Scoliosis - Treatment for Adult Scoliosis

Highlights	Symptoms	Surgery
Introduction	Diagnosis	Treatment for Adult Scoliosis
Causes	Treatment	Resources
Risk Factors	Managing Scoliosis	References
Prognosis	Braces

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Treatment for Adult Scoliosis

Adults who had been surgically treated for scoliosis in their youth are at risk for disk degeneration and spinal fusion failure. In most adults with previous scoliosis, moderate exercise is not harmful and is extremely important for maintaining healthy supportive muscles and preventing disk degeneration. In one study, Pilates, an exercise practice that uses yoga principles, was helpful in a woman with progressively and disabling severe low back pain and who had a history of fusion surgery. This approach deserves further research. The only cautionary note is for people with only one or two mobile lumbar vertebrae below the area that was fused during surgery. These people should avoid activity or exercise that causes excessive twisting on the spine; some experts believe this may accelerate spinal degeneration.

Nonsurgical Treatment of Adult Scoliosis

In most cases of adult scoliosis, nonsurgical care is preferred if possible. This can include patient education, exercises, and medical treatments. Braces are not useful.

One center reported that epidural steroid injections were a beneficial alternative to surgery in patients with degenerative lumbar scoliosis.

In one case study, a middle aged patient with severe scoliosis experienced significant chest expansion and fewer respiratory infections using an approach called comprehensive manipulative medicine (CMM) along with daily traction and massage. Professionals who employ CMM first analyze a person's posture and movements and apply specific techniques to the most disabled parts of the body. This warrants more research.

Surgical Treatment in Adult Scoliosis

Candidates for Surgery. In general, pain is the most common reason for surgery in adult scoliosis. Surgery may be recommended in the following cases:

Curvatures over 50 degrees with persistent pain.
Surgery is almost always recommended for adults with curvatures over 60 degrees; those over 100 are life-threatening.
Progressive mid and low back curve or low-back curve with persistent pain.
Reduced heart and lung function. Most surgeons, however, will not operate on adults with severely impaired lung function and heart failure. Once this has occurred, most experts do not believe that surgery will help lung capacity and in fact, surgery can cause the condition to worsen, at least temporarily.
Significant deformity is present. Adults should not expect to achieve a completely straight spine, however. There is a high risk for nerve damage if the spine is over-corrected, and adult spines are less flexible than children's are. Usually, however, the correction still achieves an acceptable cosmetic improvement.