Another important disease caused by a spinal abnormality is scoliosis. Although it is believed to be a disorder affecting adolescents, it also causes problems to adults as well. Scoliosis is caused to adults mostly because:
- It is not treated during childhood, and its curve may appear as thoracic, lumbar, or even both.
- Because of the asymmetric degeneration of spinal elements.
- Or a combination of the above.
There are many symptoms that help diagnose scoliosis such as severe back pain. In some cases the patient may experience breathing difficulties as well and the function of the lungs or even heart may be compromised. There may also be some certain physical characteristics such as deformity, lack of symmetry in hips or shoulders, body imbalance causing the patient to be listing to one side, as well as, the imbalance of walking caused by an asymmetry of the patient&rsquos legs.
The diagnosis of scoliosis in adult patients includes a thorough review of the patient&rsquos personal and family medical history, an examination for spinal joint and/or peripheral vascular disease, and in the most extreme cases an evaluation of the patient&rsquos cardiopulmonary function. The medical examiners usually also assess the level of pain, numbness and paresthesias, muscle spasms, bowel and bladder dysfunction and weakness in a patient. They also request full length posterior and anterior x-rays, as well as, CT or MRI imaging in order to have a full image of the patient&rsquos spine especially if the patient presents a rare case of neurological dysfunction and spine surgery is a serious consideration.
Surgery may be considered if any of the following conditions exist:
- Thoracic (mid back) curve is greater than 50-degrees with persistent pain
- Progressive thoracolumbar (mid and lower back) curve
- Lumbar (low back) curve with persistent pain
- Decreased cardiopulmonary (heart and lung) function
Spine surgery to treat adult scoliosis may include the removal of one or more intervertebral discs (discectomy), and removal of bone (osteotomy) followed by spinal instrumentation and fusion to stabilize the spine. Spinal instrumentation provides immediate spinal stability using different devices such as rods and screws. Bone graft stimulates new bone to grow into and around bone and instrumentation. In time, bone graft fuses (eg, joins) surgically treated spinal levels together. The surgeon may recommend and prescribe a bone growth stimulator to "stimulate" new bone growth, and bone healing following a spinal fusion surgery. Spine surgery to treat adult scoliosis is followed by physical therapy either in a rehabilitation facility, on an outpatient basis, or at home to help the patient build strength and endurance.