Adult Scoliosis is a curve of the spine. 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. Adult Scoliosis can vary from a minor problem, where it just needs to be watched, to chronic pain and a severe deformity.
“At Southwest Scoliosis Institute, we see adult patients who are in pain or are embarrassed by their curves. Consequently, we can use our expertise and experience with complex adult scoliosis to make a difference in improving these lives.”
Richard Hostin, MD
Southwest Scoliosis Institute studies adult patients, the majority being women, who develop Scoliosis and who can go through life with little or no pain. On the other hand, we see young women with spinal curves and they too have no pain. “I tell them that the disease will progress and that if left alone, 80 or 90 percent of the time problems and pain will occur later in life. With these women, we discuss their treatment options on a case-by-case basis.” Richard Hostin, MD
Adult Scoliosis Diagnosis
To diagnose Scoliosis, we conduct a physical exam with specialized X-rays. During the physical exam, Dr. Hostin looks for the degree of rotation in the curvature of the spine, as well as other changes in other parts of the body. These may include:
- Uneven shoulders
- Rib hump
- Low back hump
- Change in the shape of the waist
- Uneven pelvic bones or hips
Frequently, these changes do not show in a person while standing but become noticeable when the person bends forward. X-rays are important to pinpoint the shape and location of the curves, as well as for measuring the degree of the curvature for proper diagnosis. Because of this, we use an advanced X-ray imaging system that allows us to quickly take full-body images of patients in standing or seated positions while delivering the lowest possible dose of radiation.
Adult Scoliosis Treatment
Dr. Hostin performs complex surgeries to treat adult scoliosis. As such, Scoliosis Treatment decisions are based on many factors: the degree of curvature, curvature location, risk of progression, spinal imbalance, other disease factors, and the patient’s pain. In recent years, the medical profession has made great strides in the diagnosis and treatment of scoliosis. To be at the leading edge and forefront of this disease, our doctors and medical staff offer the most advanced treatment options available. To date, we have seen over 29,000 new patients and successfully performed more than 5,900 surgeries.
You deserve to get the care you need from only the best-trained doctors. At our practice, we understand our patients are dealing with more than the physical challenges of scoliosis. In addition, they also cope with emotional challenges as well. Therefore, having our patients talk with others who underwent scoliosis surgery provides a powerful method to alleviate the fear of an operation. “We measure our success by our patients’ expectations of success,” says Dr. Hostin. “We commonly receive letters and pictures from our patients telling us how we improved the quality of their lives.”
Adult Scoliosis Treatment Options
Whenever possible, nonsurgical adult scoliosis treatments provide the first steps to a pain-free life. As a general rule, spinal surgery occurs as a last resort due to the risks involved. Thus, our initial treatments commonly include medication, bracing, physical therapy, and exercise. For those with osteoporosis, the treatment of this disease may also slow the progression of scoliosis. Thus, the current treatment includes increasing calcium and vitamin D intake and weight-bearing exercises.
Because of the pain with Scoliosis, we often prescribe mild pain medications to use as needed. Usually, we do not prescribe strong pain drugs, such as narcotics due to the risk of addiction.
Adult Scoliosis Brace
A spinal brace may provide some pain relief; however, in adults, it will not cause the spine to straighten. Once skeletal maturity is reached, bracing provides pain relief rather than prevention. If a significant difference in the length of your legs exists (or if scoliosis causes you to walk somewhat crooked), special shoe inserts, called orthotics, or a simple shoe lift may reduce your back pain.
Physical Therapy and Exercise
Also, adults with scoliosis may work with a physical therapist because a well-rounded rehab program assists in calming pain, improving mobility and strength, and helping patients conduct daily activities with greater ease and ability. Moreover, exercise does not help to reduce the curves of scoliosis; albeit, it does help with addressing pain, posture, and spinal stabilization. Our doctors advise some patients to schedule therapy sessions each week for four to six weeks.
