Adult scoliosis: Common symptoms include back pain and imbalance
December 10, 2024
Study reveals 50-70% of children with adult idiopathic scoliosis have minor spinal surves under 30 degrees.
Scoliosis is a condition where a patient’s spine exhibits an abnormal lateral curvature, most commonly forming a C-shape or S-shape. A study indicates that around 2.55% of Malaysians aged 13 to 15 have been diagnosed with scoliosis. Contrary to popular belief, scoliosis can affect adults, significantly impacting their quality of life — an aspect often overlooked.
Adult scoliosis and risk factors For adults, scoliosis can appear in two ways. The first type develop scoliosis during childhood or teenage, which doesn’t cause problems initially but become severe and cause issues in adulthood. This is called 'Adult Idiopathic Scoliosis'. 50 to 70 per cent of children with this condition have minor spinal curve of less than 20-30 degrees. This group of scoliosis patients typically will be observed by the doctor with regular follow ups to monitor their spinal curve and treat any issues they may face due to their condition. The scoliosis become severe due to degenerative process and become symptomatic at late adult age. The second form of adult scoliosis is called ‘De novo scoliosis’ which develops in adulthood due to spine degeneration from ageing. Both forms can significantly impact daily life if not properly managed. The risk factors for developing adult scoliosis include a lack of paraspinal muscle strength due to inadequate exercise, poor bone quality, overuse of the spine from labor-intensive work, poor back care or posture, and spine fractures at a young age. Adult patients with scoliosis often experience regular back pain or body imbalance. Common symptoms include back stiffness or pain, particularly in areas where the facet joints are compensating for the imbalance, leading to discomfort and soreness. In severe cases, scoliosis can result in complications such as spinal nerve compression, which may cause leg numbness, weakness, and difficulty walking. When the thoracic spine is involved, it can lead to reduced exercise tolerance and respiratory distress. To accurately diagnose scoliosis, an X-ray is the best tool as it allows for measuring the Cobb’s angle to determine the severity of the condition. Additionally, a spine magnetic resonance imaging (MRI) analysis is conducted to assess any nerve compression. These diagnostic tools are crucial for evaluating the severity of scoliosis and for tailoring a treatment strategy with spine surgeons. Managing scoliosis in adults For adult scoliosis, treatment is often tailored based on patients’ profiles, as this is vital for effectively managing scoliosis. By customizing the treatment plans to the specific needs and conditions of each patient, healthcare professionals can optimizze outcomes and enhance patients’ quality of life and expectations. This personalised strategy considers various characteristics of each patient, including the severity of the spinal curvature, age, overall health status, bone quality, lifestyle habits and specific symptoms. This includes conservative treatment or advanced surgical treatment. Conservative approaches often involve physiotherapy or self exercises like swimming, pilates, and yoga to improve spinal flexibility and strength as well as the use of medication to relieve pain or muscle tension. These methods aim to alleviate pain and improve the quality of life without undergoing surgical intervention. Most patients are able to live a quality life with these treatment options. However, surgical intervention is needed in some cases of adult scoliosis with some careful consideration. For scoliosis in adults, surgery is not the sole solution to alleviate scoliosis-related discomfort. Surgery can limit spine mobility due to the fixation of the spine, so it is not recommended for patients with mild curves or symptoms. However, in cases of severe spinal curvature or significant neurological symptoms, the benefits of surgery may outweigh the risks, making it a recommended option. In today’s world, advanced machinery and surgical techniques can assist spinal surgeons in several crucial aspects of the procedure. These advancements enable precise monitoring of nerves and neurological function during surgery; navigation or robotic assisted technology to enhancing the accuracy of inserting pedicle screws during surgery. In cases with severe osteoporosis, cement augmented pedicle screw could allow better screw engagement to bone and allow surgeon to correct the scoliosis and body balance. For symptomatic patient who are not keen for major surgical intervention, various pain modulation procedures are available such as radiofrequency ablation technique, epidural steroid and various pain block procedures. These procedures allow short to moderate term of symptomatic control before the patient’s condition is too severe and needing the definite surgical option. Early detection, comprehensive management, and ongoing monitoring are crucial in mitigating the progression of scoliosis and improving overall health outcomes. Regular checkups (every two years) and exercises are recommended to maintain spinal flexibility and muscle strength, which can prevent severe complications and enhance the patient’s quality of life. Additionally, a combination of vitamin D and calcium supplements can help strengthen bones and reduce the risk of fractures and scoliosis progression. |
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