By Thomas J. Haverbush, M.D. Orthopaedic Surgeon
Transforming patient information into patient understanding.
Scoliosis is easiest described as a lateral curvature of the spine. It can be very subtle or it can be massively disfiguring and disabling for the patient.........
Most people think it is an Orthopaedic problem that occurs primarily in adolescents. They think that the children have to wear a brace, do exercises and sometimes need spinal surgery. All of these things are true.
Did You Know?
However scoliosis is much more than an adolescent problem. In fact scoliosis is very common in adults. I see it all the time in my patients.
The purpose of this writing is to cover adult scoliosis. It is important to understand though that scoliosis in young people often progresses slowly in their early adult life. The cause of adolescent scoliosis is unknown in the great majority of cases.
A Different Disease
Scoliosis in middle age to older adults is a distinctly different problem than in the younger patients I see. Scoliosis in adults is most often caused by wear and tear degeneration of the spine that appears with aging. I don’t want to lose you, but I need to go into somewhat more detail than “wear and tear”. Wear and tear includes;
Everyone knows about the cushions between the back bones (vertebrae) that wear out as a normal part of life and aging. It occurs unevenly in the spine, causes stiffness and puts more pressure on the little spinal joints (the facet joints). With this uneven wear and tear a curvature can result (scoliosis).
Osteoporosis of course is a thinning and weakening of bone with age. The vertebrae can crack and compress (fracture) often to one side leading to scoliosis.
Prior Back Surgery
In some types of back surgery operations are done to remove bone such as the lamina or part of the facet joints. This is done to decompress nerves and relieve pressure.
Sadly, as we age, wear and tear changes (osteoarthritis) begin to develop in the little facet joints in the spine. This happens in conjunction with the discs wearing out.
In two words Spine Imbalance. It can be caused by a pre existing curvature from adolescence, disc degeneration or any of the above four conditions. Uneven forces placed on the back produce even more degeneration and the cycle worsens. Spinal curvature, usually in the lower back is often the result of these processes.
About the only way to avoid it is to not get old. Certainly genetics plays an important role in all of this too. It’s OK to blame your parents for the condition you find yourself in.
Incredibly, no. I see patients frequently who have a noticeable scoliosis on their plain x-rays. But their degree of pain is small and probably not coming from the spinal curve at all.
As I have pointed out before, there are many pain generators in the back and a spinal curve is only one of them potentially.
I am completely out of allotted space and only about half way through this. I don’t like to do two part articles, but sometimes I have to. Can we please resume our class on Adult Scoliosis next week? Thanks! See you then.
My patients put their trust in me and what I do improves the quality of their lives.
All Orthopaedic Surgery problems including this week’s subject can be evaluated by Dr. Haverbush at his office.
315 Warwick Drive
Alma, Michigan 48801
Office is across the street from Gratiot Medical Center.
Please call to make an appointment usually the same week you call.
Attention!! Besides what you read today there is a huge amount of musculoskeletal information on the office website www.orthopodsurgeon.com. Please check it out.