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14100 Parkway Commons Dr, Suite 100 · Oklahoma City, OK 73134
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Spinal Deformity

Scoliosis & Spinal Deformity

Our fellowship-trained spine surgeons have specialized training in adult degenerative scoliosis — the most common type we treat. Whether your curve developed gradually with age or progressed in adolescence, we offer a thorough evaluation and individualized treatment plan.

Related conditions:
Back Pain Spinal Stenosis Disc Herniation Sciatica All Conditions →
Our Patient Population

Adult & Degenerative Scoliosis

The majority of scoliosis patients we see are adults experiencing back pain, leg pain, or progressive deformity from degenerative spinal changes — not adolescents with idiopathic curves. Adult degenerative scoliosis develops as discs and facet joints wear unevenly over time, causing gradual lateral curvature that is often accompanied by spinal stenosis, nerve root compression, and sagittal imbalance.

Unlike adolescent scoliosis, adult degenerative curves are often painful and are frequently associated with neurological symptoms. Treatment decisions are guided by the degree of functional limitation, the severity of neurological compromise, and the patient's overall health and goals — not curve magnitude alone.

Common Symptoms
  • Chronic low back or flank pain
  • Leg pain, cramping, or heaviness with walking
  • Difficulty standing upright for extended periods
  • Progressive lean or list to one side
  • Numbness or weakness in the legs
  • Fatigue from muscle compensation
Common Causes
  • Asymmetric disc degeneration over time
  • Facet joint arthropathy and asymmetric load
  • Osteoporosis with asymmetric compression
  • Prior lumbar surgery altering spinal mechanics
  • Untreated or progressed adolescent curve
  • Sagittal imbalance (flat back or kyphosis)
Treatment Approach

Treatment Pathway

Adult degenerative scoliosis treatment is highly individualized. Goals include relief of pain, improvement in neurological symptoms, correction of deformity, and restoration of sagittal balance — while minimizing surgical risk appropriate to each patient's age and health status.

1
Physical therapy & pain management
Core strengthening, postural training, and anti-inflammatory medications help manage pain and improve function in patients with mild to moderate deformity and no significant neurological compromise.
2
Targeted injections
Epidural steroid injections, facet blocks, and SI joint injections can relieve nerve-related symptoms and help clarify the predominant pain generator — useful both therapeutically and diagnostically.
3
Surgical decompression (limited)
For patients whose primary complaint is leg pain or neurological symptoms from associated stenosis, limited decompression without fusion may provide relief — particularly when the curve is modest and the patient is not a candidate for larger reconstruction.
4
For patients with progressive deformity, significant sagittal imbalance, or severe neurological symptoms, surgical correction combined with spinal fusion restores alignment and provides durable relief. Planning includes full-length standing X-rays and careful assessment of surgical risk and patient goals.
Surgical Considerations

When Surgery May Help

Surgery for adult scoliosis is considered when pain is severe and debilitating despite adequate conservative care, when neurological function is declining, or when progressive deformity threatens long-term quality of life. The scope of surgery — from limited decompression to multi-level instrumented fusion with deformity correction — is tailored to each patient's unique presentation, goals, and medical fitness.

Sagittal balance restoration is a critical goal in adult deformity surgery. Evidence consistently demonstrates that restoring lumbar lordosis and overall alignment leads to better functional outcomes and higher patient satisfaction than curve correction alone.

General medical consensus supports a careful, stepwise approach to adult scoliosis — reserving larger reconstructive procedures for patients who are medically optimized and have failed conservative management.

The information on this page is for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified physician regarding your specific condition. Surgery is not appropriate for every patient, and our physicians evaluate each case individually.
Adolescent Scoliosis

Adolescent Idiopathic Scoliosis

While adult degenerative scoliosis is the more common presentation in our practice, we also evaluate adolescents and young adults with idiopathic scoliosis. For growing patients, bracing is recommended for curves between 25–45 degrees; surgery is considered for curves exceeding 45–50 degrees or those progressing rapidly despite bracing.

Posterior spinal instrumentation and fusion in adolescents carries a high rate of successful correction and durable long-term outcomes in experienced hands.

Not Sure If Surgery Is Right for You?

Our surgeons take a conservative approach — surgery is recommended only when it is clearly the best option. Schedule a consultation and we will walk through your imaging, history, and all available treatments together.

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Related Conditions

Other Conditions We Treat

Patient Questions

Frequently Asked Questions

What is adult degenerative scoliosis?
Adult degenerative scoliosis is an abnormal curvature of the spine that develops in adults due to asymmetric degeneration of the intervertebral discs and facet joints, typically in the lumbar spine. Unlike adolescent scoliosis, it is driven by wear-and-tear changes rather than growth, and commonly causes back pain, leg pain, and postural changes.
At what angle is scoliosis surgery recommended for adults?
The decision to recommend surgery for adult scoliosis depends on the degree of curvature, rate of progression, neurological symptoms, and the patient's overall function and quality of life — not on the Cobb angle alone. Surgery is typically considered when curvature exceeds 45–50 degrees with progressive symptoms, or when conservative treatment has failed to provide adequate relief.
What does scoliosis surgery for adults involve?
Adult scoliosis surgery typically involves spinal decompression and instrumented fusion to correct the deformity, relieve nerve compression, and stabilize the spine. The extent of the fusion depends on the severity and location of the curvature. Complex cases may require anterior and posterior approaches and sagittal balance correction.
What is sagittal balance in spine surgery?
Sagittal balance refers to the alignment of the spine in the front-to-back plane. Proper sagittal balance allows the body to stand upright with minimal muscle effort. Restoring sagittal balance is a critical goal of adult scoliosis and spinal deformity surgery, as imbalance contributes significantly to pain and disability.
Can adult scoliosis be treated without surgery?
Mild adult scoliosis with minimal symptoms is managed with physical therapy, core strengthening, and pain management. More significant curvatures causing neurological symptoms or progressive deformity that fails conservative care may require surgical correction. A comprehensive evaluation by a fellowship-trained spine specialist helps determine the best approach.
(405) 748-3300  ·   Fax: (405) 749-1671  ·  Monday – Friday 8:00 AM – 5:00 PM
Clinical References
Scoliosis Research SocietyAANS — Adult Scoliosis

Ready to Find Relief?

Our fellowship-trained spine specialists will evaluate your condition and discuss every available option — surgical and non-surgical.

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