What is Adult Scoliosis?
The human spine naturally grows in a top-outward and bottom-inward curve. However, some spines develop an abnormal curvature that arches sideways or rotates along its axis. This condition is known as scoliosis. It mostly occurs in the lower back, which is the lumbar region of the spine.
It usually occurs in adolescence but may not show any signs or cause any problems. However, it can develop after puberty and hinder your daily activities. These curves can be as mild as 10 degrees to as severe as 150 degrees.
The degree of this curve may or may not be considered a threatening problem. In most cases, scoliosis treatment is primarily focused on relieving the symptoms caused due to the pinching of the nerves and the compressive pressure on the spine.
What are the types of Adult Scoliosis?
Adult Idiopathic Scoliosis:
Idiopathic scoliosis is the formation of abnormal curves caused due to unknown causes or reasons during adolescence. When it is left untreated, it gradually develops into adulthood, causing severe pain and deformities. Adolescent spinal curves which are angled less than 30 degrees are considered to stay underdeveloped throughout one’s life, whereas curves that are more than 50 degrees most probably develop more during adulthood.It usually emerges in the thoracic or lower lumbar region causing deformities like uneven shoulders, tilted hip bone, a rib hump, or prominence of the lower back on the side of the curvature.
Adult Degenerative Scoliosis:
Also known as de novo (new) scoliosis, as the name suggests, the causes of this type of scoliosis are the degenerative disorders that come with old age. It develops in adults as a cause of ageing weakness or complications such as degeneration discs, osteoporosis, arthritis of the facet joints and collapse and wedging of the disc spaces. It almost always develops in the lower lumbar region. Unlike idiopathic conditions, degenerative scoliosis leads to straightening of the spine, causing mobility issues.
What are the symptoms of Adult Scoliosis?
Most developed scoliosis can be directly detected due to visual deformities and the amount of pain it causes in the back and the legs. However, in their developing stage, it may show signs such as:
Loss in physical height (stature)
Stiffness in the back
Frequent numbness or cramping in the legs
Uneven alignment of the pelvis and hips
Shortness of breath
What Are the Treatments for Adult Scoliosis?
Scoliosis, which doesn’t develop severe curves, can be controlled via physical therapy and medications. The treatment is usually decided after periodic observation for some time. The doctor may suggest treatment only if the condition is developing significantly. Tolerable symptoms caused by mild curves can be treated via:
- A course of prescribed and over-the-counter pain relievers
- Core strengthening exercises focused on building the abdomen and back muscles and improving flexibility.
- Postural improvement training and diet for weight maintanance
- Short term use of braces
- In case of severe back and leg pain, Epidurals or nerve block injections for temporary relief
When the condition progresses despite the medical and physical treatments, one may experience severe spinal imbalance and reduced physical movement. In such situations, surgery can prove more relieving. Based on the extent of nerve damage and the condition of the spine, the following spinal surgeries are commonly performed:
Laminectomy (Decompression Surgery):
This surgery is performed to decompress the pinched nerves and relieve pain. It is performed on one or two vertebras at the most when the abnormal curve is less than 30 degrees. In a Laminectomy, the rare wall of the vertebrae known as the lamina is surgically removed to expose the spinal canal and release the compressive pressure on the nerves.
Sometimes, the ligamentum flavum elastic tissues that runs between the lamina from the axis to the sacrum may also be removed if they are the cause of the pressure.If the abnormal curves are more arched than 30 degrees, they are ideally performed with spinal fusion surgery to maintain or improve overall balance.
In a fusion surgery, the shape of the spine is altered to make it straighter by:
- Removing parts or chips of the spinal column by performing an osteotomy
- Adding autografts or allografts of bone tissues
- Using synthetic fixations like rods, screws and plates
It is performed in the cervical and lumbar regions. Bone grafts are also used to boost the fusion healing process. The surgeon may also use artificial bone grafts made from calcium or phosphate. Fusion surgery carries the risk of partial loss of mobility and takes almost a year to heal completely.
If you’re looking for a spine surgeon who can help you find the most suitable spinal scoliosis treatment in Borivali, then Dr Akhil Tawari should be your first choice. With more than 15 years of surgical experience, Dr Tawari performs a thorough analysis with only the latest diagnostic methodologies for scoliosis treatment and provides extensive spinal care for scoliosis-in-adults. Visit Dr Akhil Tawari’s website to learn more about his state-of-the-art spinal solutions.