Adult Spinal Deformity - Symptoms, Causes & Treatment

Understanding Adult Spinal Deformity

Adult spinal deformity is a condition where the natural curvature of the spine is altered, leading to various physical challenges, including chronic back pain, difficulty walking, and impaired mobility. This condition often results from age-related changes in the spine, trauma, or congenital issues that worsen over time. While spinal deformities are more commonly associated with adolescents, adult spinal deformity is increasingly diagnosed in older populations, particularly as people live longer and stay more active. In this article, we’ll explore what adult spinal deformity is, its causes, symptoms, treatment options, and the potential complications of surgery.

What is Adult Spinal Deformity?

Adult spinal deformity refers to any abnormal curvature of the spine that develops in adulthood. The spine naturally curves at the neck (cervical), upper back (thoracic), and lower back (lumbar). However, when these curves become exaggerated or misshapen, it can lead to significant discomfort and mobility issues. The three most common types of spinal deformities include:

• Scoliosis: A sideways curvature of the spine.
• Kyphosis: An exaggerated forward rounding of the upper back, sometimes resulting in a "hunchback" appearance.
• Lordosis: An excessive inward curvature of the lower back.

Unlike adolescent spinal deformities, which often develop due to growth-related issues, adult spinal deformities typically occur due to age-related degeneration or as a result of previous injuries or surgeries. These changes can cause the spine to become misaligned, leading to pain and other symptoms.

Causes of Adult Spinal Deformity

Several factors can contribute to the development of adult spinal deformity, including:

• Degenerative changes: As we age, the discs between the vertebrae lose hydration and flexibility, which can cause the spine to shift out of alignment. This degeneration is a common cause of adult scoliosis and kyphosis.
• Previous spinal surgery: Some patients develop spinal deformities after undergoing surgeries such as laminectomies. These procedures may alter the structure of the spine, leading to long-term misalignment.
• Trauma: Injuries from falls, accidents, or sports can damage the vertebrae or spinal discs, leading to spinal deformity over time.
• Congenital conditions: Some adults are born with spinal abnormalities that progressively worsen with age, leading to significant curvature changes.

Risk factors include aging, a history of spinal injuries, and conditions such as osteoporosis, which can weaken the bones and lead to deformities.

Symptoms of Adult Spinal Deformity

The symptoms of adult spinal deformity can vary depending on the severity of the condition. Common symptoms include:

• Chronic back pain: Many individuals experience persistent pain in the back or neck, which may worsen with movement or prolonged standing.
• Posture changes: Visible changes in posture, such as a hunched back or a sideways lean, are common. These changes can affect balance and mobility.
• Loss of height: As the spine curves, it can lead to a noticeable loss of height.
• Nerve pain: In severe cases, the spinal deformity can compress nerves, leading to pain, tingling, or numbness in the legs or arms.
• Difficulty walking: Some individuals experience difficulty standing or walking for extended periods due to pain and balance issues.

These symptoms often worsen over time, making early diagnosis and treatment critical for managing the condition and preventing long-term complications.

Diagnosing Adult Spinal Deformity

A proper diagnosis of adult spinal deformity begins with a thorough physical exam. A healthcare provider will assess your posture, range of motion, and any symptoms of nerve compression. To confirm the diagnosis and determine the severity of the deformity, imaging tests are typically used, including:

• X-rays: These provide clear images of the spine’s structure, allowing doctors to measure the degree of curvature and assess any misalignment.
• MRI or CT scans: These are useful for evaluating soft tissue damage, such as herniated discs or nerve compression.
• Schwab adult spinal deformity classification: This system is often used to classify the severity of the deformity and guide treatment decisions based on the curvature and symptoms.

Accurate diagnosis is essential for creating a personalized treatment plan that addresses the patient’s specific condition and needs.

Treatment Options for Adult Spinal Deformity

The treatment options for adult spinal deformity depend on the severity of the deformity and the symptoms. For some patients, non-surgical treatments can effectively manage symptoms, while others may require surgery to correct the curvature and relieve nerve compression.

Non-Surgical Treatments

In mild to moderate cases, non-surgical treatments can help alleviate symptoms and improve quality of life. These include:

• Pain management: Medications such as NSAIDs (nonsteroidal anti-inflammatory drugs) can help reduce inflammation and alleviate pain. In some cases, corticosteroid injections may be used to target specific areas of discomfort.
• Physical therapy: Exercises designed to strengthen the muscles supporting the spine and improve posture can be highly beneficial. A physical therapist can guide patients through movements that reduce strain on the spine and increase mobility.
• Bracing: For some patients, a brace can provide additional support and slow the progression of the spinal deformity.
• Lifestyle modifications: Maintaining a healthy weight, avoiding heavy lifting, and incorporating ergonomic practices at home and work can help reduce symptoms and prevent further damage.

