Adult Spinal Deformity
Adult spinal deformity (ASD) refers to abnormal curvature or malalignment of the spine that develops or persists into adulthood. It can result from a variety of underlying conditions and may significantly impact a person’s posture, mobility, and quality of life. The deformity often involves one or more regions of the spine—cervical (neck), thoracic (upper back), lumbar (lower back), or a combination of these.
Types of Adult Spinal Deformity
Scoliosis
Definition: A lateral (side-to-side) curvature of the spine, often resulting in an “S” or “C” shape.
Causes: Can be idiopathic (unknown cause), degenerative (due to wear and tear), or secondary to another condition (e.g., neuromuscular disorders).
Kyphosis
Definition: An excessive forward curvature of the spine, leading to a hunched or rounded back.
Causes: Can result from osteoporosis (compression fractures), Scheuermann’s disease (a condition that causes abnormal growth of the vertebrae), or degenerative changes.
Lordosis
Definition: An exaggerated inward curve of the lower back.
Causes: Can be caused by conditions like spondylolisthesis (slipping of a vertebra) or muscular imbalances.
Flatback Syndrome
Definition: A condition where the normal curvature of the lower spine is lost, resulting in a straightened spine and difficulty standing upright.
Causes: Often associated with previous spinal surgery, degenerative changes, or poor posture.
Spondylolisthesis
Definition: A condition where one vertebra slips forward over the one below it, potentially leading to spinal malalignment.
Causes: Can be congenital, due to degeneration, or from trauma.
Causes of Adult Spinal Deformity
Degenerative Changes
As people age, the discs between the vertebrae and the facet joints can wear out, leading to spinal instability and deformity.
Previous Spinal Conditions or Surgery
Conditions such as adolescent scoliosis that were either untreated or inadequately treated can progress into adulthood.
Additionally, previous spinal surgeries (such as spinal fusion or laminectomy) can sometimes lead to deformities over time, such as flatback syndrome.
Osteoporosis
A condition where bones become weak and brittle, leading to fractures and potential spinal deformities, particularly kyphosis.
Trauma
Injuries to the spine can cause fractures, dislocations, or other changes that lead to deformity.
Neuromuscular Conditions
Disorders affecting the nerves and muscles, such as muscular dystrophy or cerebral palsy, can lead to imbalances in the spine, resulting in deformity.
Inflammatory Conditions
Conditions such as Ankylosing Spondylitis or Rheumatoid Arthritis may result in progressive deformity and or spontaneous fusion of the spine.
Symptoms of Adult Spinal Deformity
Pain: Chronic back pain is common and may be localized or radiate into the legs (sciatica) if nerves are compressed.
Postural Changes: Visible deformities like a hunched back, a swayback, or an uneven waist or shoulders.
Difficulty Walking or Standing: Due to imbalance and misalignment, patients may find it hard to stand upright or walk for extended periods. These limitations may be due to pain or exhaustion.
Neurological Symptoms: Numbness, weakness, or tingling in the limbs if the spinal cord or nerve roots are compressed.
Decreased Lung Function: In severe cases of thoracic spine deformity, this can affect lung capacity and breathing.
Impact on Quality of Life: Adult spinal deformity can significantly impact daily activities, causing pain, physical limitations, and emotional distress. The severity of the impact depends on the extent of the deformity, associated symptoms, and the underlying cause.
Treatment Options
Non-surgical: Physical therapy, pain management (medications, injections), bracing, and lifestyle modifications (e.g., weight management, exercise).
Surgical: In cases where conservative treatments fail, surgery may be considered to correct the deformity, stabilize the spine, and relieve nerve compression.
Adult spinal deformity requires a comprehensive approach to diagnosis and treatment, often involving a multidisciplinary team of specialists. Early intervention and ongoing management are crucial to minimizing symptoms and improving function. To learn more about surgical treatment of Adult Spinal Deformity, explore the links below.
