Adult Scoliosis: The Current Demographic

Here’s a controversy: Some researchers believe that adult spinal deformity (ASD) only causes back pain. Others believe that ASD creates functional limitations and erodes quality of life.

Researchers from numerous surgical centers around the United States examine this issue in a study that appears ahead-of-print in the journal Spine. In it, they look at patients with symptomatic adult spinal deformity (SASD) and compare them to Americans who have no such deformity and those who have other chronic diseases.

The researchers enrolled consecutive SASD patients (N=497) who had never undergone spine surgery into a multi-center database. They then evaluated study participants for type and severity of spinal deformity, and compared them to reported U.S. normative and chronic disease patients.

SASD patients had lower quality of life and more functional limitations than the average American, and SASD’s impact was similar to that experienced by people with more recognized chronic diseases. These findings held true regardless of the patient’s age.

SASD patients with no other reported comorbidities demonstrated a greater reported impact on physical health than the average American, and more decline than could be attributed to normal aging.

Measures of physical wellness indicated that patients with lumbar scoliosis and increasing sagittal vertical axis were at increased risk of functional limitation.

Measures of physical wellness also indicated that patients with isolated thoracic scoliosis had limitations similar to individuals with chronic back pain.

Patients with lumbar scoliosis combined with severe sagittal malalignment had functional limitations similar to patients with limited use of their arms and legs.

The authors conclude that SASD is a heterogeneous condition, and the patient’s deformity type and severity can have a debilitating impact on health. Often, this disability is worse than that of more recognized chronic diseases. This study helps health care providers identify types of SASD that correlate with disability, and encourages them to facilitate appropriate diagnosis, treatment and research efforts.