Understanding Adult Idiopathic & Degenerative Scoliosis

spine-scoliosisScoliosis, or an abnormal curvature of the spine, affects an estimated 7 million people across the U.S., or approximately 2% of the American population. Often the onset of scoliosis begins during adolescence, but the condition can also exist in adults. When the condition is discovered after puberty, it is referred to as adult scoliosis.

Most scoliosis cases are considered idiopathic, meaning they have no known cause. Most idiopathic scoliosis cases among adults actually began during adolescence. It is important, whether you’re an adult who’s been living with adolescent idiopathic scoliosis for years, or an adult whose scoliosis has only recently discovered, that you have your spine regularly checked by a physician to monitor the curvature and its progression. In many cases, idiopathic scoliosis does not require surgical treatment, but in the event that the curvature worsens , intervention, including surgery, might be required.

In addition to idiopathic scoliosis, there are several other types of scoliosis, most of which predominantly affect children and teens. However, there is one other form of scoliosis, degenerative scoliosis that doesn’t develop until adulthood.

As we get older and our bones and joints begin to wear and break down, we can experience a variety of conditions ranging from osteoporosis to osteoarthritis. In some cases, these same diseases can also be a cause of degenerative scoliosis.

Degenerative scoliosis does not begin until after the age of 40 and is marked by degeneration of the discs in the lumbar spine and the development of a scoliosis curve in the spine. Often times, degenerative scoliosis presents as low back pain. There may be no curve present when symptoms begin, and a patient may simply visit the doctor due to a new, but persistent pain in the lower back

Once the degeneration progresses and the scoliosis curve has occurred, this combination can put pressure on the nerves in the spine, leading to numbness, tingling sensations, weakness, pain in the lower extremities, all of which can lead to difficulties with activities of daily living.

Treatments for degenerative scoliosis vary depending on the severity of the case. Usually, conservative treatment measures including exercise, medication, and use of braces or orthotics can provide sufficient pain relief and support for a deteriorating spine. In particular, strengthening and stretching of the lumbar musculature can be very helpful in decreasing pain, as well as providing “prehab”- that is, exercise treatment BEFORE surgery to maximize the chances of a good outcome.

Treatment of other conditions (osteoporosis, osteoarthritis) that may be playing a role in the degenerative scoliosis can also help improve symptoms or slow the progression of degenerative scoliosis. In some cases, significant nerve problems or pain and/or the development of other conditions such as lumbar stenosis can mean treating degenerative scoliosis may require surgery, such as a lumbar spinal fusion or lumbar laminectomy.

To learn more about scoliosis, visit the Emory Orthopaedics & Spine Center.

About Dr. Ananthakrishnan

ananthakrishnan-dheeraDr. Ananthakrishnan trained with one of the pioneers of scoliosis surgery, Dr. David Bradford, at the University of California at San Francisco. After completion of her fellowship, she practiced orthopedic and spine surgery for over three years at the University of Washington in Seattle. In 2007, she left Seattle to work with Medecins Sans Frontieres/Doctors without Borders in Port Harcourt, Nigeria. She then worked as a volunteer consultant at the World Health Organization in Geneva, Switzerland, before starting her position at Emory University, where her focus is on adult and adolescent scoliosis.

In 2009, Dr. Ananthakrishnan co-founded Orthopaedic Link, a non-profit dedicated to improving orthopaedic care in the developing world by mobilization of unused implants from the United States. She is also a candidate member of the Scoliosis Research Society.

Although Dr. Ananthakrishnan routninely performs complex spinal reconstruction surgery, an injury in 2012 caused her to reevaluate her own approach to musculoskeletal health. Her practice philosophy now focuses on strengthening, stretching and general conditioning (“prehab”) as an adjunct to surgical care of her patients.

Related Resources
Are You One of the 7 Million in the U.S. Affected by Scoliosis?

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