Adult Scoliosis

How is adult scoliosis diagnosed?

Before your doctor can suggest a treatment plan, if adult scoliosis is suspected, he/she will need to take a history. This may include questions about:

Family history

Date when you first noticed change in your spine

Curve progression (determined from earlier X-rays, if available)

Presence and location of pain, if any

Any bowel, bladder, or motor dysfunction, which may be signs of more serious nerve damage or pressure caused by scoliosis

In a physical exam your doctor will examine your back to check the shape of your spine and see how you move around. Your nerves may also be tested through reflex, sensation and muscle-strength checks.

If needed, your doctor may order X-rays. X-rays taken from the front and side will show a full picture of your spine. Your doctor can then determine if you have scoliosis and if so, to what degree.

How is adult scoliosis treated?

Conservative treatment

The majority of cases of adult scoliosis can be managed non-operatively through regular observation by a doctor, over-the-counter pain medications, and core-strengthening exercises to strengthen your abdomen and back and to improve flexibility. If you smoke, it’s important that you quit. Smoking has been shown to speed up the degenerative process.

In most cases, your doctor will recommend some forms of physical therapy, to both maintain strength and relieve pain. These may include:

·        Working to improve posture

·        Doing low-impact exercises, such as swimming

·        Daily stretching

·        Staying active

If pain is not relieved by oral medications or physical therapy, your doctor may recommend epidural (given around the spinal cord) or nerve block injections for more effective relief.

Surgical treatment

Surgery is necessary in some cases of adult scoliosis. This treatment is the last option because of the risks of complications from spinal surgery. Surgery may be suggested for the following reasons:

·        Pain. Surgery may be needed if back and leg pain from the scoliosis becomes severe and ongoing, and doesn’t respond to conservative treatment.

·        Spinal imbalance. Whether the spine remains balanced is important in assessing the scoliosis’ progression and the need for surgery. When we stand, the head should be balanced over the center of the pelvis when looking from the front, and over the hip joints when looking from the side. If the curve progresses to the point that this is no longer possible, patients will tend to progress over time and have more pain and disability.

·        Surgery is needed to improve quality of life. Although surgery is not recommended solely to improve appearance, some people find the symptoms of their spinal deformity unbearable. Their spinal imbalance, too, affects basic function and overall quality of life. Surgery is the only option in these cases. In younger adults the cosmetic deformity may be a major factor in the decision to have surgery but in older adults this is not usually the case. There are a variety of spinal surgical options, depending on each case. Generally, surgical procedures are designed to stabilize the spine, restore balance, and relieve pressure on nerves. Spine stabilization surgery fuses the bones of the spine together using bone grafts and then metallic implants to hold the spine in place.

Advances in surgical techniques and computer-assisted navigation systems make less invasive approaches possible, and recovery time quicker.