Adult Scoliosis

Adult Scoliosis

Adult scoliosis – The development of scoliosis in an adult


 

Usually, most degenerative Adult Scoliosis are particularly found in women, who may have had slight scoliosis in their puberty or may not have noticed any. After 2-3 decades, and more specifically after the age of 35 and up to 50, these scoliosis reach gigantic dimensions and enter to the mechanic vicious circle of aggravation. Problems usually begin with mild chronic back pain. Patients usually visit Spine Centers reporting back pain and in some cases sciatica.Some of them may observe a change in their bodies or they may not associate this change with their symptoms.

In their majority, patients have put on weight during these years and most of them have been pregnant and where they never exercised on a scoliosis exercise program or generally were not particularly athletic.

 

We have two types of adult scoliosis:

 

1-deterioration of adolescent idiopathic scoliosis and

2- degenerative scoliosis of adults

1- Idiopathic Adult Scoliosis


 

Idiopathic adult scoliosis is essentially a continuation of adolescent idiopathic scoliosis. Sometimes an idiopathic scoliosis of the spine (theoretically unknown aneurysm but it seems to be a genetic etiology), launched during adolescence may develop during adulthood.

The angles may increase in size from 0,5 ° to 2 ° per year. The adolescent scoliosis with angles smaller than 30 ° is are unlikely to progress significantly in adulthood and above 50 ° is likely to become larger, so specialists in scoliosis should monitor scoliosis them over time.

Appears in the thoracic and lumbar spine, with the same basic appearance as adolescents, such as shoulder asymmetry, lumbar or thoracic spine hump.

The angle may worsen in the elderly due to disc degeneration and / or sagittal loss. In addition, arthritis usually affects the joints of the spine and leads to the formation of osteophytes.

Symptoms

Adults with idiopathic scoliosis have more symptoms than adolescents due to degeneration of the discs and vertebral joints, leading to narrowing of the foramina of the spinal canal and nerve (spinal stenosis).

Adult patients may have a variety of symptoms, which may lead to a gradual loss of function:

  • Low back pain and stiffness are the two most common symptoms
  • Numbness, cramps and hypoesthesia of the legs due to nerve pressure
  • Fatigue due to tension in the back and leg muscles

 

Diagnosis

 

It is done with radiographs anteroposterior  and lateral.

In the case of lower extremities symptoms, Magnetic Resonance imaging is performed.

Adult Scoliosis

2- Degenerative scoliosis of adult 

 

Also known as de novo scoliosis (new scoliosis). This type of scoliosis occurs in the adult patient due to disc degeneration, arthritis of the joints of the surface and wedge malformation of the discs.

It is often observed in the lumbar spine and is usually accompanied by a straightening of the spine from the side view (loss of lumbar lordosis).

Symptoms

Disc degeneration and vertebral stenosis associated with degenerative scoliosis of adults can cause the following symptoms:

  • Low Back pain
  • Numbness
  • Reflection of pain to the legs.

 

Diagnosis

It is done with radiographs anteroposterior and lateral.

In the case of lower extremities symptoms, Magnetic Resonance imaging is performed.

Adult Scoliosis

Problems usually begin with mild chronic back pain. Patients usually visit Spine Centers reporting back pain and in some cases sciatica.Some of them may observe a change in their bodies or they may not associate this change with their symptoms.

Back pain is one of the most serious problems for an adult with scoliosis, especially if it is a low back scoliosis.

Adult Scoliosis
Adult Scoliosis

But also the aesthetic deformation is great, especially at low scoliosis, by a large deviation of the pelvis and increase of the hump.

The problem is clearly mechanical.

On the side of the curve, discs are subjected to larger loads than the curved side; this results in their plastic deformation and consequently an increase in the scoliotic angle.

If this continued beyond a point usually occurs a lateral sliding on top vertebra of the curve.

Conservative Treatment

Treatment should be cause therapy and not only symptomatic for provisional pain reduction.

It is well known the use of braces reduced the pain that a patient with degenerative adult scoliosis felt, in the same way that exercise slowed down its natural process.

Also, patients have always preferred treatment with a brace to surgery, where the older the patient, the more the problems and risks from a surgical operation.

Adult Scoliosis
Adult Scoliosis

The combination of asymmetrical exercise and a brace of a special type succeed to change the course of adult scoliosis.

After years of research and clinical observations in 2009 SPONDYLOS created for the first time in the world a program that has already delivered spectacular results.

The program is based on three axes:

1. Exercises for scoliosis with Schroth breathing and asymmetrical exercises,

2. SEAS exercises for correct posture and

3. the special SPONDYLOS Rigo-Cheneau brace by to maintain the corrections.

Adult Scoliosis

Surgical treatment

 

Surgery is intended for patients who have:

  • Failure of conservative treatment
  • Permanent sciatica and loss of spinal balance.
  • Limited activities and overall significantly reduced quality of life.

The goals of surgery are to restore the balance of the spine and to reduce pain and discomfort by decompressing the pressure of the nerves.

Decompression with wide laminectomy.

Normally used only in one or two vertebral levels in patients with pain in the legs of narrowing and lower curves (<30 degrees).In patients with more than two levels of stenosis and greater curves> 30 degrees, the decompression without fusion runs the risk of destabilizing the spine causing a worsening of the curve.

Surgical Stabilization

It involves the placement of hooks, wires or screws in the spine and the use of metal rods to connect the hooks together. It is always done with the addition of fusion.

Spinal Fusion

Bone grafts of the patient, cadaveric bone or synthetic bone grafts are used to “stabilize” the spine in a straight position.

Osteotomy

A process in which the vertebral fragments are cut and redefined.

Spinal resection

Removed whole vertebral segments prior to the realignment of the spine and is used when an osteotomy and other operational measures can not correct scoliosis

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