Scheuermann's Kyphosis
	Adult Scoliosis

Degenerative scoliosis is a slow process that occurs in older patients, generally in their sixties and beyond. As a result of age, wear and tear, and the development of arthritis in the spine, some patients may develop a condition where their spines become unstable and curve out of position. This is known as degenerative scoliosis, and is usually the result of several factors. First, there is often a gradual loss of calcium in the spine, which causes osteoporosis. Osteoporosis makes the bones of the spine weak, and if they crumple under the weight of the body (a type of fracture that is called a "compression fracture"), they can cause abnormal curvatures in the spine. Also, as patients get older, their back muscles get weaker, their discs start to collapse, and the ligaments that support their spine do not function as well as they once did.

This process most commonly occurs in patients who previously had a straight spine, and while the pain and disability that this process causes can be quite severe, the size of the curve is usually limited to the 15 to 40 degree range. Degenerative scoliosis is most commonly found in the lumbar spine, because this part of the spine suffers the most wear and tear.

Like many age-related conditions, degenerative scoliosis is thought to be at least partly preventable. A regular exercise program, a proper diet, supplementary calcium and vitamin D, and regular checks of bone mineral density are all helpful in avoiding degenerative scoliosis. Weight bearing exercise programs may be particularly helpful in avoiding early osteoporosis, but you should consult with your doctor before starting this type of an exercise regime.

Degenerative scoliosis is often accompanied by spinal stenosis, or narrowing of the spinal canal, which pinches the spinal nerves and makes it difficult for them to function normally. Spinal stenosis can cause many symptoms, including numbness, weakness, and tingling in the legs. It can also interfere with normal bowel and bladder function. One of the common symptoms of spinal stenosis is called spinal claudication, in which the nerve entrapment makes the legs feel weak and unable to support the weight of the body. Over time, patients will be forced to walk shorter and shorter distances, and they will have to rest more and more frequently. Leaning forward usually increases the amount of space available for the nerves as they exit the spinal canal, and as a result, many patients are able to walk farther if they are able to lean on something while the walk - like a shopping cart.

The treatment of degenerative scoliosis is complicated and needs to be individualized for every patient. Often, it requires the advice of many doctors, and may require medications, physical therapy, and bracing in order to control the pain. Many adults with degenerative scoliosis can be treated with physical therapy programs to rebuild muscle strength and flexibility, non-steroidal anti-inflammatory medications, bracing and osteoporosis prevention regiments to stem future bone loss. Surgery is reserved for those patients who do not improve with these treatments or have evidence of ongoing damage to the nerves to their legs, bowel, or bladder.

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