What is adult idiopathic scoliosis?
Adult scoliosis may be an illness that began in childhood and continues to progress. While painless during childhood, it may present pain in adulthood. The cause of this type of scoliosis beginning in childhood is unknown, and it is named adult idiopathic scoliosis.
What is adult degenerative scoliosis?
Adult degenerative scoliosis is the type of scoliosis that develops due to wear and aging of the spine. It generally occurs after age 50. In older women, osteoporosis may cause a curve to form or worsen an existing one. Osteoporosis describes the weakening of bone due to a decrease in calcium, and also named bone resorbtion.
Degenerative scoliosis caused by wear may affect any of the areas in the spine including the neck, thoracic, and lumbar, however the lumbar area is the most commonly involved. The spine is bent to the side, and also rotates around itself. These deviations may result in asymmetric appearances in the waist, hips, and shoulders.
The stability and balance of the spine may be disrupted in patients with severe adult degenerative scoliosis. This, in turn, may cause the spine and the chest to deviate to the side depending on the curve, and will cause the chest to bend to the front due to decreased anatomic angle in the sagital plane of the lumbar region. These deformations will increase the severity of the curve, and a vicious circle may form because the deformations will increase as the severity increases. This progression often occurs slowly.
Spinal curves have a concave and convex side. In the concave side, compressive forces cause excessive loading on spinal facet joints; they also cause the nerves to be compressed within the canals located on the same side. Also, excessive bone formation in the joints caused by wear of the spine, or reactive thickening in the soft tissues will also increase nerve compression Therefore patients with degenerative scoliosis may have back or lower back pain, pain distributed along the nerve tract (radiculopathy), and loss of power in muscles innervated by the nerve.
In adult idiopathic scoliosis, there may be severe pain due to degeneration in facet joints. Respiratory functions may be compromised by the extreme deformities in the thoracic cage, and this may result in early fatigue and respiratory problems in patients.
The treatment decision of adolescent scoliosis is made based on the deformity, however treatment of adult scoliosis mostly depends on the symptoms.