Study of Adult Scoliosis Concludes That Surgery Is Not Always Necessary

Though we generally associate scoliosis with adolescent girls, the condition can appear at any age. When scoliosis appears in adults, it can result in pain that is significantly worse than is the case with teens. This is largely due to the fact that adult symptoms are exacerbated by the normal degeneration of vertebral discs that come with age.

Historically, creating scoliosis in adults has not presented as clear-cut a treatment path as is true of younger patients, for whom stopping the disease from progressing further is almost as important as correcting the problem that exists. Following the release of an 8-year-long government-funded study, patients and physicians alike now have a much better idea of the best options that are available for adults diagnosed with the condition.

Adult lumbar scoliosis can result in back pain and leg pain. Though some have assumed that the best answer is corrective surgery, the NIH-funded study reveals that the right course of treatment is largely dependent upon the individual patient’s original condition. Though the general consensus is that surgery leads to improvement of patient symptoms, correcting the curvature and decreasing pain, the study revealed that skipping surgery in favor of physical therapy is a viable option for those who are not experiencing significant pain or loss of function. Unlike the risk with adolescents, adults did not exhibit any worsening of either their deformity or their discomfort two years later, making it clear that the question of surgery is really dependent on the degree to which the condition is impacting the quality of daily life.

The study was published in a recent edition of The Journal of Bone and Joint Surgery,  and the study’s senior investigator, J. Albert Key Distinguished Professor of Orthopaedic Surgery Keith Bridwell M.D. of Washington University School of Medicine in St. Louis, says, “If patients are expecting less pain or better function, they probably won’t see improvement unless they have surgery. On the other hand, if patients have adequate quality-of-life, and the goal is simply to keep them from getting worse, nonoperative treatment probably is fine.”

Scoliosis in adults is frequently a carryover from when they were teens: their condition was either missed entirely or at the time of diagnosis, surgery might have been ruled out for a variety of reasons. When symptoms manifest in later years, they can range from back and/or leg pain or a dramatic loss in height from the waist upwards as a result of the curvature.  However, despite fears that ignoring the problem will lead to the same kind of progression that is seen in teens, the study’s first author Michael P. Kelly, M.D., associate professor of both orthopedic and neurological surgery at Washington University, said, “We found that, on average, patients are unlikely to rapidly get worse. Those who don’t have severe pain and can easily carry out their daily activities seem to progress slowly and often their symptoms are not severe enough to undergo the risks of surgery.”

If you have been diagnosed with scoliosis and would like more information on the best treatment option for your situation, contact our lumbar spine specialist in New Jersey today to set up an appointment.

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