Scoliosis is a medical condition in which a person's spine has a sideways curve. In some cases, adolescent scoliosis may develop symptoms with aging and require treatment. Mild scoliosis does not typically cause problems, … This type of deformity occurs in adults and adolescents. Adults with surgically treated scoliosis that end up with a balanced spine — that is, the head is positioned directly over the pelvis from front-to-back and side-to-side — can achieve a high degree of satisfaction after surgery. Adult scoliosis is defined as a spinal deformity in a skeletally mature patient with a Cobb angle of more than 10 degrees in the coronal plain. Surgery Helps Adults With Scoliosis. Surgery for adult scoliosis is associated with improvement in radiographic and clinical outcomes at a minimum 2-year follow-up. Treatment may include observation, a brace or surgery. Quality of life is the deciding factor, research finds. Pediatric Anesthesia: What Parents Need to Know, The Role of Bone Graft in Spinal Fusion Surgery, Video Series: Exercises for Spondylolisthesis, Bone Growth Stimulation After Neck or Back Spinal Fusion, How Kettlebell Exercises Can Help Your Back Pain. Scolioisis most frequently occurs in children and teenagers. The process of fusion is complete when all the bones included in the fusion have grown together, which can take several months to occur. On an x-ray with a front or rear view of the body, the spine of a person with scoliosis looks more like an \"S\" or a \"C\" than a straight line. Adult Scoliosis is a curve of the spine. All of a sudden, I felt like my body was foreign, as if I underwent the procedure and woke up to find the surgeon had given me a new body. Learn all about what Children's Hospital Colorado surgeons do during Scoliosis surgery to help straighten out spines and prevent the Scoliosis from returning. Decompression surgery (e.g. These more complicated procedures are called pedicle subtraction osteotomies—in which a wedge of bone is removed from the spine—and vertebral column resection—in which an entire vertebral body is removed from the spine. During this procedure, the spine is fused to bone grafts or substitutes to hold the spine in a straighter position. Because these techniques remove bone and ligament, there is some concern that when used alone in the setting of adult scoliosis, the scoliosis or deformity can worsen and cause recurrent symptoms. Adults with Scoliosis: Surgery Options. Prior to your surgery, your doctor will be able to give you a general scoliosis surgery recovery timeline. “Patients who need surgery can benefit tremendously, but surgery is most likely not the best option for more than 90 percent of adults with scoliosis.” For example, one small study in 2004 of young adults found that while scoliosis surgery patients had slightly lower physical health scores compared with peers who did not have scoliosis, their mental health scores were actually higher. The curve is usually "S"- or "C"-shaped over three dimensions. Photo Source: SpineUniverse.com. For years, spine surgeons have debated the best methods for treating scoliosis in adults. Yet, surgery is often prematurely recommended when a teenager's scoliosis curve measures over 40 degrees. SOSORT (International Society on Scoliosis Orthopedic and Rehabilitation Treatment) recommends both scoliosis specific rehabilitation programs and bracing for adults with progressive scoliosis and back pain for patients that are not good surgical candidates or to try non-surgical treatment options before perusing surgery. While it is desirable to reduce the amount of scoliosis (side-to-side curve), it is probably more important that any loss of lordosis or kyphosis (front-to-back curves) is corrected to keep the patient standing upright. Scoliosis surgery is typically not considered unless bracing has been tried and failed to prevent the curve from reaching 45 or 50 degrees. “Only a small percentage of patients with adult scoliosis will ever need surgery, but if surgery is deemed necessary it’s generally due to dysfunction related to back and leg pain,” explains Dr. Kang. The most common form of adult scoliosis is degenerative (spine curves as you age). These curves can't be corrected simply by learning to stand up straight. Long-term risks of scoliosis surgery have not yet been reported upon in research. Mayo Clinic scientists study many different aspects of scoliosis treatment — including improved bracing technology, imaging and surgical techniques, as well as the long-term results of treatment. Abnormal reflexes There are different considerations for children/adolescents and adults as to whether to consider scoliosis surgery; every curve is different! In most patients, no surgery is needed; however, in