Degenerative adult scoliosis is a condition that begins after the age of 40 years, and is attributed to deterioration of the spine. Osteoporosis will weaken the spinal bones (vertebrae), which causes abnormal spine curvature. The spine begins to sag as the degenerative condition worsens, creating a scoliotic curve.
Scoliosis that occurs in adulthood is often from a secondary cause. Conditions that contribute to degenerative adult scoliosis include osteoporosis, osteomalacia (softening of bones), and degenerative disc disease. In addition, scoliosis can appear after spinal surgery for other problems, such as a herniated disc.
Degenerative adult scoliosis is usually diagnosed in people age 40 years and older who have a history of back pain. Diagnosis requires a lumbar curve of 10 degrees or more. Both men and women are affected equally, and the mean age at time of presentation is 70 years.
Degenerative adult scoliosis usually begins as low back pain. Over time, and as the curvature worsens, a deformity causes the back to look peculiar, such as humpback (kyphosis). In addition, pain of the spine causes bony prominences to put pressure on spinal nerves, which can lead to arm or leg weakness, numbness, and tingling. Other symptoms include walking with a limp, leg length discrepancy, and breathing problems.
To diagnose degenerative adult scoliosis, the orthopedic specialist will:
The treatment of degenerative scoliosis is usually conservative. Options include:
For some patients with degenerative scoliosis, surgery is an option. The surgeon can remove portions of the spinal bones that impinge on the nerve roots. A lumbar laminectomy involves decompression of the spine with spinal fusion, which will straighten the spine. This surgery is done to take away pressure and provide spinal stability.
The prevalence of adult scoliosis is reported at 5-30%, depending on which study you read. In a recent clinical study of elderly volunteers, the prevalence of the condition was reported at 60%.
Aebi M. The adult scoliosis. Eur Spine J. 2005;14(10):925–948. doi: 10.1007/s00586-005-1053-9.
Kotwal S, PUmberger M, Hughes, A, & Girardi F (2011). Degenerative Scoliosis: A Review. HSS J, 7(3), 257-264.