What Are the Causes of Scoliosis/Spinal Deformity?
Degenerative adult scoliosis occurs because a deterioration in the spine results in the development of a curve in the spine. It is more commonly found in women and usually begins after the age of 40. It is also often related to osteoporosis, which is a condition that weakens the bones of the spinal column, making it difficult for the spine to maintain its normal shape. Severe pain and disability caused by severe curves in the spine are the more common reasons why a patient will undergo spinal fusion surgery for scoliosis as an adult. The advantages and disadvantages of undergoing a spinal fusion for scoliosis as an adult needs to be discussed in detail with a spine surgeon who is an expert in spinal deformity, and this decision needs to be made with care.
The goals of spinal fusion surgery for scoliosis in adults are a reduction in pain, increase in function, and partial correction of the deformity. No surgery comes with a guarantee for complete pain relief, and in fact, significant pain relief may only be possible 65 or 70 percent of the time. At the same time, it is often difficult to correct the abnormal curvatures of the spine because the adult spine is much stiffer than the spine of a child or adolescent. As a result, the spine is often fused in place and only partial correction of the scoliosis is possible.
Adults who have scoliosis can also develop nerve root compression when the vertebral bodies press on the nerves that exit the spinal canal. This process can be aggravated by scoliosis, since an abnormal tilting of the vertebral body can allow it to slip out of its normal position, decreasing the amount of room available for the nerves to the legs. The warning signs of this condition include weakness, numbness, tingling, and a lack of bowel or bladder control. Surgical procedures may become necessary in this situation in order to enlarge the openings for the nerves, and more information about this type of surgery can be found in the section on Spinal Stenosis.
What Are the Treatments for Scoliosis?
Before determining the best treatment, the Midwest Orthopaedics at Rush physicians will consider a variety of factors including the age of the patient when the curve began, the location and severity of the curve, and any family history of spinal deformity. If the curve worsens, Midwest Orthopaedics at Rush physicians may suggest the patient wear a back brace.
Patients with severe back pain and scoliosis should make every effort to treat their pain with a combination of medications, physical therapy, and regular exercise. A combination of anti-inflammatories, narcotic pain relievers, and anti-depressants may be necessary in order to effectively control the pain.
For patients with a severe curve or whose curve continues to worsen despite wearing a brace, Dr. Singh may recommend surgery to control the curve. Surgery is a safe and highly effective treatment option in these cases. Not all spine surgeons treat scoliosis, so it is important to consult a surgeon with experience in scoliosis surgery, such as the surgeons at Midwest Orthopaedics at Rush Minimally Invasive Spine Institute.
The goals of surgery are to straighten the spine and balance the waist and torso areas. Dr. Singh may recommend lumbar fusion as an effective, surgical treatment for scoliosis when nonsurgical methods are not successful.