Scoliosis

There are two main types of scoliosis in adults: adult idiopathic scoliosis and adult degenerative scoliosis.

Adult idiopathic scoliosis

Adult idiopathic scoliosis is a curved spine that has no apparent cause. If idiopathic scoliosis is diagnosed in an adult, it's typically because it went undiagnosed when they were a child or teenager.

Adult degenerative scoliosis

This type of scoliosis is more common in adults. Adult degenerative scoliosis develops as a result of spinal disc degeneration. As a disc deteriorates, it loses height and begins to tilt, which can cause the spine to bend and curve. Sometimes it's associated with osteoporosis, a condition that causes bones to weaken as a result of a loss of bone density.

Symptoms of degenerative scoliosis in adults

Although low back pain is one of the symptoms of degenerative scoliosis, the pain isn't due to the spine's curvature but to its deterioration.

Degenerative scoliosis is usually seen in the lumbar spine (lower back). Signs of degenerative scoliosis include:

In the majority of scoliosis cases, a specific cause cannot be determined. There are common misconceptions about what causes this condition. Scoliosis isn't caused by carrying heavy things (like a backpack), participating in sports or athletic activities, poor sleeping or standing posture, lack of calcium or having one leg shorter than the other.

Scoliosis in children and adolescents might be caused by genetics, neuromuscular disorders, asymmetric growth or a hormonal or muscular imbalance. In adults, scoliosis usually develops as a result of the spinal discs or arthritis of the facet joints breaking down.

When treating adults with scoliosis, the goal is to restore function and relieve pain. There are many scoliosis treatment options that don't require surgery.

Nonsurgical methods

We understand that surgery can have a large impact on your health. With this in mind, our team offers plenty of nonsurgical methods, including:

• Brace — used for short-term pain relief, not prevention
• Epidurals or nerve block injections — used to temporarily relieve leg pain or other symptoms
• Exercise or physical therapy — done to strengthen the core muscles and improve flexibility
• Over-the-counter (OTC) pain relievers — used to reduce back, hip or leg pain
• Routine or periodic observation — monitoring the curve of the spine to see if it gets worse over time

Surgical procedures

We might recommend surgery for scoliosis if more conservative methods fail. We might also recommend it if the pain is severe. The goal of surgery is to restore spinal balance, reduce discomfort and correct alignment.

Scoliosis procedures our team performs include:

• Decompression — removing the “roof” of the spinal canal and enlarging the spaces where the nerve roots exit the canal, which decompresses nerve roots and provides pain relief
• Fusion — uses your own bone, a donor bone or synthetic bone substitutes to hold the spine in a straighter position
• Osteotomy — a procedure that involves cutting and realigning spinal segments
• Surgical stabilization — a procedure that involves fastening hooks, wires and screws to stabilize the spine and help it fuse in the correct position
• Vertebral column resection — removing entire vertebral sections and then realigning the spine

In our pediatric spine care program, our specialists can diagnose scoliosis in your child or adolescent in several different ways:

• Performing a physical observation
• Using a scoliometer, a tool that provides a rough estimate of how much your spine has curved
• Taking X-rays if the doctor suspects you might have a spinal curve of 10 degrees or more

The goal of treating scoliosis in children and teenagers is to stop the curvature of the spine from progressing.

Typically, treatment isn't considered necessary unless the curvature of the spine reaches 25 degrees or more. There are three main approaches we take for scoliosis treatment:

• Active observation — used for children and teenagers with a curved spine of less than 25 to 30 degrees who are still growing or those with curves less than 45 degrees who have stopped growing
• Bracing — used to halt or slow the progression of the curve, with the goal of avoiding surgery
• Surgery — usually recommended if you're going through puberty and have a curved spine greater than 45 degrees or if your spine keeps curving past 45 degrees after puberty