Scoliosis & Spinal Deformities

Adult scoliosis is an abnormal curvature of the spine in a patient who has finished growing. This condition affects approximately seven million people in the United States. In these patients their spine curves abnormally to the right or left side and also involves a twisting or rotation of the bones of the spine. While many patients with adult scoliosis do not have any specific symptoms, as the vertebrae rotate, this may cause physical change in the appearance of the patient’s back. It may also lead to painful degeneration of the spine leading to back pain, nerve pain, or in severe cases alter lung and heart function. Most patients never require surgical treatment. For patients with symptomatic scoliosis, a number of non-operative treatment options are available to help treat pain and maximize function.

Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis and typically affects children who are at least 10 years old. The term adolescent means that a patient is not yet skeletally mature, meaning that they are still growing. The term idiopathic means “occurring without known cause.” Idiopathic scoliosis affects 2-3% of children aged 10-18 years old and is more common among females than males. The symptoms of scoliosis vary based on the severity of the curve. Some patients with AIS first notice that their clothes no longer fit correctly. Most patients with AIS do not have many symptoms, but large curves may cause noticeable deformity.

Flatback syndrome is an abnormal condition where the spine loses its natural low back curve to become flat. The spine becomes imbalanced and the patient leans forward. Patients with flatback syndrome typically notice troubles standing upright or have ongoing back or leg pain. Symptoms usually worsen as the day goes on and the patient feels they lean further and further forward the longer they try to stand upright. The severity of the symptoms usually depends on the amount of curvature present and difficulties with standing erect.

In patients with flatback syndrome, a loss of normal lumbar curvature causes an imbalance of the spine. The patient’s head begins to lean forward, away from the body and they may have trouble standing upright. This imbalance can cause muscle fatigue and pain.

Kyphosis is a rounding of the back and can cause back pain and an abnormally curved spine. The most common form of kyphosis is postural kyphosis which can be consciously corrected by standing up straight. For these patients there is no structural abnormality. However, for patients with structural kyphosis, such as Scheurmann’s kyphosis, they are unable to consciously straighten their spine. They may notice difficulty standing upright or have ongoing back or leg pain. Treatment for a kyphosis abnormality depends on multiple factors including the patient’s age, size of curve, underlying cause, and symptoms.