Degenerative scoliosis

Scoliosis is a condition characterized by an abnormal sideward curvature of the spine. Adult degenerative scoliosis is defined as abnormal curvature of the spine in individuals over 18 years of age.It can affect the thoracic (mid back) or the lumbar (lower back) region of the spine.

Causes

Adult degenerative scoliosis results from degenerative changes in the spine due to aging. Sometimes, it can result from a progression of an untreated childhood curvature. A few degenerative spinal conditions may also cause the spine to curve to the left or the right.

Symptoms

The most common symptom of adult degenerative scoliosis is back pain. You may also notice an abnormal curvature of the spine, entire body leaning to one side, unstable spine, prominent ribs on either side, humpback deformity (abnormal backward curve), abnormal gait, rigid and stiff spine, and heart and lung problems.

Degeneration of the spine and scoliosis deformity may cause pressure on nerves and the spinal cord, resulting in weakness, numbness, and pain in the lower extremities. If the spinal cord is compressed it may cause loss of coordination in the muscles of the legs making it difficult to walk, stand or sit. Occasionally, compression of the nerves may cause impaired bowel or bladder function.

Diagnosis

Your physician will diagnose scoliosis based on your family history, previous medical history, presenting signs and symptoms and physical examination. Your doctor will perform a physical examination to access limitation of movements, balance problems, ability to bend, and to identify any inequality in the lengths of your legs. Your doctor may also perform a neurological examination to evaluate your sensations, reflexes, and the strength of the muscles. Diagnostic tools such as X-rays, computed tomography (CT) or magnetic resonance imaging (MRI) scans may also be used to determine the compression of any nerves.

Treatment

Treatment of scoliosis is based on your physician's assessment of the spinal curve. Not every patient with degenerative scoliosis requires treatment. Lifestyle changes such as abstinence from smoking, weight loss, eating a healthy diet, and regular exercise may be helpful in certain cases. Most cases are treated using non-surgical methods such as anti-inflammatory and pain medications, physical therapy, spinal injections, and braces to control pain.

Surgery is an option for individuals with excessive curvature, cardiopulmonary (heart, lung) problems, and on failure of conservative treatments. Surgery for scoliosis involves correction, stabilization, and fusion of the vertebrae responsible for the curve. The surgery repairs the abnormal curvature of the spine, prevents progression of the curve and stabilizes the spine.