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Degenerative Scoliosis

Degenerative scoliosis describes a sideways curvature of the spine that results from degeneration of the joints and disks in the spine. This degeneration and the resulting asymmetry of the spine most often occurs gradually as a person ages.

Our fellowship-trained surgeons, Richard Hostin, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD, will take the time to properly evaluate your condition and discuss the most effective treatment options with you.

A particularly debilitating form of the disease in adults is degenerative scoliosis, which produces incapacitating pain and progressive curvature of the spine. Untreated cases may manifest as a disfiguring S- or C-shaped curve and often a large hump in the back. As they age, patients with this form of scoliosis have increasing difficulty exercising, and their lifestyle may be impacted by pain. As the disease progresses, some may experience difficulty breathing and walking.

Southwest Scoliosis Institute offers a comprehensive diagnosis of each patient’s specific curvature through a physical examination of the back and extensive testing including specialized low dose X-rays.

Degenerative scoliosis is classified as:

  • Pure degenerative – Scoliosis patients who had straight spines earlier in life but developed curvatures from wear and tear of the aging spine.
  • Old idiopathic curves with degenerations – Scoliosis patients who had curves in childhood that increased in curvature later in life.
  • Secondary – Scoliosis patients who experienced curves caused by other conditions, such as tumors and fractures.


Degenerative scoliosis can have a range of symptoms depending on what is causing the condition. Some patients with degenerative scoliosis experience no symptoms, or they may be severely disabled. Degenerative scoliosis symptoms may include:

  • Back pain that gets worse while standing (and may get better while laying down)
  • Pain in one or both legs
  • Numbness and/or weakness in one or both legs

Diagnosing Degenerative Scoliosis

Scoliosis is usually diagnosed by a combination of physical examination and specialized X-rays. During the physical examination, Dr. Hostin or Dr. Avramis will look at the degree of rotation in the curvature of the spine, as well as secondary changes in other parts of the body, such as:

  • Uneven shoulders
  • Rib hump or asymmetry
  • Low back hump or asymmetry
  • Change in the shape of the waist
  • Uneven pelvic bones or hips

Often, these changes are not noticeable while standing and only become visible when the person bends forward. X-rays are an important tool for pinpointing the shape and location of the curves, as well as for measuring the degree of the curvature so it can be classified. Southwest Scoliosis Institute uses the revolutionary EOS X-ray imaging system, which allows us to quickly take full-body images of patients in multiple positions while delivering the lowest possible dose of radiation.

When Does Degenerative Scoliosis Become Serious?

If degenerative scoliosis causes the spinal cord or a nerve root to become impinged, either through stenosis (narrowing of the spinal canal) or severe bending of the spine, nerve function could be jeopardized. Initially, this is often felt as a sharp or shock-like pain in the back that radiates down the buttock and/or into the leg, or as tingling or numbness that can radiates down into the leg. This is commonly referred to as sciatica or sciatic pain, and the medical term for this type of radiating pain is radiculopathy. While uncommon, it is possible for degenerative scoliosis to cause permanent weakness in the legs and/or problems with bladder and bowel control.

Treating Degenerative Scoliosis

In many cases, the symptoms of degenerative scoliosis can be addressed through a combination of physical therapy and pain management. However, in cases where the patient’s curve has progressed to the point that they are in pain or having difficulty breathing, surgery may be the best option.

Physical therapy. A physical therapist or other qualified medical professional can help develop an exercise and stretching routine to meet the patient’s specific needs. Physical therapy can help keep the soft tissues and joints limber as well as strengthen the targeted muscles. The physician will most likely prescribe non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or medications that treat inflammation from arthritis to help reduce pain and allow the patient to continue his or her physical therapy.

Injections. Epidural steroid injections can reduce inflammation, and facet-block injections can prevent pain signals from reaching the brain. These types of injections deliver the anti-inflammatory medication directly to the affected area in the spine.

Scoliosis surgery. If the curve is severe and the patient is in a great deal of pain, the physician may recommend surgery. The most common type of surgery to address degenerative scoliosis is called spinal fusion, which involves inserting rods and screws (known as instrumentation) into the vertebrae to prevent the spinal curvature from progressing any further.

Surgeries to fix degenerative scoliosis are complex, multi-step procedures, but Richard Hostin, MD, Shyam Kishan, MD and Kathryn Wiesman, MD, specially trained and have years of experience performing these types of complex spine surgeries.

For more information or to make an appointment, call 214-556-0565.