Degenerative Scoliosis

As we age, our spine wears out – much like the rest of us. Our discs slowly dry out and lose height. In some individuals, the spine begins to rotate as it collapses thus causing an abnormal curvature. This curvature can become large enough that the spine becomes unstable. Instability can then lead to pain in the legs and back.

Scoliosis can usually be diagnosed by examination of the spine as the curvature is often readily apparent. Xrays are done to confirm the diagnosis and to detemine the size of the curve.

Pain in the buttocks, thighs and/or legs can be an indication of nerve compression in the spine from the scoliosis. Often these symptoms are more pronounced when standing or walking. For these symptoms, MRI or CT myelogram are often done to evaluate the problem further.

Treatment

Treatment of adult degenerative scoliosis can be complex. On one hand, correction of the curve helps with pain in the buttocks and legs caused by narrowing around nerves and sometimes decreases mechanical back pain. On the other hand, since treatment of scoliosis generally requires a fusion procedure, the back is stiff and sore after the procedure. This stiffness and soreness is permanent. So in effect, one pain is traded for another. Often, activity modification is necessary as even simple tasks can be more difficult given the decreased motion.

The deciding factor in whether or not to go ahead with such a large surgery is generally not pain, but function. If you have pain but are still highly functional, meaning that you can still perform most of your daily activities, then surgery is probably not the best option. However, if your function is so limited that even simple daily tasks are impossible, surgery can restore some quality of life. 

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