Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine
adult scoliosis is a pathology characterized by an abnormal curvature of the spine. The mild forms cause only simple discomfort, but in more critical situations it is likely to cause more or less intense pain. It can also affect internal organs. This deformation affects 6% of people aged 40, 10% of people aged 65 and 50% of people over 90. Discover in this article all about the adult scoliosis.
Scoliosis, what is it?
Scoliosis means a three-dimensional deformity of the spine or spine. The deviation can be forward or backward; right or left; or in rotation.
La adult scoliosis is similar to that of the child. The only difference is that adult scoliosis is usually symptomatic, which is not necessarily always the case in .
To know everything about the scoliosis in children (including support), see the following article.
The causes of scoliosis
La deformation of the spine can have different origins. There are also two types.
La idiopathic scoliosis is secondary to the development of adolescent scoliosis. Sometimes scoliosis appears in childhood and does not stabilize by late adolescence. Thus, she continued to progress into adulthood.
“De novo” or “degenerative” scoliosis
La degenerative scoliosis occurs around the age of 45 to 50 years. It is generally of mechanical origin. With age, the vertebrae are weakening. At the same time, the intervertebral discs that connect the vertebrae together wear out and the muscles and ligaments become distended.
To these causes can be added other neurological problems that are likely to modify the perception of space. Certain pathologies such as osteoarthritis of the joints, osteoporosis (in post-menopausal women) can cause spinal fractures. Such factors combine to cause the subject to lean forward in order to maintain balance when standing or walking.
However, this gesture leads to a deformation of the spine. Indeed, when we are standing or walking, the constitution of our skeleton allows us to be in balance without making any effort, with the spine well balanced as well. When the spine loses its solidarity and flexibility, we tend to lean forward. Over time, the muscles get tired, the vertebrae move little by little and scoliosis can then set in.
What are the main symptoms of scoliosis in adults?
Scoliosis may be asymptomatic for a long time. But, it happens that it is symptomatic in some individuals. It is generally manifested by a deformation of the upper back, which is called humpback. There are also other characteristic signs of this spinal deformity.
About 40% of people with scoliosis have spinal pain. This pain predominates at the lumbar level, but can also occur in the dorsal and cervical (neck) area. It begins with chronic pain and can become very severe if neglected. With increasing pain, the severity of the deformity also increases (in front and in profile).
Sciatica or cruralgia
In a more advanced form of scoliosis, it is common to find a sciatica. It is a neurological pain that is expressed as a burning from the back to the back or the side of the leg and goes to the foot.
To learn more about sciatica and its treatment, see the following article.
La cruralgia manifests with the same type of pain, but it is located in the front (inguinal hollow and anterior aspect of the thigh). The pain is related to the compression of one or more nerves at the level of the Lumbar spine.
To know everything about cruralgia and its treatment, see the following article.
Neurogenic claudication (or intermittent claudication) is none other than fatigue when walking. It occurs after a specified distance or time. We talk about walking distance (5, 10 minutes or 500 meters, etc.).
When walking, some patients report having a feeling of “walking on eggshells”. In fact, the legs lose their strength and can no longer support the body. Sometimes the subject is forced to sit up or lean forward so that he can recover before continuing his journey.
La lameness results from narrowing of the spinal canal (also called Spinal canal) where the nerve roots that innervate the legs and the perineum circulate. It can come from a condition named narrow lumbar canal.
In more severe cases, vesico-sphincter disorders may be added. These result in frequent urinary leakage, fecal incontinence and insensitivity of the perineum (reduced feeling of touch on the buttocks and genitals).
A sagittal imbalance
As you age, the lumbar lordosis (curvature of the lower back inwards) decreases and the thoracic kyphosis (exaggeration of the dorsal curvature over the thoracic area) increases. As a result, the patient finds himself “hunched over”. This is called decompensated sagittal imbalance. In more critical cases, the patient walks with the knees bent to maintain an upright posture.
Respiratory failure is a form of complication of idiopathic scoliosis adulthood. It occurs when the thoracic curvature is beyond 100°. We are talking about Cobb's angle and it only occurs in adults.
Apart from these symptoms, be aware that adult scoliosis can lead to many disorders such as asymmetry of the trunk, loss of autonomy and strength, muscle sensitivity as well as digestive problems.
Possible treatments for adult scoliosis
The treatment of scoliosis is based on symptomatic treatment. It can be either simple monitoring and orthopedic treatment, if the curvature of the spine is not significant.
In addition, if the curvature is more substantial, surgery may be possible.
In the context of scoliosis, conservative treatment always has its place. It corresponds to medical treatment, rehabilitation (physiotherapy) and conservative orthopedics (wearing a corset). It is suitable for adults as well as teenagers.
Wearing a corset
The corset is a medical device that helps to support the spine to reduce the risk of curvature related to scoliosis. The choice of the type of corset depends on the importance of the deformation of the spine.
Made to measure by molding the body, this device adapts perfectly to the morphology of the patient.
In adults, the brace eases scoliosis pain, restores the balance of the spine and limits the evolution of the pathology.
To know the different types of braces used in the treatment of scoliosis, see the following article.
The exercises offered in physiotherapy improve muscle tone, flexibility and strength. They also act on the deformation of the spine and help to better control pain and improve posture.
The surgical operation
La adult scoliosis surgery is indicated when the discomfort felt with the symptoms becomes disabling and affects the patient's activities of daily living.
Intervention is also advised when conservative treatments fail or when the disease is more serious. In this type of surgery, the work stoppage can last up to a year or more.
Before proceeding with thescoliosis surgery, the patient must carry out a series of examinations in order to be able to make an exhaustive assessment of the disease and to secure the conditions for carrying out the operation.
The surgery first consists of aligning the vertebrae from the front and restoring the profile of the spine.
It then intervenes in the fusion of the vertebrae between them. This is carried out by a bone graft making it possible to weld the vertebrae on a certain number of floors. The replacement of intervertebral discs is necessary sometimes (disc prosthesis).
Is scoliosis an occupational disease and a disability?
A occupational disease is the consequence of more or less prolonged exposure to a risk during a usual and professional activity.
Nowadays, only sciatica and radiculalgia by herniated disc appear in the table of occupational diseases of the general scheme (RG) or the agricultural scheme (RA) of the Social Security. So no, the scoliosis is not an occupational disease.
In addition, the crippling disease is a set of health disorders that affect vital internal organs (respiratory failure, heart or kidney failure, joint disorders, etc.). According to this description, as scoliosis is a joint pathology, it can thus be considered as a disabling disease. It is estimated that 10% of people with scoliosis all suffer from disability.
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