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Adult scoliosis can result from idiopathic adolescent scoliosis that has progressed slowly over decades. Alternatively, it may develop in patients who did not previously have scoliosis. Most adult scoliosis can be managed with weightloss, smoking cessation, exercise, and nutritional supplementation under the direction of a physician. Curves that exceed 50 degrees or more may be treated with surgery, especially if the curve is becoming worse over time.
As a general rule, adult scoliosis curves are quite stiff as compared to adolescent curves. Therefore full correction is difficult to achieve and may not be necessary; a well-balanced curve is the goal. When surgery is required, often anterior and posterior release, fusion, and instrumentation is required. This combined anterior and posterior surgery is usually performed on the same day. The following case study shows a progressive adult scoliosis. The first stage consisted of anterior thoracotomy and spinal fusion, followed by posterior fusion and instrumentation. |
