Scoliosis Research Society (SRS)
An International Organization Dedicated to the Education, Research and Treatment of Spinal Deformity
Our Mission is to Foster Optimal Care for All Patients with Spinal Deformities
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. Some of these 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. They include shoulder asymmetry, a rib hump or a prominence of the lower back on the convex 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). Additionally, arthritis sets in the joints of the spine (facets) which 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.
Adult degenerative scoliosis:
This condition also goes by the name, “de novo” scoliosis. As the name implies, this variety begins in the adult patient due to degeneration of the discs, arthritis of the adjacent facet joints and collapse and wedging of the disc spaces. It is typically seen in the lumbar spine (lower back). It is usually accompanied by straightening of the spine from the side (loss of lumbar lordosis). Pain, stiffness, numbness and shooting pain down the legs are seen in symptomatic patients.
This type is seen in patients who had previously undergone spinal surgery either for scoliosis or for degenerative low back conditions. These patients develop a condition called “Flat Back Syndrome” where the lower back has lost its normal inward curvature or lordosis. As a result, patients with this condition are unable to stand upright and are usually “pitched forward”. They are typically seen in patients who have had long fusions of the spine in the past. Another category of post-surgical deformity is “Junctional Kyphosis” which is an angular deformity (kyphosis) that develops just above or below a previous spinal fusion. Both these conditions result in an imbalance of the spine from the side (sagittal imbalance) and lead to progressive low back pain and stiffness.