patients who have an excessive curve and it compromises breathing or walking, surgery can help correct those complications. The duration and ease of your recovery will depend on the type of scoliosis surgery you have, but your surgeon will likely recommend physical therapy to help strengthen your muscles and improve flexibility. This has the advantage of aiding the surgeon in optimal placement of screws and avoiding injury to delicate nerve tissue. Most adults with scoliosis will not need lumbar decompression surgery. Adults experience scoliosis very differently than adolescents, which is why the motivation behind getting the surgery can also be very different. Dr. Lenke is the co-chief of adult and pediatric spinal, scoliosis and reconstructive surgery at Washington University School of Medicine and the director of spinal surgery at Shriners Hospital for Children, both in St. Louis. MYTH #1: Spine surgery is my only treatment option. Adult scoliosis may be a progression of childhood scoliosis or a scoliosis … Methods. He has a professional interest in treating complex spinal disorders, scoliosis and spinal trauma. What is adult scoliosis? TOP 3 MYTHS ABOUT ADULT SCOLIOSIS SURGERY. The surgeon removes the damaged disc tissue and inserts a spacer between the vertebrae. Scoliosis Surgery in adults. Spinal Reconstruction: Every individual’s deformity is different and requires a tailored approach. Correction can be obtained by removing the discs between the vertebrae and placing cages or bone between them. Adult Scoliosis can vary from a minor problem, where it just needs to be watched, to chronic pain and a severe deformity. The goal of surgery for scoliosis is to correct the curve, halt its progression, and reduce pain and neurological symptoms. The general principles involved in surgery on adult patients with scoliosis, which will be reviewed in this article, are: Nerve compression causing pain, numbness, tingling, or weakness in the legs is commonly associated with adult scoliosis. Children who have mild scoliosis may need regular checkups to see if there have been changes in the curvature of their spines as they grow. The rate of complications may even be higher than reported. Adult scoliosis can be separated into four major groups: Type 1: Primary degenerative scoliosis, mostly on the basis of a disc and/or facet joint arthritis, … Minimally invasive spinal fusion surgery fuses the bones of the spine in the lower back together so that there is no longer any motion between them. During surgery, there are a variety of techniques available that can be used to reduce nerve compression, but may be broadly grouped into direct and indirect decompressions. In fact, researchers have found that when doctors focus on treating the underlying cause of scoliosis symptoms, adult patients experience less pain and improve their ability to function. The way to deal with your scoliosis depends on how severe the curve of your back is. A spine surgeon makes a small incision in the patient’s side, between the lower ribs and pelvis, and inserts a special surgical instrument just above the disc space. As a scoliosis specialist, I’m here to debunk common myths surrounding treatment for adult scoliosis. Waking up after scoliosis surgery was incredibly mind-blowing. 4. A surgical procedure called spinal fusion is used to treat scoliosis. A medical indication for this treatment cannot be established in view of the lack of evidence. Every year, about 8,000 people who underwent this surgery in their youth for the correction of their scoliosis are legally defined as permanently disabled for the rest of their lives. Treatment may include observation, a brace or surgery. As many as seven in 10 adults over the age of 60 have scoliosis , compared to just 3 to 5 percent of adolescents — and some doctors believe the number will increase over the next 20 years as people live longer. In the simplest form, an osteotomy may involve removing only part of the small facet joints along the back of the spine. The most common spinal surgery used to treat scoliosis is spinal fusion. Surgical techniques for scoliosis have come a long way recently with the development of minimal access, minimally invasive techniques, although traditional open surgery may sometimes be necessary. When I look back at the time before my surgery to correct severe scoliosis, it is hard to believe what all I could not do or was limited in doing. However, often patients do start to slowly return to some school and work activities prior to 3 months after surgery. Conclusions. Spinal fusion is a common type of spine surgery—not only for scoliosis but for a host of other spine conditions. So, ask questions if you’re not clear how to move forward after the procedure. Low