Adult Scoliosis

If your spine twists or develops side-to-side curves, it may be caused by scoliosis. This condition changes the normal shape of the spine and it can affect either the middle back (thoracic spine), the low back (lumbar spine) or both. When you look at a healthy spine from the front or back, it appears straight.  Scoliosis can change the spinal curves anywhere from 10 degrees to more than 100 degrees.  The more extreme the abnormal curve, the more severe the condition.

Causes of Adult Scoliosis

Scoliosis appears most often in children and adolescents. As a result, when adults are diagnosed with scoliosis, it is often juvenile or adolescent scoliosis that went untreated or unrecognized. But scoliosis can also develop during adulthood. We call this condition adult scoliosis.

Scoliosis that appears in adulthood is often caused by a combination of age and spine deterioration. Called degenerative adult scoliosis, this condition usually affects people over age 40. In women, it is often related to osteoporosis. Osteoporosis weakens the bone and leads to deterioration. As the deteriorating spine sags or bends downward, a curve can slowly develop.

Other types of adult scoliosis are rare. They include congenital curve, paralytic curve, myopathic (abnormal) deformity, and secondary scoliosis.

We diagnose adult scoliosis with X-rays and magnetic resonance imaging.

Treatments We Offer

Mild cases of scoliosis typically don’t require treatment. Instead, our experts focus on relieving symptoms—decreasing pain and improving function—rather than getting rid of the curve. It is more difficult to get rid of the curve in adults than children because the skeleton has completed its growth. 

If you are having symptoms caused by age-related degeneration of the bones, we can help. The most common symptoms are back pain, tingling or pain in the legs, and fatigue.    We may treat you to slow the condition’s progression. Current recommendations include:

Increasing  calcium and vitamin D intake

  • Hormone replacement therapy
  • Weight-bearing exercises.

Exercise can help to relieve pain, but it will not affect the natural history of the curve.

Surgical Treatment for Scoliosis

People who have medium and large curves, however, are a different story. With larger curves, adult progression and the presence of secondary symptoms become more likely. Possible symptoms include leg pain, numbness or tingling when you walk, and back pain and stiffness.  If you have severe pain, difficulty breathing, or increasing deformity, you might well benefit from surgery.

Most surgery for adult  scoliosis involves spinal fusion with instrumentation. We almost always use rods to help straighten the spine. Your surgeon may use a posterior approach, which involves entering the spine through the back; an anterior approach, which is performed from the front or side; or a combined approach. 

We work with you and your family to decide whether you should have surgery. Surgery for scoliosis is never an emergency and there’s always plenty of time to make everyone comfortable with the decision.