Tuesday, January 31, 2012
74 yo who had adolescent scoliosis "in dark ages" now w severe pain
In between adolescent scoliosis surgeries yesterday, I saw this very healthy 74 yo woman who is now really suffering with long-term consequences of untreated and un-monitored progressive scoliosis.
This lady used to hike all the time all across country in every state except Nebraska!
But in recent years, her quality of life has taken a real "nose dive" with increasing severe low back that makes even basic activities of daily living unbearable.
In addition to her large scoliosis, she has also developed a spondylolisthesis also w stenosis at L45.
This is a good example of the long-term consequences of scoliosis which can eventually greatly affect quality of life. When treated earlier as an adolescent or younger adult, such deformities can be treated less invasively, and improve quality of life as well as posture many years in advance. Realignment of the spine in earlier years can help prevent the lower collapse which can lead to stenosis, spondylolisthesis, and the need for larger surgeries all the way down to pelvis.
While surgery is still quite possible in the older adult, there are greater risks due to osteoporosis which can lead to spinal fractures, as well as increased medical risks, and slower recovery times. This is yet another reason why scoliosis and kyphosis should be tracked throughout life with regular X-Rays and exams with at a scoliosis center or spinal deformity physician/surgeon to look for any signs of curve progression. It is also to look for signs of decreasing quality of life and neurologic function like spinal claudication, which can occur in the older adult with progressive spinal stenosis.
Even though this lady may have developed her scoliosis initially in the "Dark Ages" of scoliosis over 60 years ago, before the dawn of spinal instrumentation, there is still hope for better quality of life now. It is also important for all adults with scoliosis and kyphosis to be periodically checked, usually once every 5 years for older adults, and once a year or so for adults under 25 to try to determine if curves are progressing.
While we enjoy caring for people with spinal deformity of all ages at Hey Clinic, there are definitely advantages to stay on top of this problem earlier rather than later.
Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery