Scoliosis (Adult)

Scoliosis is a condition in which the spine has an abnormal curve when looking at a patient from the front or the back. A healthy adult spine viewed from the back appears straight. A spine with scoliosis, however, shows an abnormal sideways curve that can develop in the cervical (neck), thoracic (mid-back), or lumbar (lower back) regions, or a combination of the three. Unlike scoliosis in children or adolescents, adult scoliosis is often a result of worn-out joints, bones, and spinal discs.  In adults, scoliosis is often associated with kyphosis, which is an abnormal spine curve visualized when looking at a patient from the side.  When a patient has an abnormal curve when looking at them from the front or back (scoliosis) in addition to having an abnormal curve when looking at them from the side (kyphosis), this is known as kyphoscoliosis  (See Adolescent Idiopathic Scoliosis for information about scoliosis in young patients.)

The sideways spinal curve of adult scoliosis can lead to an uneven distribution of weight that can cause pain, disability, and neurological problems including numbness, tingling, weakness, urinary/bowel issues, and problems with walking (see Symptoms of Scoliosis).  In severe curvatures, the scoliosis can cause breathing problems due to a decrease in lung volume. Adult scoliosis can also be disfiguring, which can lead these patients having feelings of isolation and despair.

What Causes Scoliosis in Adults?

There are multiple common causes of scoliosis in adults as well as several ways of classifying it:

• De novo or degenerative scoliosis describes scoliosis in adults (usually older than 40) who have no history of scoliosis as adolescents but then develop a curve from changes in the spinal column linked to osteoporosis, degenerated disks, and vertebral body fractures. As a disc degenerates or bone collapses, it loses height. Pressure on the spine and gravity cause it to curve, and the deformity increases as more segments become affected, especially if the disk or bone is affected more on one side than the other causing asymmetric collapse.
• Adult idiopathic scoliosis (idiopathic means the cause is unknown) is the condition in which an individual has had scoliosis since childhood. A person may have had scoliosis in adolescence but never had it treated, or had a mild condition that was treated but got worse with aging.
• Iatrogenic scoliosis describes the situation that occurs when scoliosis develops as a complication following other surgeries. These other surgeries include spinal fusion or a laminectomy.  When patients with these operations do not heal properly, this may cause instability and/or scoliosis and often requires a second, revision surgery.
• Traumatic accidents and certain infections and cancers can lead to conditions which can develop into adult scoliosis. The mechanism of this type of scoliosis is similar to the degenerative type as it is caused by asymmetry in the degeneration of the affected vertebral bodies or disks, which cause the spine to curve abnormally.

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