Adults with scoliosis usually have no symptoms for most of their lives. When symptoms finally appear, it is because the curvature has increased or the adult suffers problems such as degeneration of the spinal discs. In this article, Instituto Clavel provides information about this condition in people over 50 years of age.
Adult scoliosis can be the result of progressive degeneration of the vertebral elements that occurs in middle age. This can alter the way in which the spine bears weight, and consequently, causes it to deform. Degenerative scoliosis is known as de novo, or new onset, and it affects the spine in the sagittal, coronal and axial planes.
The sagittal plane includes the pelvis, lumbar spine, and kidneys; while the axial and coronal planes are limited to the pelvis. We speak of scoliosis in adults at age 50 or older when the deformity of the mature skeleton reaches a Cobb angle of greater than 10 degrees in the coronal plane.
Types of adult scoliosis
This type of scoliosis typically falls into three categories:
- Primary degenerative scoliosis: this is new onset scoliosis found in adults after the skeleton is fully matured. It is characterized by minimal structural deformities in the vertebrae, such as compression fractures in cases of loss of bone density due to osteoporosis. In addition, the patient may experience other pathologies such as spinal stenosis, bulging discs and arthritis of the facet joints.
The misalignment of the sagittal plane is responsible for the pain. In these cases, the curves observed are shorter than those that occur in idiopathic scoliosis and, initially, there is less deformity of the vertebral body.
- Progressive idiopathic deformity: this begins before skeletal maturity. It appears in childhood or adolescence, but does not begin to cause symptoms until the patient is an adult. This type of scoliosis occurs in the thoracic, thoracolumbar and lumbar spine. Sagittal deformity is almost always exclusive to flatback syndrome, which refers to the loss of the natural lordosis, and in extreme situations, it may be true kyphosis.
- Secondary degenerative scoliosis: this is located in the thoracolumbar, lumbar or lumbosacral spine and can originate in or outside the spine.
- When the origin is in the spine, it is secondary to an adjacent curvature (idiopathic, neuromuscular or congenital).
- When the origin lies outside the spine, it is due to a pelvic tilt secondary to a difference in lower limbs, hip pathology, or temporary lumbosacral anomaly.
Clinically speaking, the most common type is secondary degenerative scoliosis or primary degenerative scoliosis. In patients over 65 years of age, both of these types of scoliosis can be aggravated by osteoarthritis or degeneration of the discs or facet joints, followed by progressive idiopathic deformity.
Symptoms of scoliosis in adults: most common signs
The symptoms of scoliosis vary according to the severity of the deviation of the spine, and also the length of time that the person has had the condition. Scoliosis begins to worsen in adults over 30 years of age, and that is when the symptoms begin to appear:
- Back pain in adults when sitting or standing for a long time: this kind of discomfort increases over time due to the degeneration of the spine.
- As the scoliosis progresses with the passing of time, other more serious symptoms can occur because the position of the torso affects the heart or lungs.
Can scoliosis be corrected in adults?
Scoliosis in people over 50 is treated based on the severity of symptoms. In most adults, this spinal condition can be successfully treated without needing surgery. In some patients, medication and physical therapy are enough to relieve the back pain.
In cases where the curvature of the spine is not severe, the doctor may opt for a more conservative treatment for scoliosis. In these cases, the doctor may recommend physical therapy so that you can learn:
- The right way to move and rest to relieve pain
- Strength exercises to help you increase support for your joints and reduce fatigue.
- Flexibility exercises, including deep breathing techniques to help you expand your chest.
- Ways you can stay active and improve your quality of life without increasing symptoms.
Adult scoliosis surgery: when is it necessary?
For patients having a very severe curvature of the spine, sometimes surgery is necessary to relieve the symptoms. The surgery is very complex and is recommended only for those cases where the curvature exceeds 45-50 degrees and the patient’s quality of life is severely affected.
Recent advances in scoliosis surgery allow the surgeon to plan and predict the results of the operation before it is carried out. Because the surgery is so highly complex, presurgical planning is key to successful results.
In this video, Dr. Català explains the type of cases in which cases scoliosis surgery is recommended, what the process is like, and what measures we take at IC to ensure the safety of patients:
In the following article, Dr. Pablo Clavel explains the procedure that Instituto Clavel uses prior to a surgery of this type.
Learn more about advances in scoliosis surgery
At Instituto Clavel we have a Scoliosis Unit, made up of a team of surgeons specialized in the treatment of this disease. If you would like to learn more about the condition of your back and find out about the most appropriate type of treatment, please don’t hesitate to contact us.
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Categories: Spine treatments, Spine pathologies, Back pain