliosis?
Adult scoliosis refers to the abnormal curvature of a spine of a fully-grown adult. This is most often caused by idiopathic scoliosis that began in childhood, or adolescence, and progressed during adulthood. Other causes may include degenerative conditions such as osteoarthritis, previous fracture from trauma, infections, tumors, or spondylolisthesis. Older people and females are more prone to scoliosis.
When does adult scoliosis present?
Patients who seek consult for adult scoliosis vary widely in age and presentation. Patients may be relatively young, or may be geriatric patients, with symptoms of pain and loss of function.
Is it possible to for scoliosis to improve on its own?
Curves due to scoliosis are persistent, but do not always require treatment. However, only surgery and bracing have been shown to consistently improve outcomes. Physical therapy, rehabilitation, chiropractic medicine, and other alternative treatments have not been shown to significantly improve the spinal curves from scoliosis.
Do I need surgery for scoliosis?
Surgery is a risky option and comes with a high incidence of complications. Ideally, you should exhaust the conservative, non-operative solutions first. The goal of treatment for adult scoliosis is to prevent the worsening of the curve and to relieve any associated symptoms or discomfort. This may be achieved with physical therapy and medications, and most cases of scoliosis are not candidates for surgery.
Surgery involves the bracing and fusion of the misaligned vertebrae. This can provide relief from the more severe symptoms, although patients who undergo this procedure are at risk for re-operation due to infection, persistent pain, or other complications.
When should I consult for adult scoliosis?
Scoliosis should not be causing back pain, so if you are experiencing any kind of persistent discomfort or pain in your back, then you may want to consider consulting a physician. If you notice that the curve is progressing or if you are experiencing loss of function, then it is advisable to seek consult. Most cases of scoliosis are incidental findings during medical screenings and do not warrant treatment or follow-up interventions.
Will my activities be limited by scoliosis?
Most people who have scoliosis go on to lead normal lives, albeit with small curves on their spine. For the most part, cases of scoliosis do not affect a person’s functional activities. Sports, weightlifting, and other physical activities have not been shown to aggravate the curve from scoliosis. Having an active lifestyle is encouraged; however, if you begin to feel discomfort or pain from your activities, you may want to stop first and seek clearance from you physician.
Barbanti Bròdano G, Terzi S, Gasbarrini A, et al. (2014). Do benefits overcome the risks related to surgery for adult scoliosis? A detailed analysis of a consecutive case series. European Spine Journal. doi: 10.1007/s00586-013-3031-y
Palmisani M, Dema E, Cervellati S. (2013). Surgical treatment of adult degenerative scoliosis. European spine journal. doi: 10.1007/s00586-013-3012-1
Urrutia J, Zamora T, Klaber I. (2014). Thoracic scoliosis prevalence in patients 50 years or older and its relationship with age, sex, and thoracic kyphosis. Spine (Phila Pa 1976). doi: 10.1097/BRS.0000000000000095
Youssef JA, Orndorff DO, Patty CA, et al. (2013). Current Status of Adult Spinal Deformity. Global Spine Journal. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/24436852