All About Adult Scoliosis!

Authored by: VSI

Adult scoliosis refers to an abnormal curvature of the spine in a patient who has finished growing. It is natural for the spine to curve forward and backward to a certain degree, but when the curve develops an “S” shaped side-to-side curve, it is considered scoliosis. Adult scoliosis is often the result of untreated or unrecognized childhood scoliosis and currently affects seven million people in the United States. While the cause of most adult scoliosis cases is unknown, sometimes it may be a result of changes in the spine due to aging and degeneration of the spine. These degenerative spinal conditions may include disc degeneration, compression fracture, osteoporosis, or spinal stenosis. It is important to understand the symptoms and treatment options available for adult scoliosis, as the curvature in the spine can lead to physical pain, difficulty in breathing, significant disfigurement, or progression of the curve.


Many patients with adult scoliosis do not have specific symptoms, as it is generally painless unless caused by spinal degeneration. Symptoms also depend on the curve severity. Patients with scoliosis may notice some of the following things about their body:

  • Clothes no longer fit properly
  • One shoulder or hip may be higher than the other
  • A “rib hump” may occur when scoliosis causes the chest to twist
  • Difficulty standing or sitting upright and problems with balance
  • One arm hangs longer than the other because of the tilt in the upper body
  • Back pain, spinal stiffness, and nerve pain if the scoliosis leads to disc degeneration
  • In severe cases the curvature can progress to affect heart or lung function in the thoracic spine

In order to properly diagnose adult scoliosis and rule out other possible conditions, your physician will ask several questions to gain a history. Some of the questions may include:

  • Family History
  • Date of Onset
  • Measured Curve Progression
  • Presence or Absence of Pain
  • Bowel or Bladder Dysfunction
  • Motor Function
  • Previous surgery

Most patients with adult scoliosis never require surgical treatment. A number of non-operative treatment options are available to help treat pain and maximize function including physical therapy, medication management, and spinal injections. For most patients, a combination of aerobic weight bearing and core muscle strengthening exercises are recommended. Physical therapy, spinal mobilization techniques, or chiropractic treatment can be beneficial for treating symptoms. While these treatments reduce pain and improve mobility, none of these treatments have been shown to effectively reduce the size of a curvature. Medication management for some patients with scoliosis can include the use of anti-inflammatory or pain medications. Spinal injections can be performed to treat areas where arthritis is causing pain or causing nerve irritation.


Surgery to correct adult scoliosis is an option if nonsurgical treatments do not relieve pain or symptoms. Surgery is also needed for patients whose curves are progressing over time or have curvatures leading to nerve compression causing symptoms such as numbness, weakness, or pain. In general curves greater than 45° and curves with severe degenerative changes are best treated with surgical reconstruction. Surgical reconstruction for adult scoliosis involves some correction of the curvature. Goals of surgery are to relieve pain and prevent the curvature from worsening in the future.

Surgery to correct adult scoliosis may be performed from several approaches. Before deciding on the best surgical approach, our surgeons at Virginia Spine Institute review patient’s x-rays, imaging tests, and clinical examination multiple times to formulate a surgical plan. Our surgeons always try to fuse the smallest number of vertebrae possible. This helps preserve the greatest amount of motion in the spine. The final recommendation for each patient is based on the desire to prepare the least invasive and safest procedure for each patient.


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