What is the natural course of scoliosis?
Adult scoliosis will tend to evolve from menopause. Not all patients with idiopathic scoliosis show any progression, but close follow-up from this period is recommended.
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What other complementary examinations are possible?
An EMG (electromyogram)
It can be prescribed in case of severe clinical damage to a nerve root. This examination evaluates the vitality of the suffering root and makes it possible to diagnose the level of the attack. From a certain age, several pathologies can co-exist and cause nerve damage (diabetes, polyneunopathy, etc.) EMG is not systematic but can be performed if the doctor doubts the origin of the damage , the irreversible nature of it,…
This examination is carried out by a neurologist.
Functional respiratory explorations (EFR)
They are performed in patients with thoracic scoliosis with strong angulation (likely to interfere with lung expansion when breathing) or patients who describe breathing difficulties.
What is the natural course of scoliosis?
Adult scoliosis will tend to evolve from menopause. Not all patients with idiopathic scoliosis show any progression, but close follow-up from this period is recommended.
An idiopathic scoliosis known or not since adolescence can evolve after the end of growth. Some patients are diagnosed between the ages of 30 and 50.
Pregnancy is a sensitive time for scoliosis. A more intensive follow-up around this period is necessary to detect an evolution.
The maintenance of a sporting activity and the fight against osteoporosis are also important therapeutic axes.
If symptoms appear, they do not regress spontaneously, however non-invasive treatments can relieve patients up to a certain stage.
What are the possible treatments?
Adult scoliosis is a pathology that combines a deformation, an imbalance of the trunk, osteoarthritis, wear of the discs, and often an impact on the nerve roots.
The objective of the treatments is to treat each of the symptoms to optimize the quality of life.
In case of isolated lumbago or back pain, rehabilitation is the first step. Its purpose is to maintain the flexibility of the spine by: – softening
- back and abdominal muscle strengthening
- postural education (spinal sparing gestures)
- massage
- respiratory rehabilitation if necessary.
In case of sciatica, cruralgia, epidural or foraminal infiltrations can provide temporary or permanent relief. A repetition of infiltrations (which must be radiologically guided) is possible.
An orthopedic treatment by corset can be proposed to pass a painful cap or used in patients who do not wish an intervention. It will then have to be worn permanently.
Surgery is indicated when the medical means are insufficient to effectively relieve the patient. The objectives of the intervention are to treat the “disabling” symptoms. One or more gestures are performed during the intervention depending on
- the deformation will be corrected and the vertebrae fused together using screws, hooks and rods and the addition of a bone graft, this is a correction-fusion. The instrumentation also makes it possible to treat an imbalance of the trunk within certain limits.
- The suffering of the nerve roots (sciatica, cruralgia or weakness of the legs) will be treated by a release. The surgeon will remove the posterior part of the vertebrae (the blades) to decompress the roots.
- The wear of the discs, in certain cases, will require their replacement by This gesture makes it possible to correct the sliding of the vertebrae, the imbalance, increase the chances of fusion of the vertebrae (the cages also contain bone graft).
There is no age limit for undergoing an operation, the decision is made jointly by the patient, the surgeon and the anesthesiologist depending on:
- symptoms and patient expectations
- the state of health (presence of pathologies such as diabetes, heart problem, etc.), therefore the physiological age.
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