What is degenerative scoliosis?
Degenerative scoliosis is a sideways curve in your spine, caused by age-related changes in your spine’s discs and facet joints.
Your spine is made up of building blocks known as vertebrae, held together by hinges called facet joints. These joints give your spine flexibility, enabling you to move. Sandwiched between each vertebrae is a disc, a soft shock-absorbing cushion that stops your bones rubbing against each other.
As you get older, the discs and the facet joints may start to show signs of wear and tear. In some people, that degeneration triggers scoliosis. When the degeneration is worse on one side, your lower spine may start to curve, forming the tell-tale S-shape of scoliosis.
What are the symptoms of degenerate scoliosis?
Many people with mild degenerative scoliosis have no symptoms.
If you do develop symptoms, they may include:
- Back pain – often worse when standing and easier when lying down
- Sharp, shock-like pain in one or both legs
- Numbness or weakness in your leg(s).
Degenerative scoliosis can cause nerve-related pain and lead to nerve damage. Sometimes a nerve is compressed (impinged) as your spine curves or if your spinal canal starts to narrow (spinal stenosis). That’s what causes symptoms such as a sharp, shocking pain, tingling or numbness in your legs, following the path of your sciatic nerve.
Symptoms of degenerative scoliosis usually develop gradually. You may notice that they change throughout the day too, probably worse when you first get up, easing as you move during the day and worsening again as the day ends.
What causes degenerative scoliosis?
Degenerative scoliosis is caused by age-related changes in your spine.
There’s nothing you can do about growing older, but you’re at higher risk of developing degenerative scoliosis if you have other conditions that affect your spine such as:
- Degenerative disc disease or facet joint syndrome/arthritis – these conditions can affect the alignment of your vertebrae
- Vertical compression fractures
- Previous spine surgery.
How is degenerative scoliosis diagnosed?
First, we start by listening to your symptoms and medical history.
Then, we’ll examine you, asking you to stand in different positions so we can observe or feel your spine.
If we think you may have degenerative scoliosis, we’ll order some images of your spine using a CT-scan, an X-ray or an MRI. These images allow us to see your spine and measure its curves. If your spine curves by more than 10 degrees on the Cobb Angle measurement process, then we’ll diagnose degenerative scoliosis.
How do you treat degenerative scoliosis?
Treatment for degenerative scoliosis depends on the impact it’s having on your life.
If your symptoms are mild, then we’ll start with lifestyle modifications and physiotherapy.
If degenerative scoliosis is causing you nerve pain, then we can try:
- Medication to control the pain – being careful about side effects and interactions with other medications you might take
- Nerve root or epidural injections
- Surgery to decompress the nerve and stabilise the spine.
Because degenerative scoliosis is a ‘wear and tear’ condition, you’re likely to be older when you develop it. You may have other medical conditions or be dealing with increasing frailty.
That means we have to weigh up the risks and benefits of surgery very carefully.
New minimally invasive spinal surgery techniques like OLIF are making surgery easier for older patients to tolerate.
How can the Victorian Orthopaedic Spine Service help?
We see many older people dealing with pain that turns out to be caused by degenerative scoliosis. Once we’ve diagnosed your condition, we’re able to advise you on the most appropriate treatment to help relieve your symptoms.
Our care pathway is carefully designed to ensure you only progress to surgery if you really need it. We’ll often try conservative treatments first.
Please make an appointment (you’ll need a referral from your GP first).