Adult Scoliosis: Etiology and Management

Abstract

Adult scoliosis is a curvature in the spine that becomes symptomatic or develops during adulthood. As opposed to idiopathic adolescent scoliosis, adult scoliosis is frequently associated with back pain in addition to neurologic claudication or radiculopathy from stenosis. Patients may also have significant functional limitation from sagittal or coronal imbalance. Nonsurgical treatment should be the first approach in managing these patients, and may include physical therapy, activity modification, and epidural steroid injections. Surgery is indicated for patients who are refractory to nonsurgical management and/or have severe debilitation. Complications of surgical intervention include neurologic deficit, significant loss of correction, deep infection, medical complications, and even death. Newer techniques in fixation, approach, anesthesia, improved perioperative care, and use of neuromonitoring have decreased these overall risks.

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