The goals of physical therapy are to help
- learn ways to manage the symptoms of scoliosis
- improve spine posture
- maximize spinal stabilization
Surgery may be needed in the following situations:
- Chronic pain provides the most common reason for scoliosis surgery. Severe pain relief comprises about 85 percent of adult scoliosis surgeries. We will not recommend surgery if the pain is manageable through conservative treatments or facet joint injections.
- Curve Surgery may be suggested if the curvature continues to worsen and the curve gets beyond 40 to 45 degrees to prevent problems that come with severe scoliosis. Surgery will usually be recommended for curves above 60 degrees, as the twisting of the torso can lead to serious lung and heart conditions.
- We do not recommend Cosmetics Surgery merely for the sake of appearance. But sometimes scoliosis causes extreme physical deformity and maybe the only option for correcting the condition. Most cases of cosmetic scoliosis surgeries occur in young adults that possess very noticeable curves.
Adult Scoliosis Surgery
For scoliosis patients whose curvature has increased and they are in pain, we may recommend surgery. To clarify, scoliosis deformity surgeries are serious and complex with multi-step procedures, and sometimes more than one surgery occurs — one performed from the front and one from the back. Typically, this can be done in one operation but in some cases two are necessary. In the event a patient needs surgery, our doctors sit down and explain the risks and benefits of the procedure, and expected outcomes. At Southwest Scoliosis Institute, we are with you every step of the way.
When a patient requires surgery, your doctor can choose from a number of different procedures, usually, a spinal fusion procedure occurs. For instance, each case of scoliosis is somewhat different and may require a very specialized approach for optimal results. Normally, surgery will solve the problems brought on by scoliosis — not just to straighten the spine. The goals of most surgical procedures for adult scoliosis include:
- reducing the deformity (straighten the spine as much as needed)
- stopping the progression of the deformity
- removing any pressure from the nerves and spinal cord or spinal canal
- protecting the nerves and spinal cord from further damage
To achieve these goals, your doctor may suggest an operation. Straightening the spine is the first goal and then fusing the vertebrae together into one solid bone provides a positive solution and outcome. To accomplish this, two different types of surgical methods can be used. One is called lumbar fusion with pedicle screws and rods. The second method inserts special cylinders between the vertebrae to be fused, a procedure called lumbar fusion with intervertebral cages.
Accordingly, both procedures usually require some type of metal screws, plates, or rods, in order to help straighten the spine and hold the vertebrae in place while the fusion heals and becomes solid. The screws are placed into the vertebra. Also, the rods or plates then attach to the screws to connect everything together. Tightened together, they form an internal brace to hold the vertebrae in alignment while the fusion heals.
Possible Complications of Adult Scoliosis Surgery
Like all surgical procedures, operations on the back may have complications. Because the surgeon operates around the spinal cord, back operations are always considered extremely delicate and maybe dangerous. Finally, take time to review the risks involved with spine surgery with your doctor. Also, make sure you agree with both the risks and the benefits of the planned procedure.
Over the years, many patients come to us with a flat-back deformity. This condition occurs from the surgical treatment of adult scoliosis. The lumbar (lower) spine naturally has a slight inward curve called lordosis. When the vertebrae in the lumbar spine become fused together, this lordosis curve may disappear, leaving the patient with a “flat-back” deformity. The loss of the curve may not appear right after surgery. If a young person is a patient, the loss of lordosis may not even appear until sometime between the ages of 30 and 50. Meanwhile, patients who experience a “flatback” syndrome after surgery experience pain and decreased mobility.
“After a routine scoliosis surgery, patients are admitted to the intensive care unit where there is focused nursing care,” says Dr. Hostin. “It really is very comforting for both the patient and their family to know that there’s one nurse who is completely attentive to their needs.”
If you experience pain from scoliosis, there is help. Call the Southwest Scoliosis Institute at 214-556-0555.