Spinal deformities such as scoliosis usually develop during the growth years of adolescence, or as a result of aging and “wear and tear.” In some cases, the deformities can progress during adulthood as well.
Scoliosis, a word that means curvature of the spine, is not a disease, but rather a term used to describe any abnormal, sideways curvature of the spine. Scoliosis can affect the spine in three sections: the cervical (neck), thoracic (chest region), and lumbar (lower back). Degenerative scoliosis, also known as adult scoliosis or adult onset scoliosis, features the same curvature as pediatric scoliosis, but is caused by degeneration of the facet joints, which provide spinal stability in certain motions. This type of scoliosis occurs most frequently in people over 65 years of age.
While scoliosis in children is often discovered during a screening, scoliosis in adults is typically discovered when the condition causes pain or discomfort. The deformity in an adult may have been present since childhood or may be the result of the aging process. It is not unusual for patients who are well into their 60s, 70s or even 80s to present with symptoms of pain and functional limitations caused by scoliosis. Researchers say about 500,000 adults in the U.S. suffer from scoliosis and have severe sideways curvature.
There are many different causes of spinal deformity in an adult. The most common varieties include idiopathic scoliosis that was present during adolescence and then became worse during adulthood. The other common occurrence is deformity that began in adulthood due to degenerative (wear and tear) changes in the spine and that developed later in life. Other causes, though less frequent, include trauma (from an injury or illness), bone collapse, previous major back surgery, osteoporosis (thinning of the bones), spondylolisthesis (slipped vertebrae) and rarely, infections and tumors of the spine. With increasing life expectancy along with more active lifestyles, the number of older adults requiring treatment for scoliosis has also risen.
Surgery may be recommended when the spinal curve is greater than 50 degrees and the patient has nerve damage to the legs and/or is experiencing bowel or bladder symptoms.