Surgical Treatments

In severe cases where non-surgical treatments are ineffective or if the deformity significantly impacts mobility, surgery may be necessary. Common surgical options include:

• Spinal fusion: This is the most common surgery for adult spinal deformity. It involves fusing two or more vertebrae together to stabilize the spine and prevent further curvature.
• Osteotomy: In this procedure, a portion of the vertebra is removed to realign the spine.
• Correction surgery: This surgery is performed to correct the curvature of the spine, often involving metal rods, screws, or plates to hold the spine in proper alignment.

Preoperative optimization is critical for successful surgery. This includes preparing the patient physically through strengthening exercises and optimizing nutrition to promote healing and reduce the risk of complications.

Complications in Adult Spinal Deformity Surgery

While surgery can be highly effective, it’s important to be aware of the potential complications in adult spinal deformity surgery. These include:

• Infection: As with any surgery, there is a risk of infection at the surgical site.
• Hardware failure: In some cases, the metal rods or screws used in the surgery may fail, requiring additional procedures.
• Nerve damage: There is a risk of nerve damage during surgery, which can lead to lasting neurological symptoms.
• Revision surgery: Some patients may require additional surgeries to correct issues or address complications that arise after the initial surgery.

Despite these risks, many patients experience significant improvements in pain, posture, and mobility following surgery, especially when postoperative care and rehabilitation are followed closely.

Recovery and Long-Term Management

Recovery after adult spinal deformity surgery can take several months, during which physical therapy is essential. A rehabilitation program will help strengthen the muscles around the spine, improve mobility, and restore function. Patients should follow their doctor’s postoperative guidelines to ensure proper healing and minimize complications.

Long-term management of adult spinal deformity focuses on maintaining spinal health, continuing physical therapy, and making lifestyle changes that promote good posture and reduce strain on the spine. Many patients experience a marked improvement in their quality of life following surgery.

Conclusion

Adult spinal deformity is a complex condition that can significantly impact a person’s quality of life. Understanding the causes, symptoms, and treatment options is essential for effective management. For many individuals, non-surgical treatments such as physical therapy and pain management can provide relief, while surgery may be necessary for more severe cases. Early diagnosis and treatment are key to preventing long-term complications and improving outcomes.

If you are experiencing symptoms of adult spinal deformity, it’s important to seek medical advice to explore your treatment options and develop a personalized care plan that addresses your unique needs. 

Frequently Asked Questions (FAQs): Adult Spinal Deformity

What is Adult Spinal Deformity?

Adult spinal deformity refers to abnormal curvature of the spine that develops during adulthood. This condition often leads to chronic pain, mobility issues, and changes in posture.

What causes Adult Spinal Deformity?

Common causes include age-related degeneration, previous spinal surgeries, trauma, and congenital conditions. Risk factors are aging, osteoporosis, and a history of spinal injuries.

What are the symptoms of Adult Spinal Deformity?

Symptoms include chronic back pain, noticeable posture changes, height loss, nerve pain, and difficulty walking or standing for long periods.

How is Adult Spinal Deformity diagnosed?

Diagnosis typically involves a physical exam and imaging tests, such as X-rays, MRI, or CT scans, to assess the spine’s curvature and any nerve compression.

What treatment options are available for Adult Spinal Deformity?

Options range from non-surgical treatments, such as physical therapy and bracing, to surgical procedures like spinal fusion and correction surgery, depending on severity.

What non-surgical treatments are available?

Non-surgical treatments include pain management, physical therapy, bracing, and lifestyle modifications to reduce strain on the spine.

When is surgery recommended for Adult Spinal Deformity?

Surgery is often recommended when non-surgical options are ineffective or when deformity significantly impacts mobility or quality of life.

What are the risks of surgery for Adult Spinal Deformity?

Potential complications include infection, hardware failure, nerve damage, and the need for revision surgeries.

What is the recovery process like after spinal deformity surgery?

Recovery can take several months and typically involves physical therapy to strengthen muscles and improve mobility. Patients should follow postoperative guidelines closely for optimal healing.

How can Adult Spinal Deformity be managed long-term?

Long-term management includes physical therapy, lifestyle changes for better posture, and periodic medical assessments to maintain spinal health and prevent further complications.

Where can I find more information or seek treatment?

If you are experiencing symptoms, consult a healthcare professional for a personalized care plan. Early diagnosis and treatment can greatly improve quality of life.