Adult spinal deformities

What is it?

Spinal deformity is any abnormal curve in the spine, such as scoliosis or kyphosis. It can affect spine’s ability to do its job, leading to pain, neurological and mobility challenges. Spinal deformities can occur for a wide range of reasons, including birth defects, aging and degeneration, to trauma.

When the spine becomes weak or deformed, the rest of the body reacts. Muscles strain, lungs pump harder, and even simple functions like walking become difficult.

Common adult spinal deformities are scoliosis, kyphosis, and lordosis. Kyphosis involves the upper back curving forward. The condition can create the form of a hump. Lordosis is also known as swayback. This is a deformity of the lower back, in which it curves inward instead of outward. Scoliosis is a frontal deformity in which the spine, when viewed straight on, curves to the left or the right. This curving ordinarily ends at the same time the skeleton stops growing but in adulthood, the curve can still progress slightly, often as a result of disk degeneration.

Symptoms

Symptoms differ, depending on the type of deformity. They may take the form of:

  • Having difficulty walking or standing. 
  • Feeling of being off balance.
  • Pain in the upper spine and the ribs.
  • Visible curve (hunched over). 

For some patients with mild deformities, the curves may not cause any symptoms.

When these spinal deformities affect the ability to perform daily activities, or if they cause dysfunction of the spinal cord/nerve roots, treatment (surgical and/or non-surgical) may be required.

Diagnosis

To see whether there is an underlying cause of the curve, we may recommend imaging, such as X-rays, magnetic resonance imaging (MRI) or computerized tomography (CT) scans, to analyze the internal structure of the spine and surrounding area.

Treatment

To treat spinal deformities, we look to:

  • relieve pain,
  • lighten the strains on the spine,
  • ease breathing
  • prevent deterioration of spinal structures
  • reduce the appearance of the deformity.

 

Intervention may not be needed if the deformity is not progressing, and the symptoms aren’t problematic for the patient. There are also several methods of physical therapies to treat spinal deformities.

Surgery is performed when the curve is symptomatically compressing organs, or if the curve continues to progress or if the pain becomes severe and is unresponsive to medical and conservative care. Spinal surgery involves mobilizing and straightening the spine, and then placement of instrumentation with a spinal fusion to hold the spine in the new position and prevent further progression of the curve. 

Adult spine deformities are treated differently than children’s. For children, nonsurgical treatments are often chosen since children’s bones are still developing.

In older adults, if osteoporosis is the underlying cause of the deformity, we may treat it with calcium, hormone replacement therapy, or weight-bearing exercises. Bracing is another nonsurgical option for adults. It will not change the position of the spine, but it may ease pressure and pain. Orthotics (shoe inserts) can also help reduce back pain if the legs have been affected by the spine’s changing shape.