FAQ’s on Adult Degenerative Scoliosis
Scoliosis refers to an unnatural curvature of the spine. The condition affects about 2% of the population and is much more common in children than in adults. Adult scoliosis occurs mainly due to the condition either not being diagnosed during childhood, or simply having not been severe enough to warrant treatment during this time.
For some patients, the spinal curvature will progress over time until symptoms again begin to appear in adulthood once more. Other causes are related to degenerative diseases of the spine, such as osteoporosis, degenerative disc disease, or herniated discs.
What are the symptoms of Adult Scoliosis?
The most noticeable symptom in adults is severe back pain which normally leads to the individual seeking treatment. It is also common for an Adult with Scoliosis to have a visible deformity of the spine, with symptoms that may include deformities such as: misaligned hips or shoulders, protruding shoulders, or shoulder blades and a tendency to lean to one side. A patient changing their normal walking gait in an effort to cope for a curved spine is also known to occur.
Along with significant back pain, most patients also have buttock and leg pain either on one side or both due to pinched nerves. Because of the spinal degeneration, various nerve roots may become pinched, which is known as spinal stenosis. Spinal stenosis and adult scoliosis typically go hand in hand.
How does a doctor diagnose Adult Scoliosis?
Diagnosis needs to be made by a medical professional such as a Dallas pain doctor as other conditions may be responsible for one, or more, of the above symptoms. A simple set of long X-rays is normally used to confirm adult scoliosis. Visual examination is typically obvious in those with significant scoliosis – patients may be tilted to one side along with stooped forward.
The spinal column will appear curved in either a ‘S’ or ‘C’ shape instead of running in a straight line on the x-rays. Once adult scoliosis has been confirmed, a treatment plan can be devised depending on a number of factors.
Common factors that contribute to the treatment plan include the cause of the curvature, the length of time the condition has been present, and the location or severity of the curvature.
What is the first step in treating Adult Scoliosis?
Patients will be offered conservative treatment options first, including
- Medications for symptoms of pain. This may include NSAIDS, Tylenol, Muscle Relaxers, opiates and neurogenic stabilizing medications such as Lyrica or Neurontin.
- TENS Units, Physical Therapy, Chiropractic and Acupuncture.
- Interventional treatments such as facet injections, epidural injections, medial branch blocks.
- Radio frequency Ablation – this treatment can provide 12-18 months of consistent back pain relief.
Of note – bracing for adult scoliosis does not work. It’s only prescribed for adolescents who have a flexible scoliosis and are still growing.
Is surgery needed for Adult Scoliosis?
In severe cases of adult scoliosis (where spinal curvature approaches or exceeds 100 degrees), conservative treatment may not offer enough relief. Less than 10% of those with adult degenerative scoliosis will end up needing a procedure.
Adult scoliosis surgery is an elective procedure and has significant complication rates. Therefore, all attempts at conservative treatment should be attempted first.
Normally, the surgical correction options available to the patient involve spinal fusion in an effort to straighten the curved vertebrae and provide further support to the spine. Spinal grafts are inserted into the tissue between the vertebrae, encouraging the bones to grow together, or fuse. Metal rods and screws are inserted into the spinal column to keep the spine aligned while the healing or fusing process takes place. A spine or back brace may need to be worn for a few months during the recovery period.