Degenerative scoliosis is a condition characterised by an abnormal curvature of the spine that develops gradually over time due to degenerative changes in the spinal discs and joints. While scoliosis is often associated with adolescents, degenerative scoliosis primarily affects older adults and is commonly seen in individuals over the age of 50. 

At LBO we have two exceptional spinal surgeons who both specialise in complex spinal deformity.

This blog aims to provide a comprehensive overview of degenerative scoliosis, including spinal anatomy, causes of the condition, symptoms, diagnosis, and management options.

Anatomy of the Spine:

To understand degenerative scoliosis, it is essential to first grasp the anatomy of the spine. The spine, also known as the vertebral column, is composed of 33 vertebrae stacked on top of one another, divided into five regions: cervical, thoracic, lumbar, sacral, and coccygeal. The natural curvature of the spine includes lordosis in the cervical and lumbar regions and kyphosis in the thoracic and sacral regions. Scoliosis refers to an abnormal lateral curvature of the spine, causing it to bend sideways in a C or S-shaped curve.

Causes of Degenerative Scoliosis:

The exact cause of degenerative scoliosis is multifactorial and often involves a combination of genetic predisposition, ageing, and environmental factors. 

Degenerative scoliosis typically develops as a result of age-related changes in the spine, including degeneration of the intervertebral discs, facet joints, and spinal ligaments. 

As the intervertebral discs age, they lose height, the bony vertebrae may begin to shift out of alignment, leading to curvature of the spine. Additionally, factors such as poor posture, repetitive movements, heavy lifting, and a sedentary lifestyle can exacerbate spinal degeneration and contribute to the progression of degenerative scoliosis.

Symptoms of Degenerative Scoliosis:

The symptoms of degenerative scoliosis can vary depending on the severity and location of the spinal curvature. 

Common symptoms of Degenerative Scoliosis may include:

1. Back pain, particularly in the lower back or lumbar region.
2. Muscle stiffness and fatigue, especially after prolonged periods of standing or walking.
3. Numbness, tingling, or weakness in the legs, indicating nerve compression or spinal stenosis.
4. Changes in posture, such as uneven shoulders or hips, and visible curvature of the spine.
5. Difficulty performing daily activities, such as bending, twisting, or lifting objects.
6. Radiating pain that travels down the legs, known as sciatica, due to compression of the spinal nerves.

Diagnosis of Degenerative Scoliosis:

Diagnosing degenerative scoliosis typically involves a thorough medical history, physical examination, and imaging studies to assess the curvature of the spine and identify any underlying degenerative changes. Imaging modalities such as X-rays, magnetic resonance imaging (MRI), or computed tomography (CT) scans may be ordered to visualise the extent of spinal curvature, assess the condition of the intervertebral discs, and evaluate for spinal stenosis or nerve compression.

Nonsurgical Management of Degenerative Scoliosis:

For individuals with mild to moderate degenerative scoliosis, nonsurgical management strategies may be effective in relieving symptoms and improving spinal function. 

Nonsurgical Management may include:

1. Physiotherapy: Performing targeted exercises and stretches to improve spinal mobility, strengthen the supporting muscles, and alleviate pain.
2. Pain management: Using nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or epidural steroid injections to reduce pain and inflammation in the affected area.
3. Activity modification: Avoiding activities that exacerbate symptoms and practising proper posture and body mechanics to minimise stress on the spine.
4. Bracing: Wearing a back brace or support garment to provide stability and support to the spine, particularly during activities that require prolonged standing or walking.

Surgical Management of Degenerative Scoliosis:

In cases where conservative treatments fail to provide relief or the curvature of the spine is severe and progressive, surgical intervention may be recommended to correct the deformity and stabilise the spine. 

Surgical options for degenerative scoliosis may include:

1. Decompression surgery: Removing the bone spurs, herniated discs, or other structures compressing the spinal nerves to alleviate pain and improve nerve function.
2. Spinal fusion: Joining two or more vertebrae together using bone grafts, screws, rods, or plates to stabilise the spine and prevent further curvature.
3. Osteotomy: Removing a wedge-shaped portion of bone to realign the spine and correct the curvature.
4. Artificial disc replacement: Removing the damaged intervertebral disc and replacing it with an artificial implant to maintain spinal mobility and reduce pain.

Conclusion:

Degenerative scoliosis is a common condition that can significantly impact the quality of life for older adults.

Our spinal team at LBO is highly experienced in treating this condition. 

Both Mr Pavlos Panteliadis and Bahram Fakouri work at the prestigious Guys and St Thomas’s NHS trust where they see some of the country’s most interesting and complex cases.

You can book an appointment with either of them by calling our booking team or filling out an online appointment request today

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