Scoliosis of the spine in adults
Scoliosis is more common in children or adolescents, but it can also be diagnosed in adults. Why it occurs and how to correct posture – let’s figure it out with an expert

What is scoliosis

Scoliosis is an abnormal curvature of the spine. The spine has a natural curve forward and backward. In scoliosis, it curves from side to side (lateral bend). Curves can range from mild, around 10 degrees, to severe, up to 80 degrees or more.

In adolescents, scoliosis most often occurs in the thoracic or thoracic spine. In adults, the main problem is usually located in the lumbar or lower spine – these areas are most susceptible to changes with aging.

In most cases, scoliosis is mild and does not require treatment. But in some cases, it may be required and, as a rule, is aimed at relieving symptoms, and not necessarily correcting the curvature. The goal is to reduce pain and improve function.

Causes of scoliosis of the spine in adults

The cause of scoliosis in adults depends on its type.

The most common form of scoliosis in adults is degenerative, that is, age-related curvature of the spine. Scoliosis in adults can be a case of childhood scoliosis that is not detected in time. In some cases, adolescent scoliosis may develop symptoms with age that require treatment.

Idiopathic (of unknown cause) scoliosis is usually diagnosed in childhood or adolescence. But it also happens in adults.

Symptoms of scoliosis of the spine in adults

There are several signs that may indicate the possibility of scoliosis:

  • shoulders uneven – one or both shoulder blades may bulge;
  • the head is not in the center;
  • one or both thighs are elevated or placed unusually high;
  • costal arches are at different heights;
  • the waist is uneven;
  • the whole body leans to the side.

About 23% of patients with idiopathic scoliosis complain of back pain. 10% of them have comorbidities such as spondylolisthesis, syringomyelia, a fixed spinal cord, herniated disc, or spinal tumor. Back pain occurs for many reasons, including arthritis, inability to stand upright, weakness of the underlying muscles, and loss of fitness. Pain, numbness, or weakness in the legs can develop if there is pressure on the nerves in the lumbar spine.

Due to changes in the shape and size of the chest, idiopathic scoliosis can affect lung function.

If you notice one or more of these signs, make an appointment with your doctor.

Degrees of scoliosis of the spine in adults

Scoliosis has 3 degrees.

  • mild scoliosis. It is diagnosed by measuring the Cobb angle (calculated from an x-ray of the spine) by 10 – 25 degrees. At this stage, treatment may not be required or may be delayed.
  • moderate scoliosis. In this case, the Cobb angle is 25 – 40 degrees.
  • severe scoliosis. With this degree of curvature of the spine, the Cobb angle is 40 – 60 degrees or more.

Treatment of scoliosis of the spine in adults

If there is suspicion of scoliosis in adults, before the doctor proposes a treatment plan, he needs to take an anamnesis:

  • family history;
  • the date when you first noticed changes in the spine;
  • progress of the curve (determined from previous x-rays, if available);
  • the presence and place of pain, if any;
  • any bowel, bladder, or motor dysfunction, which may be a sign of more severe nerve damage or pressure caused by scoliosis.

In addition, the doctor will examine your back to check the shape of the spine and ask you to move around. It will also test reflexes and muscle strength.

Diagnostics

Scoliosis is usually confirmed by a physical examination, X-ray, CT scan, or MRI. The curve is measured by the Cobb method and diagnosed in terms of severity by the number of degrees.

A positive diagnosis of scoliosis is based on the curvature of the spine measured on a posteroanterior radiograph (deviation greater than 10 degrees). As a rule, the curve is considered significant if it exceeds 25 – 30 degrees. Bends greater than 45 to 50 degrees are considered severe and often require more aggressive treatment.

X-rays of the spine are also taken to look for other potential causes of pain, such as infections, fractures, deformities, etc.

Computed tomography can show the shape and size of the spinal canal, its contents, and structures around it. Very good visualization of bone structures.

Magnetic resonance imaging (MRI) can show the spinal cord, nerve roots, and surrounding areas, as well as enlargement, degeneration, and deformities.

Modern treatments

In most cases, scoliosis in adults can be treated non-surgically with exercises to strengthen the abdomen, back, and increase flexibility. In addition, you need to quit smoking – it has been proven that smoking accelerates the degenerative process. In most cases, a doctor will recommend some form of physical therapy, both to maintain strength and relieve pain. They may include:

  • work on improving posture;
  • doing low-impact exercises, such as swimming;
  • daily stretch.

If the pain is not relieved by oral medications or physical therapy, a doctor may recommend an epidural (placed around the spinal cord) or nerve block injections for more effective relief.

In some cases, scoliosis requires surgery. This treatment is the last option due to the risk of complications after spinal surgery. Surgery may be suggested for the following reasons:

Pain. Surgery may be required if back and leg pain due to scoliosis becomes severe, persistent, and not amenable to conservative treatment.

Spinal imbalance. Maintaining the balance of the spine is important in assessing the progression of scoliosis and the need for surgery. When standing, the head should be balanced at the center of the pelvis when viewed from the front and over the hip joints when viewed from the side. If the curve progresses to such an extent that it is impossible to stand straight, patients are constantly in pain and are at risk of disability.

The operation is necessary to improve the quality of life. Although it is not recommended solely to improve appearance, some people find the symptoms of spinal deformity intolerable. Their spinal imbalance also affects basic functions and overall quality of life. Surgery is the only option in these cases.

Typically, surgical procedures are designed to stabilize the spine, restore balance, and relieve pressure on the nerves. Spinal stabilization surgery fuses the bones of the spine together using bone grafts and then metal implants to hold the spine in place.

Advances in surgical techniques and computer navigation systems make less invasive approaches possible and speed up recovery.

Prevention of scoliosis of the spine in adults at home

Scoliosis in adults cannot be prevented. In patients with idiopathic scoliosis, the cause of the condition is unknown. Degenerative scoliosis develops over time. Changes can be slowed down with a regular program of aerobic and low-impact muscle strengthening exercises.

Popular questions and answers

We asked patients to answer typical questions about scoliosis traumatologist-orthopedic doctor Oleg Sazhnikov.

What are the complications of scoliosis of the spine?

The most common problems with scoliosis are neurological: pain, numbness of the skin, lack of sensitivity, and movement disorders.

When to see a doctor for scoliosis of the spine?

If you see a big difference in the level of the shoulder girdle in the mirror, or noticed (or someone else noticed) that when you lean forward, the level of the ribs on the back differs in height on the right and left, you need to visit a doctor.

Can scoliosis be completely eliminated?

It all depends on the degree and cause of scoliosis. It is possible to significantly correct the deformity, both by conservative methods of treatment and surgically.

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