Medical Health Encyclopedia

The following are some possible causes of later back problems in people with a history of treated scoliosis:

• Spinal fusion disease. Patients who are surgically treated with fusion techniques lose flexibility and may experience weakness in back muscles due to injuries during surgery.
• Disk degeneration and low back pain. With disk degeneration, the discs between the vertebrae may become weakened and rupture. In some patients, years after the original surgeries, particularly with the first generation of the Harrington rods, the weight of the instrumentation can cause disk and joint degeneration severe enough to require surgery. Treatment may involve removal of the old instrumentation and extension of the fusion into the lower back. Still, most patients do not experience significant back pain from these problems.
• Height loss.
• Scarred regions. Pain can occur from old scars in the incision areas.
• Lumbar flatback. This condition is most often the result of a scoliosis surgical procedure called the Harrington technique, which eliminated lordosis (the inward curve in the lower back). Adult patients with flatback syndrome tend to stoop forward. They may experience fatigue and back and even neck pain.
• Rotational trunk shift (uneven shoulders and hips).

Note. Evidence suggests that previous treatment with braces may also cause mild back pain and more days off, but problems appear to be less than with surgery. In one study, dysfunction was comparable to people without a history of scoliosis.

Problems in Adult-Onset or Untreated Childhood Scoliosis

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Pain in adult-onset or untreated childhood scoliosis often develops because of posture problems that cause uneven stresses on the back, hips, shoulders, necks, and legs. In one study conducted 20 years after growth had stopped, two thirds of adults who had lived with curvatures of 20 to 55 degrees reported they experienced back pain. In this study, most cases were mild, although others have reported that adults with a history of scoliosis tend to have chronic and more back pain than the general population.