Adult degenerative scoliosis
Adult degenerative scoliosis is a curvature of the spine in which the spinal column bends from side to side instead of straight up and down. The condition is a result of degeneration of the facet joints, which are small joints between the backbones (vertebrae) that help your spine move. When the facet joints deteriorate, the surrounding bones or vertebrae shift and stack on top of one another, which then causes the spine to curve abnormally to the side. This condition affects adults, mostly over the age of 65.
There can be confusion about idiopathic scoliosis and adult degenerative scoliosis. Idiopathic scoliosis occurs in adolescents between the ages of 10 and 18. The most profound difference between these two types of scoliosis is that there is no known cause for idiopathic scoliosis, while there is a very distinct cause for adult degenerative scoliosis. Patients who suffer from idiopathic scoliosis rarely feel pain from the condition. Those suffering from adult degenerative scoliosis often feel pain caused by the deterioration of the facet joints. The abnormal curvature itself is not the cause for pain; the deterioration of the discs and facets resulting in arthritic changes of the spine causes most of the back pain.
It is important not to confuse adult scoliosis with adult degenerative scoliosis. Adult scoliosis refers to abnormal curvature of the spine in patients over the age of 18. Sometimes this can be a result of untreated and progressive childhood scoliosis or scoliosis that formed during adulthood. Adult degenerative scoliosis usually affects people over the age of 65 and is a direct result of the degeneration of the facet joints in the spine.
Some physicians define scoliosis as a spinal curvature of 10 degrees or more. This small amount of curvature is not usually visible to the untrained eye. More obvious symptoms can include:
- Gradual pain – Pain in different areas of the back, depending on the area affected by scoliosis, that comes on gradually and increases with activity.
- Pain in the morning – Pain is worse upon wakening, but eases once you are up and moving around. The pain increases later in the day, especially after a significant increase in activity.
- Less pain when sitting – Pain is worse when you are standing or walking, because there is more pressure on the deteriorating facet joints. Sitting takes the weight and stress off the affected joints.
- Leg pain – Feeling pain in one or both of your legs is a common symptom of adult degenerative scoliosis. When the facet joints are irritated, they become enlarged and can constrict the lumbar spinal canal, resulting in spinal stenosis or narrowing of the spinal canal, causing the leg symptoms. This constriction increases when you stand or walk. Sitting can relieve the constriction and pain.
- Spinal instability
- Humpback or increased roundness of the back and abnormal posture
- Stiffness in the spine
- Nerve damage
- Heart and lung problems
- Difficulty breathing
The most common treatments for adult degenerative scoliosis are nonsurgical approaches such as anti-inflammatory and pain medicines, therapy and exercise. Corrective surgery is rarely performed but can be quite complex, depending on your symptoms.
The multidisciplinary team of spine experts at Northwell Health Orthopaedic Institute treats adult degenerative scoliosis as well as a broad range of spine conditions that can occur at any stage of life.