back degenerative scoliosis in an adult is shown in this x-ray. Surgery may seem like the only option if a doctor says your child \"needs it immediately,\" and the doctor may say that spinal surgeries are much less invasive than they used to be, but all surgery is invasive especially if it fuses a majority of … This is a retrospective review of a prospective, multicenter spinal deformity database. Surgery may be recommended when conservative treatments did not work and the spinal deformity is progressing or has caused serious complications. For adult scoliosis, surgery, other treatments are viable options. The size or the location of your spine’s curve doesn’t predict whether or not you will have symptoms. In some cases, the spine fails to fuse or the curves continue to progress even after the surgery. Antoinette's Story: Adult Scoliosis. Most people think of scoliosis as a condition that affects only ado… Your surgeon will also insert material to promote healing of the bone between the vertebrae. After having surgery, especially a scoliosis corrective surgery, it is natural and necessary to take a few weeks off to focus on your body healing. This will allow you to plan accordingly and help you focus more on healing rather than fixating on minor details. When Scoliosis Surgery May Be Recommended Surgery for Adult Scoliosis The treatment of adult scoliosis is very individualized and based on specific symptoms, degree of curve, where the curve is located on the spine, how quickly the curve is progressing, existence of other medical conditions, and age and overall health of the patient. Everyone's spine has subtle natural curves. Patients undergoing this procedure usually have faster recovery times that those having open surgery. During the surgery, the surgeon makes several small incisions along the back. lumbar laminectomy). With time and dedication, pain associated with adult scoliosis can be improved, and patients can achieve significant improvement in their quality of life. You will have postoperative activity restrictions for 12 weeks after surgery. The process of spine fusion involves stabilizing the bones and placing material around the bones to promote bone healing. For that reason, correction and fusion of the spine are often used along with these techniques, as discussed below. However, when symptoms don’t respond to nonoperative treatment, or when the spinal deformity is severe or getting worse, spine surgery may become necessary.The general principles involved in surgery on adult patients with scoliosis, which will be reviewed in this article, … There have been a few studies suggesting that some types of soft braces might help reduce back pain, but these are not intended to correct the scoliosis. In some cases it may be caused by aging, a disease or condition, including: 1. The doctor will initially take a detailed medical history and may ask questions about recent growth. When this occurs, it’s known as adult degenerative scoliosis. However, when symptoms don’t respond to nonoperative treatment, or when the spinal deformity is severe or getting worse, spine surgery may become necessary. Surgery for scoliosis in adults – Scoliosis is a problem that leads to curved spines i.e. In certain patient scenarios, scoliosis reconstructive surgery is discussed to help improve symptoms of pain, numbness or tingling. (Download the “About Lateral Access Surgery” brochure here). In spinal fusion, rods and screws are attached to the spine to hold the spine in a straighter alignment. Symptoms associated with adult scoliosis are often initially managed with non-surgical therapies; such as medications, physical therapy and/or injections. To contact one of our physicians with a question, patient referral or second opinion, you may also email: BWHNeurosurgery@partners.org . He or she then inserts a device called a tubular tool. Our experienced neurosurgeons, who have been trained in the most advanced reconstructive surgical techniques, can determine the best treatment for each patient and each situation. If you’re at a greater degree of curve than 45 degrees, surgery, the appropriate resting period and physical therapy can help. This groundbreaking study has given hope to thousands of adults with scoliosis who struggle daily with pain and other symptoms. And it can develop in adults too. Instead, trying to stop the curve from getting worse later is the main goal. The only procedure that is recommended to correct adult scoliosis is surgery. Another new study from 2019 2 looked at adults (ages 46 to 68 on average) with curves 75 degrees or larger who had spinal fusion performed and found 32% of these patients required a second (revision) surgery. 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