This type of deformity of the spine, also known as new onset scoliosis, is defined as a deviation of the spine resulting from the progressive degeneration of the spinal elements, and it usually appears in adulthood. We invite you to read this article to learn more about this condition.
Among other characteristics, degenerative scoliosis is associated with the rigidity of the spinal curvature and the degeneration of the lower lumbar discs. Every person’s spine has a natural curve that is considered normal and that plays an essential role in helping you carry your body’s weight, maintain balance, move and walk correctly. However, when that curvature looks like a pronounced “S” shape, we must pay attention.
Adult degenerative scoliosis
Adult scoliosis is the result of progressive degeneration of the vertebral elements which causes the appearance of a Cobb angle of greater than 10º in the coronal plane, altering the sagittal and axial planes as well. It is a degenerative disc disease that creates unequal distribution of the weight-bearing function, deforming the spine as a result.
The following symptoms stand out:
- Axial pain: This type of pain is present in 90% of patients. Also known as mechanical pain, it comes on when the person is standing or sitting. There is instability of one or more segments of the spine, causing a vicious cycle that generates loss of lumbar lordosis, loss of waist and increased axial pain in the lumbar region.
- Radicular pain: The nerve roots are stretched due to being pulled along the convex curvature and are compressed or pinched in the foraminal space in the concave curvature. This causes leg pain when walking or standing.
- Neurological deficit: This can occur as a result of the progression of the curve, or because of a disc herniation or acute decompensation of the curve. The most frequently noted deficit is an altered gait (claudication), or limping, while dysfunction of the sphincters is noted much less frequently. The problem of claudication is a progressive pain in one or both legs when walking or standing that can force the person to sit or lie down.
- Fatigue or tiredness
How does scoliosis affect children and adults?
In addition, there are other, more visible signs that can help the doctor with the diagnosis:
- Abnormal spinal curve to one side (lateral curve)
- Misaligned hips and shoulders
- One leg shorter than the other
- Small deformities in the vertebrae of the spine
At Instituto Clavel, our first choice of treatment for adult degenerative scoliosis is to begin with conservative measures that include medication to reduce pain, physical therapy, and epidural infiltrations. In the case of infiltrations, these are carried out by our specialists in the Pain Clinic, who create a personalized plan for each patient, taking into account their state of health and physical condition.
If the patient’s quality of life does not improve and pain-relief medications stop being effective, and the patient begins to experience radiculopathy or a neurological deficit, surgical treatment becomes the next step. The goal of surgery is to release the compression of the nerves, to correct of the spinal deformity in three planes, and stabilize the coronal and sagittal balance.
After the surgery, we implement a rehabilitation program designed to meet the specific needs of the patient and guided by our professionals. Surgeons and physical therapists prescribe an exercise plan for each stage of recovery. The goal of rehabilitation is to accelerate the recovery process in a way that offers the best results so that the patient can return to their normal daily activities.
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Degenerative lumbar scoliosis
Most of the patients who come to with degenerative lumbar scoliosis are over 50 years old, and we see more cases in women than men. It is worth mentioning that there is not a significant number of cases; however, whenever a person suffers from this condition, their ability to perform certain activities will inevitably become more limited over time.
That is why it is important to pay close attention to the symptoms, and consult a spine expert for medical advice as soon as possible if you have them. The specialist will carry out a series of studies including an MRI and telemetry x-rays of the frontal and side views that will help determine the diagnosis accurately. At Instituto Clavel, we use the EOSedge device which allows us to obtain high quality images of the patient with less radiation than conventional x-rays.
Degenerative lumbar scoliosis can make the intervertebral discs and facet joints in the lumbar spine function incorrectly, causing the body to generate a lot of bone as a defense mechanism. This condition is known as osteoarthritis. Osteoarthritis of the spine and the curvature of scoliosis can cause spinal stenosis -- the exit holes of the nerves narrow and this causes pinched nerves and sciatica in the patient.
Likewise, the vertebral discs can rupture and herniate as a result of scoliosis, further restricting the patient’s mobility as a result. When this happens, it is time to consider surgical treatment as a solution. The surgery would consist of correcting the deformity of the spine with the goal of stabilizing it.
This type of surgery can take from 3 to 5 hours, and depending on the severity of the scoliosis, the patient can expect a hospital stay of 7 to 10 days. After discharge from the hospital, the patient will need to wear a rigid, heat-molded scoliosis brace for 2 months. During this period, it will be essential to follow the doctor’s instructions to the letter in order to ensure a correct recovery.
In Instituto Clavel, for scoliosis surgery, we use the EOSedge to aid in the surgical planning as a key element to guarantee the result we are looking for. One of the things it allows us to do is to custom design the surgical rods to fit the patient’s specific needs.
We should emphasize, again, that surgery is not always the first course of action for treating cases of degenerative scoliosis; there are people who live with this condition without any discomfort.
Scoliosis surgery: what you need to know
Categories: Spine treatments, Spine pathologies, Innovation