Adult Spinal Deformity

Adult spinal deformity is an abnormal curve, rotation or imbalance of the spine in adulthood. It may involve scoliosis, kyphosis, loss of normal lumbar curve or a forward-leaning posture that makes it hard to stand straight. Some people have a childhood spinal curve that progresses later in life, while others develop deformity from age-related spine changes such as disc degeneration, arthritis or spinal instability.

The spine supports the body, protects the spinal cord and helps maintain posture. When alignment changes, the body may compensate through the hips, pelvis and legs, which can lead to pain, fatigue, nerve compression and reduced mobility. Baptist Health Brain & Spine Care specialists evaluate adult spinal deformity using imaging, physical assessment and individualized treatment planning.

Adult spinal deformity can appear in several patterns. These patterns may overlap, and the best treatment depends on the location, severity and impact of the deformity.

Common types include:

• Adult degenerative scoliosis: A side-to-side spinal curve caused by age-related disc and joint changes
• Progressive adult idiopathic scoliosis: A curve that began earlier in life and worsens during adulthood
• Kyphosis: An exaggerated forward curve that can cause a rounded upper back or forward-flexed posture
• Flatback syndrome: A loss of normal lower-back curve that can make standing upright difficult
• Sagittal imbalance: A forward shift of the trunk that affects posture, walking and endurance

Related spine conditions, including spinal stenosis, herniated disc and sciatica, may contribute to symptoms or influence the treatment approach.

Symptoms of adult spinal deformity vary widely. Some people notice only mild posture changes, while others develop pain, nerve symptoms or difficulty completing daily activities.

Symptoms may include:

• Back pain that worsens with standing or walking
• Uneven shoulders, ribs, waist or hips
• A forward-leaning posture or trouble standing upright
• Loss of height or visible spinal curvature
• Leg pain, numbness, tingling or weakness
• Symptoms of sciatica, including pain that travels from the lower back into the buttock or leg
• Fatigue from trying to maintain posture
• Trouble walking longer distances or balancing

Seek urgent care if back pain occurs with new bowel or bladder problems, rapidly worsening weakness, numbness in the groin area or loss of leg control.

Adult spinal deformity may develop when the discs, joints, bones or supporting muscles of the spine change over time. Degenerative changes can cause uneven loading across the spine, leading to curvature, rotation, instability or nerve compression. Prior spine surgery, fractures, osteoporosis or untreated spinal conditions may also contribute.

Risk factors include:

• Aging and natural wear-and-tear changes in the spine
• A history of scoliosis or spinal curvature earlier in life
• Degenerative disc disease or arthritis of the spine
• Osteoporosis or previous vertebral fracture
• Prior spine surgery or spinal injury
• Family history of spinal deformity
• Conditions that affect balance, strength or neuromuscular control

Adult spinal deformity can also occur with conditions such as spinal stenosis or herniated disc, especially when nerve compression contributes to leg pain or walking limitations.

Diagnosing adult spinal deformity begins with a detailed discussion of symptoms, medical history, prior spine care and how posture or pain affects daily life. Your provider will examine spinal alignment, walking pattern, strength, sensation, reflexes and balance.

Diagnostic evaluation may include standing X-rays to measure spinal curves and overall alignment. MRI may be used when symptoms suggest nerve compression, spinal stenosis or disc-related problems. CT scans may help evaluate bone anatomy, prior fusion areas or complex deformity. In some cases, additional tests help determine whether symptoms are coming from the spine, nerves, hips or other conditions.

The goal is to understand both the shape of the spine and the reason symptoms are occurring. This helps the care team recommend conservative treatment, image-guided pain care, rehabilitation or surgery when needed.

Treatment for adult spinal deformity depends on symptom severity, curve progression, nerve compression, bone health, overall health and personal goals. Many people begin with nonsurgical care, especially when symptoms are mild or moderate.

Nonsurgical treatment options may include:

• Physical therapy and posture training
• Core-strengthening and flexibility exercises
• Anti-inflammatory medications
• Activity modification
• Pain management strategies
• Targeted injections and other spine pain treatments

Baptist Health Brain & Spine Care also offers spine care resources to help patients understand their condition and care options.

Surgery may be considered when deformity causes severe pain, progressive imbalance, worsening nerve symptoms or major limits on function despite conservative care.

Surgical treatment options may include:

• Spinal decompression procedures
• Laminectomy
• Spinal realignment procedures
• Spinal fusion
• Minimally invasive spinal fusion

For some patients, treatment also addresses related conditions such as herniated disc or sciatica.

Untreated or progressive adult spinal deformity can affect more than posture. Over time, the spine may become less balanced, muscles may fatigue more easily and nerve compression may worsen. Some people become less active because standing and walking are uncomfortable, which can affect strength, endurance and overall health.

Possible complications include chronic back pain, worsening leg pain, numbness, weakness, reduced walking tolerance, balance problems and decreased independence. Severe deformity may also make daily activities such as dressing, lifting, driving or standing in place more difficult.

Surgical treatment, when recommended, also requires careful planning because spine deformity procedures can be complex. Your care team will discuss potential benefits, risks, recovery expectations and whether less invasive options may be appropriate.

Not every case of adult spinal deformity can be prevented, especially when it is related to aging, genetics or a curve that began earlier in life. However, healthy spine habits may help reduce symptoms, support bone health and slow functional decline.

Prevention and self-care strategies include:

• Staying physically active with exercises that build core, hip and back strength
• Maintaining good posture and body mechanics during daily activities
• Managing osteoporosis risk with medical guidance, nutrition and weight-bearing activity
• Avoiding tobacco, which can affect bone health and healing
• Seeking care early for worsening back pain, posture changes or nerve symptoms
• Following treatment plans for related spine problems such as spinal stenosis or sciatica

If you have back pain, posture changes, trouble standing upright or symptoms that travel into your legs, a spine specialist can help identify the cause and explain your options. Early evaluation can help you understand whether your symptoms are related to adult spinal deformity, nerve compression or another spine condition.

To schedule a visit with a Baptist Health Brain & Spine Care provider, fill out an appointment request form or call 833-596-3876.