Scoliosis - Surgery

Treatment for Adult Scoliosis

Adults who were treated with surgery 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. However, people who have only one or two mobile lumbar vertebrae below the area that was fused during surgery 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

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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.

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
• Curvatures over 60 degrees (surgery is almost always recommended in this case)
• 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, surgery will not help improve lung capacity, and may 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 an adult spine is less flexible than a child's. Nevertheless, the correction usually achieves an acceptable cosmetic improvement.

Surgeons prefer to operate on adults under 50 years old, although surgery may be appropriate in some older people.