Adult spinal deformity is a common medical issue in the United States. Specialists find themselves increasingly facing large numbers of older patients with spinal problems. As Current Reviews in Musculoskeletal Medicine stated, “Spinal deformity is becoming more common as adults 55–64 years of age are the fastest growing proportion of the U.S. population. As the percentage of elderly in the United States accelerates, more patients are expected to present with painful spinal conditions, potentially requiring spinal surgery.”
Fortunately, not all deformities are equally severe or have as severe symptoms. The following sections detail the types of spinal deformities, their treatments and risks, general recovery outcomes, and whether or not procedures can correct common deformities.
Types of Spinal Deformities
The most prevalent type of adult spinal deformity is degenerative scoliosis. According to U.S. News & World Report, “It’s estimated that 40 to 60% of adults will develop degenerative scoliosis by age 65.” Degenerative scoliosis is caused by a form of osteoarthritis of the spine. This condition occurs when degenerating discs cause the spine to shift to the side, leading to an unnatural curvature that may cause spinal asymmetry, chronic pain, and damage to organs such as the heart and lungs.
Other deformities that alter the normal curvature of the spine include:
- Iatrogenic deformity (aka iatrogenic flatback): The Lancet states that spinal deformities occurring after surgical procedures are another typical cause of adult spinal deformity.
- Injury-related deformities: Various kinds of injury can prompt spinal disc displacement and an eventual adult spinal deformity diagnosis.
- Kyphosis: An exaggerated rounding of the spine that curves the body forward; it is usually caused by spinal nerve compression or lumbar fracturing, but sometimes it can be a manifestation of less common conditions such as ankylosing spondylitis or Scheuermann’s disease.
- Spondylolisthesis: A condition affecting the lower vertebrae where one bone slips forward on the bone beneath it.
Considerations and Risks for Treatment
Patients have a large number of adult spinal deformity treatments available, many of which do not involve surgical intervention. Current Reviews in Musculoskeletal Medicine noted, “Nonoperative treatment for adult spinal deformity includes a physical conditioning program, spinal manipulation, pharmacologic agents for symptoms management, the use of orthotics or braces, and more invasive modalities including epidural steroid injections and joint injections.”
However, some conditions are serious enough that physicians will recommend adult spinal deformity surgery. When dealing with kyphosis of 70 degrees or more and scoliosis of 45 degrees or more, doctors suggest surgery due to the typically severe complications experienced by patients. All procedures have the same goals, which include:
- A reduction in or elimination of chronic pain
- Improvement in posture
- Removal of pressure on the heart, lungs, and other internal organs
- Halting progressive deformity
Like all surgeries, adult spinal deformity treatments carry certain risks. Common surgical complications involve:
- Reactions to anesthesia
- Deep venous thrombosis or Pulmonary embolism
- Excessive blood loss
- Pseudoarthrosis (failure of fusion to occur)
- Fracturing of internal surgical hardware
- Nerve damage
The vast majority of these complications are rare. If you’re concerned about surgical complications, make sure to discuss them with a doctor at The Spine Center.
Recovery and Treatment Outcomes
There are almost as many treatment options as there are specific surgical cases, and procedures may involve the implantation of special cages, rods, plates, and screws. Sometimes a surgeon may remove a section of bone from the arch of the spine (an osteotomy) or remove an entire vertebra (a vertebral column resection). A doctor can also affix the lower spine to the pelvis in order to stabilize it (spinopelvic fixation).
Such procedures are always considered major surgery and require a longer convalescence than minimally invasive treatments. You will need to undergo general anesthesia and have a hospital stay of several days. Full recovery can take anywhere from three to six months. However, recovery periods can vary depending on a patient’s particular circumstances.
After adult spinal deformity recovery, what kind of outcomes can patients expect? Research indicates that they can look forward to mostly good ones. An article in Spine entitled “Adult spinal deformity surgery: complications and outcomes in patients over age 60” concluded that “final patient reported outcomes … showed significant improvement.” What’s more, the presence of comorbidities (i.e., multiple chronic diseases) didn’t affect those outcomes, although surgeries performed later in life had more complications.
When considering treatment outcomes, patients should remember that many adult spinal deformities are caused by natural aging processes. This means that you may need to undergo further surgeries in the future even if your initial procedure was successful.
Can Adult Deformities Like Scoliosis be Corrected?
The question as to whether or not surgical interventions can correct adult spinal deformities is a complicated one. In some instances, physicians can only hope to stabilize or slow degenerative deformities. In others, surgeons can make significant corrections, radically reshaping the day-to-day lives of their patients.
If you’re dealing with adult spinal deformity and would like to learn more about your treatment options, contact The Spine Center at (847) 628-8147.