Care at CNSO – Adult (Degenerative) Scoliosis

S

coliosis occurs when the spine abnormally curves to one side. Most commonly, scoliosis occurs in either the thoracic and/or lumbar spines. In general, scoliosis tends to occur in children around the age of puberty, known as idiopathic scoliosis or in patients older than 60 as a result arthritic, degenerative changes. Adolescent scoliosis tends to develop between the ages of 11–18 years and accounts for approximately 90 % of cases of idiopathic scoliosis in children. It is the most common spinal deformity in school aged children and the number of cases in children within the United States, exceeds 4 million.

“Scoliosis has a prevalence of more than 8 % in adults over the age of 25 and rises up 68 % in the age of over 60 years, caused by degenerative changes in the aging spine.” (J Child Orthop. 2013 Feb; 7(1): 3–9. Published online 2012 Dec 11. doi: 10.1007/s11832-012-0457-4) Females are more often by affected by scoliosis as opposed to males. Curvature can vary in degrees and scoliosis can be mild or severe. Scoliosis can be treated with a variety of techniques, from physical therapy to bracing or surgery, in severe cases.

Pain and disfigurement are the two most common symptoms of scoliosis. Studies have shown that the incidence of low back pain is almost twice as high in people living with scoliosis as those without. Physical therapy is an important step in helping to reduce pain and minimize deformity even if bracing and/or surgery are the primary treatment.

Bracing remains a standard in the treatment of care for idiopathic scoliosis in children. Bracing is typically initiated when the curvature of the spine measures 20 degrees or greater. Research indicates that scoliosis may rapidly worsen during adolescence, especially if the curve is greater than 25 degrees. Although results of bracing are highly variable and dependent on compliance, brace quality and length of time worn, bracing has been shown to decrease the progression of scoliosis. Typically, the brace is worn for 23 hours per day, and only taken off for bathing or self-care purposes. The length of time a brace is worn depends on the compliance and progress observed during bracing treatment. Your child will be monitored with routine x-rays during treatment to determine this.

Bracing is not indicated in adult degenerative scoliosis.

In severe cases, which compromise pulmonary or cardiac function, or in progressive cases that have failed bracing and are associated with symptoms, surgery many be indicated. Deformity correction surgery usually involves several levels of fusion with-in the spine. This allows for rods and screw to be placed and provides a mechanical stability that can be manipulated to straighten out the spine. This type of surgery typically involves multiple levels of fusion in the spine and can offer significant relief of symptoms or organ compromise. However, physical therapy to retrain the muscles and ligaments around the spine following this type of surgery is extremely important; and often times, correlates to the overall success rate of the surgery itself.

Treatment at the Centers for Neurosurgery, Spine, and Orthopedics

At Centers for Neurosurgery, Spine, and Orthopedics, the surgeons conservatively advise on when surgery for scoliosis is necessary versus when it is not. If a patient were to meet the criteria for a surgical intervention, the best surgeons for scoliosis surgery are at CNSO. They each have over 10 years of experience and have been recognized as the best doctors for spine surgery as per the “Top Doc” Award since 2013. CNSO offers comprehensive care from physical therapy for the spine to pain management experts who can offer nerve injections in order to reduce or eliminate pain. All are in communication regularly with the surgeons whether before or after any surgery that might be necessary. Each of the CNSO six locations offers Pain Management doctors and surgeons. Physical therapy is offered at our Jersey City, Wayne, and Paramus location. The other locations, Morristown, Glen Ridge, and Landing, can recommend physical therapy centers with selected physical therapy experts nearby the CNSO patient’s home.

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