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Scoliosis

Scoliosis is a curvature of the spine that occurs most often in adolescents, but adults develop the condition too. An estimated 60 percent of the older population have what is known as adult scoliosis. As people live longer and are more active, this number is expected to increase.

Adult scoliosis is most common in people between the ages of 50 and 80. It is characterized by a side-to-side curvature of the spine caused by degeneration of the spine's facet joints, which act as hinges to help the spine bend./

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As people age, the cartilage that protects the joints may develop arthritic changes, causing the joints to become irritated and inflamed resulting in back and leg pain. Some adults had childhood scoliosis that worsened with age or was untreated in their youth.

Spinal curvature is measured in degrees. Unlike the slow progression of adolescent scoliosis, adult scoliosis can remain the same, can progress slowly and can progress at higher rates of more than 3 degrees a year. Often, the condition causes significant physical pain and can impact quality of life.

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Mid to lower back pain and back stiffness are often the first symptoms of degenerative adult scoliosis.

Other symptoms include:

  • Curved posture
  • Difficulty sitting or standing
  • Difficulty walking due to loss of leg muscle coordination
  • Humpback
  • Leaning towards one side
  • Nerve damage, causing weakness, numbness and pain in legs and feet
  • Protruding rib
  • Reduction in height due to a curved spine
  • Shortness of breath and fatigue, caused by an upper spine curve
  • Spinal stiffness

To make a diagnosis, a spine specialist will record your medical history, including information about your symptoms, previous treatments and family history of scoliosis.

A physical examination will include tests to measure your range of motion, balance, reflexes, muscle strength, sensation and neurologic function.

Standing X-rays, from the front and side, will be taken to document the curvature of your spine and to determine how fast the curve is progressing.

MRIs and CT scans may be performed to determine the health of the discs above and below your curve and to determine if there is any nerve compression.

Treatment usually begins with physical therapy and medications, including:

  • Anti-inflammatory medications and occasional mild narcotics for pain relief
  • Epidural steroid injections to relieve leg pain
  • Physical therapy to stabilize the spine

Surgery

For patients whose back or leg pain doesn't respond to medication and physical therapy, surgery may be considered. Spinal surgery to treat adult scoliosis is complex, considering the average patient's age and the possibility of other medical conditions, such as osteoporosis, but a patient's age should not rule out surgery.

Research has shown that age is not as important as a person's health in determining the success of the surgery and rate of recovery. Patients considering surgery are encouraged to adapt a healthy diet and weight, and participate in an exercise regimen before and after surgery.

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Reviewed by health care specialists at UCSF Medical Center.

Related Information

UCSF Clinics & Centers

Spine Center
400 Parnassus Ave., Third Floor
San Francisco, CA 94143-0332
Phone: (866) 81-SPINE or
(866) 817-7463
Neuro-spine Fax: (415) 353-2176
Ortho-spine Fax: (415) 353-4047
Appointment information

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