Scoliosis specialists in Denver
The network of board-certified surgeons and specialists within HealthONE Physician Group are committed to providing you with quality, effective care for spinal conditions, including scoliosis. While scoliosis usually develops in the childhood or teenage years, adults may receive a diagnosis of scoliosis without ever having spinal issues as a child.
Our spine specialists treat various types of scoliosis affecting patients of all ages using a range of approaches, including nonsurgical intervention, therapy and minimally invasive surgeries. We work one-on-one with you to create a treatment plan tailored to you needs to minimize the effects of scoliosis and allow you to resume an active lifestyle.
To speak with one of our scoliosis specialists, schedule an appointment today.
What is scoliosis?
Scoliosis is a sideways curvature of the spine that measures more than 10 degrees. Instead of seeming like a straight line, a curved spine appears to look like a “C” or “S” shape. With scoliosis of the spine, some bones in the spine may have rotated slightly, making a person’s waist or shoulders look uneven.
In children and adolescents, scoliosis appears before the onset of puberty and skeletal maturity. Scoliosis in adults occurs after skeletal maturity.
What causes scoliosis?
In the majority of scoliosis cases, a specific cause for the condition cannot be determined. There are common misconceptions about what causes this scoliosis, but the condition is not caused by carrying heavy things (like a backpack), participating in sports or athletic activities, poor sleeping or standing postures, lack of calcium or having one leg that is slightly shorter than the other.
Research suggests that scoliosis in children and adolescents may be caused by genetics, neuromuscular disorders, asymmetric growth or a hormonal or muscular imbalance. In adults, scoliosis usually develops due to degeneration of the spinal discs and/or arthritis of the facet joints.
Types of scoliosis affecting adults
There are two main types of scoliosis in adults: adult idiopathic scoliosis and adult degenerative scoliosis.
Adult idiopathic scoliosis
Adult idiopathic scoliosis is a curved spine for which there is no apparent cause and no evidence of underlying physical or radiographic pathology. If idiopathic scoliosis presents in adulthood it is typically because it went undiagnosed in adolescence or childhood.
Adult degenerative scoliosis
This type of scoliosis is more common in adults. Adult degenerative scoliosis develops as a result of disc degeneration. As a spinal disc degenerates, it loses height and begins to tilt, which can cause the spine to bend and curve. Sometimes it is associated with osteoporosis, a condition that causes bones to weaken due to a loss of bone density.
Signs of degenerative scoliosis in adults
While one of the signs of degenerative scoliosis is low back pain, the pain is not due to the curvature of the spine. Rather, the degeneration of the spine is causing pain in the low back and is also causing the curve to form.
Degenerative scoliosis is usually seen in the lumbar spine (lower back). Signs of degenerative scoliosis include:
- Back pain
- Forward lean
- Loss of height
- Low back pain and stiffness
- Numbness, cramping or shooting pain in the legs
- Shooting pain in the legs
- Spinal curvature
Scoliosis treatment in adults
The goal of scoliosis treatment in adults is the restoration of function and relief of pain. There are many scoliosis treatment options that do not require surgery.
Nonsurgical treatment for degenerative scoliosis
For patients who don’t have disabling symptoms (causing significant pain or reduced overall quality of life), there are multiple, nonsurgical treatment options for adult degenerative scoliosis:
- Routine or periodic observation — monitoring the curve of the spine to see if it is increasing (in degrees) over time
- Over-the-counter pain relievers — used to reduce back, hip or leg pain
- Exercise or physical therapy — aimed at strengthening the core muscles and improving flexibility
- Brace — used for short-term pain relief, not prevention, and will not help to strengthen the spine
- Epidurals or nerve block injections — used to temporarily relieve leg pain or other symptoms
Surgical treatment for degenerative scoliosis
Occasionally, surgery for degenerative scoliosis might be recommended when more conservative (nonsurgical) treatment methods have failed. We might also recommend surgery when the pain caused by degenerative scoliosis is severely disabling for the patient. The goal of surgery for degenerative scoliosis is to restore spinal balance, reduce pain and discomfort by relieving nerve pressure, and maintain corrected alignment by fusing and stabilizing the spinal segments.
Types of surgical procedures for degenerative scoliosis include:
- Decompression — removing the “roof” of the spinal canal and enlarging the spaces where the nerve roots exit the canal, resulting in decompressed nerve roots and pain relief
- Surgical stabilization — a procedure that involves anchoring hooks, wires and screws to stabilize the spine and allow it to fuse in the corrected position
- Fusion — uses the patient’s own bone or cadaver or synthetic bone substitutes to hold the spine in a straighter position
- Osteotomy — a procedure that involves spinal segments being cut and realigned
- Vertebral column resection — removing entire vertebral sections before realigning the spine when other surgical measures cannot correct the scoliosis
Scoliosis care for children, adolescents and teens
While we primarily treat scoliosis in adults, our spine specialists are also experienced in treating scoliosis in children and teenagers. To diagnose scoliosis in younger patients, a doctor will perform a physical observation, use a scoliometer to give a rough estimate to the curvature of the spine, and order X-rays if the physician thinks the patient might have a spinal curve of 10 degrees or more.
The goal of treating scoliosis in children is to stop the curvature of the spine from progressing.
Treating scoliosis in kids and teenagers
Typically, treatment isn’t considered necessary until the curvature reaches 25 degrees or more. There are three main approaches we take when it comes to scoliosis treatment in younger patients:
- Active observation — Used for children and teenagers with a curved spine of less than 25 to 30 degrees who are still growing, or those with curves less than 45 degrees who have stopped growing
- Bracing — Used to halt or slow the progression of the curve, with the optimal goal being to have the patient avoid spinal fusion surgery
- Surgery — Usually recommended for patients with a curved spine greater than 45 degrees while still growing (puberty), or curves continuing to progress greater than 45 degrees after growing stopped (maturation)