Idiopathic Scoliosis

Adult

Figure 1: A 20-year old woman
whose curve progressed after
she stopped growing.

Adult Idiopathic Scoliosis

This is a slow increase in curvature that began during teenage years in an otherwise healthy individual and progressed during adult life. Curves may increase in size 0.5-2° per year (Figure 1). Adolescent curves less than 30° are unlikely to progress significantly into adulthood, while those over 50° are likely to get bigger. For this reason, it is important to be aware of adult scoliosis specialists to monitor the curves over time.

Some patients may have had brace treatment during adolescence while others may have never sought treatment during their teenage years. This can occur in the thoracic (upper) and lumbar (lower) spine and has the same basic appearance as that seen in teenagers. Physical findings may include shoulder asymmetry, a rib hump or a prominence of the lower back on the side of the curvature. These curves can get worse in the older patient due to degeneration of the discs which results in settling of the vertebrae (spinal segments). Settling of the discs may also cause patients to lean progressively forward, leading to sagittal imbalance. Additionally, arthritis sets in the joints of the spine (facets) that leads to the formation of bone spurs. This can result in pain and stiffness of the back. In more severe cases, patients may also develop shooting pain and numbness down the legs due to pinched nerves.

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