Adolescent / Adult Scoliosis

What is it?

A certain degree of curvature is normal in the human spine, which is necessary for keeping the body properly balanced and aligned over the pelvis. But when viewed from the back, the vertebrae of a healthy spine should form a straight line. In someone with scoliosis, the spine looks more like an “S” or a “C” than an “I”. The vertebrae involved in the curve also may rotate to some degree, which can further contribute to the appearance of an uneven waist or shoulders.

There are several warning signs that may signal the development of adult scoliosis. They include:

  • Shoulders at different heights;
  • Head is not centered directly above the pelvis
  • Appearance of a raised, prominent hip
  • Rib cages are at different heights
  • Uneven waist
  • Leaning of entire body to one side
  • Clothing no longer seems to “hang right” on the body; hemlines of shirts, skirts and pants may appear longer on one side than the other

How is the diagnosis made?

If scoliosis is suspected, imaging studies such as XRAYs, Cat Scan, and MRI of the spine are required to assess severity. The “Cobb Method” is a formula based in degrees which is used to determine the extent to which the scoliosis has progressed. Generally speaking, a curve is considered significant if it is greater than 25 to 30 degrees. Curves exceeding 45 to 50 degrees are considered severe and often require more aggressive treatment

When is surgery recommended?

Conservative measures should always be exhausted prior to consideration of scoliosis surgery. These modalities may include physical therapy, exercise, bracing and medications. Spine surgery for scoliosis had often been considered a major undertaking for adults, but with minimally invasive technique, scoliosis surgery is less disruptive and more tolerable for patients. Surgery may be indicated if the following are present:

  • If you’re experiencing chronic, debilitating pain that has failed to respond to conservative treatment;
  • If your curve has contributed to the development of spinal stenosis (narrowing of the spinal canal that causes pressure on the spinal cord);
  • Your spinal curve continues to get worse, and has progressed to more than 40-45 degrees
  • If physical deformity has become unbearable to you for other physical or aesthetic reasons.
  • If you have progressive, neurological changes such as numbness, tingling or weakness, or decreased tolerance for walking.