Adult Degenerative Scoliosis: Curvature and Pain

Scoliosis is the sideways curvature of the spine. Adult degenerative scoliosis, unlike childhood scoliosis, develops as a result of wear and tear in the discs and facet joints with ageing. It is generally seen in patients over 50 years of age, and low back pain and walking difficulties are the most common complaints.^1,2

Types

De novo (Newly developed) scoliosis: It emerges with the degenerative process in people who did not previously have scoliosis. De novo scoliosis is seen in the lumbar region and the Cobb angle is over 10 degrees.^3,4

Progressive scoliosis remaining from adolescence: The progression in adulthood of a curvature that started in childhood. Symptoms become prominent when degenerative changes are added.

Symptoms

The main symptoms of adult scoliosis: low back and leg pain, a decrease in walking distance, trunk imbalance (leaning forward or sideways), numbness and weakness in the legs. The pain usually increases with prolonged standing or walking, and eases when sitting or bending forward.

It is generally seen in patients over 50 years of age, and low back pain and walking difficulties are the most common complaints.

Diagnosis

The Cobb angle, sagittal balance parameters (SVA, PI-LL mismatch), and pelvic parameters are evaluated. Spinal stenosis and nerve compression are detailed with MRI. Bone quality and fusion planning are done with CT.

Why is Sagittal Balance Important?

When the natural curves in the side view of the spine (lordosis-kyphosis balance) are disrupted, the patient leans forward. This 'sagittal imbalance' condition is an important factor that negatively affects the quality of life.^5,6

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