Degenerative Scoliosis
What is it?
Scoliosis is a musculoskeletal disorder that affects the shape of the spine. There are normal front-to-back curves of the spine; however, scoliosis is a side-to-side curvature.
Adult degenerative scoliosis develops during adulthood due to degenerative changes, and it is typically seen in the lumbar spine. Degenerative changes in the vertebrae and intervertebral discs are common as a person ages. However, when these changes cause a right-to-left curvature of the spine, the disorder is known as adult degenerative scoliosis. Adult degenerative scoliosis usually affects people 40 years of age or older. In older patients, mostly women, it is often associated with osteoporosis. Osteoarthritis can also be a cause of adult degenerative scoliosis.
Symptoms
Adult degenerative scoliosis occurs more often in the lumbar spine and is accompanied by the loss of the normal, lordotic curve in this region. Symptoms of adult scoliosis due to degenerative changes may include:
- Low back pain
- Numbness, weakness, and pain in the legs
- A hump may appear to be present on the back
- Uneven hips and/or shoulders
Diagnosis
The following are used to evaluate patients for adult degenerative scoliosis: patient’s medical history, physical examination, X-rays, CT scans, or an MRI of the spine, as well as the pelvis and hips.
Treatment
Nonsurgical therapies for degenerative scoliosis include:
- Physical therapy
- Anti-inflammatory medications
- Steroids
- Injections
Spine surgery in adults may be recommended when the spinal curve is greater than 50 degrees and the patient has nerve damage to their legs or is experiencing bowel or bladder symptoms. Decompression surgery with spinal fusion and a surgical approach from both the front and back may be required.