Adult scoliosis relates to anyone that has scoliosis and is eighteen or older. Adult scoliosis is different from children scoliosis cases in that adults are skeletally mature and may have different treatment options. Scoliosis in adults is usually accompanied with back pain and that is why they choose to get themselves evaluated. Treatment difficulties for the spine surgeon may exist since adult scoliosis can cause the spine to become stiff. In many cases, advanced disc degeneration that can create severe pain is accompanied with the scoliosis. Many patients with adult scoliosis may experience osteoporosis, which can play a contributing factor. All of these factors add into the equation of what treatment is right for the patient.
Degenerative scoliosis is one of the most common types of scoliosis for older adults and may progress. This type of scoliosis is usually associated with stenosis and leg pain. Most treatment for adult scoliosis is non-operative. Conservative treatment options may include physical therapy or injection therapy.
A spine specialist will put together an individualized treatment program consisting of exercise and conditioning to help the patient increase function and energy, while trying to reduce the source of pain. Steroid injections may also be used to help control pain. Bracing is rarely used in adults nor does it provide pain relief.
Surgery is used only after non-surgical options are tried. And an emphasis is usually put on less invasive or minimally invasive surgeries unless scoliosis is severe, or global kyphosis (flatback) exists. Surgery is recommended for curvatures that have gradually worsened or previous treatment options have all been exhausted and the pain still persists. It is not uncommon in adult scoliosis cases when discs are severely degenerated, which require the spinal fusion to be extended down to the sacrum. This situation may require the surgeon to perform the surgery on both your back and front side.
The length of the recovery is dependent of how extensive the surgery was and the age of the patient. Some patients will be back to full activity in three months, and some patients may need as long as six to nine months to properly heal. Many patients become thrilled and happy knowing the pain they suffered with is no longer going to bother them.
Often older techniques such as anterior surgery for lumbar scoliosis, Harrington rods, or Cotrel-Dubousset instrumentation may have long fusions with minimal correction or they were fused in some kyphosis.
With time and aging, these individuals may develop progressive disc degeneration resulting in a stooping or flatback syndrome, or back and leg pain from degeneration. Other causes of back pain in a previously operated patient include junctional deformities or non-unions with broken rods.