01 — What it is
Adult deformity is a different problem from an adolescent curve. In adults it is often driven by degeneration, producing a curve, a loss of lumbar lordosis and a trunk that sits forward of the pelvis. The complaint is usually fatigue, difficulty standing for long, and leg symptoms from associated nerve compression. Flatback syndrome, where the normal lumbar curve is lost, is treated within the same practice.
02 — Symptoms
- Fatigue and pain that build the longer you stand
- Leaning forward or to one side
- Uneven shoulders, waist or rib prominence
- Leg pain from associated nerve compression
- Shortness of breath in severe thoracic curves
03 — Causes
- Adolescent idiopathic scoliosis progressing in adulthood
- Degenerative scoliosis developing later in life
- Flatback syndrome, including after prior fusion
- Osteoporotic fracture producing a kyphotic collapse
04 — How it is diagnosed
Full-length standing radiographs of the whole spine are used to measure pelvic parameters, lumbar lordosis and overall balance. MRI and CT assess the neural elements and bone quality. Bone density is checked before longer constructs are planned.
05 — Treatment approach
Correction is planned around restoring overall balance, not around the appearance of the curve on a single view. Where appropriate, less invasive interbody techniques and staged procedures are used. Not every curve requires surgery, and many are monitored.
General information only. Your own diagnosis and plan depend on your examination and imaging. Nothing here replaces a consultation.
