Adult scoliosis: more than a curve in the back
Assessment and treatment of adult degenerative scoliosis in Valencia — pain control, function and quality of life.
Scoliosis is not just “a teenager thing”. In adults, the spine can curve due to asymmetric degeneration of discs and joints (degenerative or “de novo” scoliosis) or due to progression of a juvenile curve. The result: mechanical low back pain, a sense of trunk imbalance and, at times, sciatica from compression of roots on the concave side of the curve.
When does adult scoliosis become a concern?
Progressive pain
Low back pain that increases through the day and with prolonged standing.
Trunk imbalance
A sensation of leaning forward or to one side when walking.
Neurological symptoms
Sciatica or claudication from stenosis associated with the curve.
Documented progression
Increase in the curve angle on successive X-rays.
Diagnosis: measure to decide
The full-spine standing X-ray allows measurement of the Cobb angle and the sagittal balance parameters (the relationship between spine, pelvis and hips). The MRI assesses discs, associated stenosis and roots. Without these objective measurements no serious decision can be made.
Treatment
1. Conservative: the basis in the vast majority. Specific trunk-strengthening exercise, weight control, physiotherapy and rational analgesia. In adults, a brace is used only as a punctual comfort measure, not to correct the curve.
2. Interventional pain treatment. Image-guided facet or foraminal injections when specific pain generators are identified.
3. Surgery: selected cases only. Reserved for progressive curves with significant imbalance, disabling refractory pain or neurological deficit. It can range from focal decompression of a trapped root to instrumented correction of the deformity in severe cases. The current trend is to operate the minimum necessary for the patient’s goal: to relieve pain and maintain function, not to chase cosmetic correction of the curve.
Frequently asked questions
Not always. Degenerative curves may progress slowly; periodic X-ray monitoring determines this.
It does not correct the angle, but it does improve pain, functional posture and quality of life — which is the real goal of treatment in adults.
No. If the problem is a root compressed at a specific point, a focal minimally invasive decompression can resolve the symptom without correcting the whole curve.
Scoliosis with pain or progression?
A specialist assessment determines whether your scoliosis needs only monitoring, pain treatment or surgery. No alarmism and no commercial pressure.