Scoliosis-Adult

Definition

Scoliosis is an abnormal curvature of the spine. It has a C or S shape instead of being a straight line from the neck to the buttocks.

Adult scoliosis may be a progression of childhood scoliosis or something that happens later in life.

Scoliosis.

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Causes

Idiopathic scoliosis is the most common form of this problem in adults. This means there is no known cause. It can result in early aging of the spine. This can worsen the curvature.

Scoliosis that starts in adulthood may be from wear and tear injuries of the spine, also known as degenerative diseases.

Risk Factors

Scoliosis that starts in adulthood is more common in people who are 60 years of age and older. It may be present with other problems, such as:

• Degenerative disc disease
• Osteoporosis
• Compression fractures
• Prior spinal surgery
• Prior spinal trauma
• Spondylolisthesis—slipped vertebrae
• Infection
• Tumors

Symptoms

A person may have hips or shoulders that are not even. People with severe curves may lean forward or to one side to try to stand upright.

Other problems depend on where the curve is and its severity. Some people may not have problems. Others may have:

• Back pain or stiffness
• Numbness, weakness, or cramping in areas or limbs around the curvature
• Changes in bowel or bladder habits—if the curvature is in the low back

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. It will focus on the spine.

Pictures of the spine may be taken. This can be done with:

• X-rays
• MRI scan
• CT scan
• Myelogram —an x-ray using a dye to highlight smaller structures

Treatment

People without symptoms may not need treatment. They may only be watched for any changes.

People with underlying causes will be treated. For others, the goal of treatment is to manage symptoms and stop the curve from worsening. Choices are:

• Wearing a brace to ease pain
• Physical therapy to help with strength, flexibility, and range of motion
• Medicines to ease pain and swelling, such as:
  • Over the counter or prescription pain relievers
  • Muscle relaxants
  • Nerve block injections

People who are not helped by these methods may need surgery. A spinal fusion connects two or more bones of the spine with rods or metal plates. This can help straighten and ease pressure on the spine.

Prevention

There are no current guidelines to prevent adult scoliosis.