In one 20-year study, about 40% of adult scoliosis patients experienced a progression of the condition.
Degenerative scoliosis occurs most frequently in the lower back (lumbar spine) and more commonly affects adults age 65 and older.
What Is Scoliosis?
Scoliosis is a condition that causes the spine to curve abnormally, like the letter “S” or “C.” The spine may also twist and cause one side of the back to stick out more than the other.
Scoliosis is usually diagnosed during childhood or adolescence as the spine is growing.
What Are Symptoms of Scoliosis?
In most cases, scoliosis does not cause symptoms. Scoliosis may be noted when a child gets a routine physical exam or during a scoliosis check at school.
Signs of scoliosis may include:
- Uneven shoulders
- One shoulder blade sticks out farther than the other
- One hip is higher than the other or both hips seem abnormally high
- One breast is higher than the other
- Head may not be centered directly above the pelvis
- Rib cages are different heights
- The waist is uneven or there is a skin fold on one side of the waist
- Changes in the appearance of the skin overlying the spine (dimples, hairy patches, color abnormalities)
- The entire body leans to one side
When symptoms of scoliosis do occur, they may include:
- Back pain
- Difficulty breathing
- Usually when there is a severe curvature
- Scoliosis this severe tends to start in children younger than 10 years
What Causes Scoliosis?
About 80% of scoliosis cases have no known cause (they are considered “idiopathic”). The most common type of scoliosis is adolescent idiopathic scoliosis which is usually diagnosed during puberty.
Other causes of scoliosis include:
How Is Scoliosis Diagnosed?
Scoliosis is usually diagnosed with a physical exam.
Scoliosis may be diagnosed with the Adam's Forward Bend Test, which is commonly used in grade school scoliosis screenings.
- The patient leans forward, feet together, and bends 90 degrees at the waist
- From this angle, abnormal spinal curvatures or asymmetry of the trunk can be detected by the examiner
- This test can detect potential problems, but cannot determine the exact type or extent of the deformity
Imaging tests used to confirm scoliosis include:
The curve of the spine is measured by something called the Cobb Method and scoliosis is diagnosed in terms of severity by the number of degrees.
- A curve is considered significant if it is greater than 25 to 30 degrees
- Curves exceeding 45 to 50 degrees are considered severe and tend to require more aggressive treatment
What Is the Treatment for Scoliosis?
Treatment for scoliosis depends on the severity. Mild scoliosis often does not need treatment but because severe scoliosis can cause breathing problems and heart problems, treatment is needed.
Treatment for scoliosis includes:
- Watchful waiting: If a child is not done growing and scoliosis is mild, watching for changes may be recommended
- Bracing to help straighten the spine
- Used in children who have not yet reached skeletal maturity
- Used if scoliosis worsens in 6 months or less
- Surgery for severe cases
- Usually only recommended when the spinal curve is greater than 40 degrees and there are signs of progression
What Are Complications of Scoliosis?
Complications of scoliosis are uncommon. Back pain may occur but it’s usually not severe.
When severe scoliosis is not treated, complications may include:
- Damage to the heart
- Decreased breathing capacity
- Spinal stenosis (narrowing of the spinal canal), which pinches the spinal nerves and makes it difficult for them to function normally
- Spondylosis, an arthritic condition in which spinal cartilage thins, joints become inflamed, and bone spurs can develop