Adult Spinal Deformities
What are adult spinal deformities, and what are their symptoms?
Although most cases of scoliosis are congenital, it isn’t uncommon for men and women over age 18 to develop spinal deformities. In many cases, this deformity develops in adolescence and worsens with age. Osteoporosis and spondylolisthesis can also cause these adult-onset conditions, though rarely.
There are two main types of adult spinal deformities – adult idiopathic scoliosis and adult degenerative scoliosis. Idiopathic scoliosis develops in adolescence, often causing no pain, and worsens in adulthood due to disc degeneration. Patients usually have asymmetrical shoulders, a rib hump or their lower back might be more prominent on the convex side of the spinal curvature. Arthritis can also cause bone spurs, resulting in pain, stiffness, and, sometimes, numbness in the legs.
Degenerative scoliosis occurs when discs begin to break down and collapse and arthritis sets into the facet joints. Patients usually experience lower back pain, as well as pain, stiffness, numbness, and shooting pain down the legs.
How are they diagnosed and treated?
Doctors frequently order radiographs on the affected segments of spine, as well as the pelvis and hips. Additional studies, such as MRI and CT myelography could be ordered to assess instability and any neurological symptoms in the lower extremities.
Many cases of adult spinal deformities require no treatment. But for patients with lasting leg pain or other arthritis- and pinched nerve-related symptoms, epidural steroid injections, nerve blocks, or facet injections can be temporarily effective. Surgery is often a last resort, reserved for patients who have debilitating pain and/or spinal imbalance. While surgical options are riskier in adults than in teenagers, recent surgical technique advancements have made these procedures less invasive. Smaller incisions and use of computer-assisted navigation systems have improved the surgical process.