Scoliosis

Idiopathic Scoliosis

Adult

Figure 1: A) Adult scoliosis present since
adolescence. B) A lumbar spine front-view X-ray
showing degenerative scoliosis (scoliosis due
to the aging process).

When a spinal deformity is discovered in an adult, it is often quite different from a deformity in an infant or juvenile. The goals for treatment are often different as is the location of the scoliosis. The deformity in an adult may have been present since childhood or may be the result of the aging process (Figure 1). In adults, it is more common for all areas of the spine to be effected including the bones in the neck. While scoliosis in children is often discovered during a screening, scoliosis in adults is typically discovered when pain or discomfort requires a physician visit. Besides pain in the back, patients may have pain radiating down their legs. Treatment of spine deformity in adults focuses on restoring function and alleviating pain in combination with correcting the curvature of the spine.

Adult spinal deformity refers to abnormal curvatures of the spine in patients who have completed their growth. Thus, they are typically seen in males and females over the age of eighteen. The age range of patients seeking treatment for adult scoliosis and other deformities varies widely, however. It is not unusual for patients who are well into their sixties, seventies or even eighties present with symptoms of pain and functional limitations. With increasing life expectancy along with more active lifestyles, the number of older adults requiring treatment has also gone up. Unlike the younger or adolescent patient with a spinal deformity, the older adult presents with a completely different set of problems and challenges to the treating physician.

Causes
There are many different causes of spinal deformity in the adult. The most common varieties include idiopathic scoliosis that was present during adolescence (teenage years) and then became worse during adulthood, and deformity that began in adulthood due to degenerative (wear and tear) changes in the spine and deformity that developed later in life. Other less frequent causes include curvatures due to osteoporosis (brittle bones), previous fractures of the spine due to an accident, spondylolisthesis (slipped vertebrae) and rarely, infections and tumors of the spine.

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