Spine problems in previously treated scoliosis patients

After 20 years or more, scoliosis patients who were previously treated with surgery experience small but significant physical impairments (mainly mild back problems), compared to their peers without scoliosis. More people with a history of scoliosis report having to take days off from work, compared to people who never had the condition. In general, however, most patients experienced a similar quality of life to peers who never had the condition.

The following are some possible causes of later back problems in people with a history of treated scoliosis:

1. Spinal fusion disease.
Patients who are surgically treated with fusion techniques lose flexibility and may experience weakness in back muscles due to injuries during surgery.

2. Disk degeneration.
With disk degeneration, the disks between the vertebrae may become weakened and rupture. In some patients, particularly those treated with the first generation of the Harrington rods, years after the original surgeries the weight of the instrumentation can cause disk and joint degeneration severe enough to require surgery. Treatment may involve removal of the old rods and extension of the fusion into the lower back. Still, most patients do not experience significant back pain from these problems.

3. Height loss.
Fusion of the spine may inhibit growth somewhat. However, much of the growth takes place in long bones, which are not affected.

4. Lumbar flatback.
This condition is most often the result of a scoliosis surgical procedure called the Harrington technique, which eliminated lordosis (the inward curve in the lower back). Adult patients with flatback syndrome tend to stoop forward. They may experience fatigue and back and even neck pain.

5. Rotational trunk shift (uneven shoulders and hips).
Evidence suggests that previous treatment with braces may also cause mild back pain and more days off, but problems appear to be less than with surgery. In one study, dysfunction was comparable to people without a history of scoliosis.