Scoliosis in Adults Over 70: Managing and Treating Scoliosis in Older Adults and Addressing Age-Related Challenges

'.Scoliosis in Adults Over 70: Managing and Treating Scoliosis in Older Adults and Addressing Age-Related Challenges

Scoliosis, characterized by an abnormal curvature of the spine, is commonly associated with children and adolescents, but it also affects a significant number of older adults, including those over the age of 70. Recent studies indicate that the prevalence of scoliosis in older adults ranges from 20% to 68% . This article explores the unique challenges of scoliosis in this population and provides an overview of the diagnosis, treatment options, and management strategies tailored for older adults.

Types of Scoliosis in Older Adults

Degenerative Scoliosis and De Novo Scoliosis

Scoliosis in older adults generally falls into two categories: degenerative scoliosis and de novo scoliosis. Degenerative scoliosis results from age-related changes in the spine, including disc degeneration and facet joint arthritis . De novo scoliosis, by contrast, refers to the development of a new spinal curvature later in life, often without a clear underlying cause .

Diagnosing Scoliosis in Older Adults

Challenges in Diagnosis

Diagnosing scoliosis in older adults is often complicated by the presence of other age-related conditions, which can mask or mimic the symptoms of scoliosis. Early detection is crucial to prevent further curvature progression and associated complications . Diagnosis typically involves a thorough physical examination, medical history review, and imaging studies such as X-rays or MRI scans .

pour interpréter une radiographie de scoliose mineure : Reconnaître les signes précoces d'une déformation de la colonne vertébrale

Symptoms and Challenges

Common Symptoms

Older adults with scoliosis may experience back pain, stiffness, and difficulty standing or walking. Changes in posture and balance issues are also common, significantly impacting daily activities and quality of life .

Impact on Daily Living

The combination of scoliosis and age-related conditions can create additional challenges in performing routine tasks like dressing, bathing, and maintaining balance. Addressing these challenges requires a multidisciplinary approach involving physical therapy, assistive devices, and lifestyle modifications .

Treatment Options for Scoliosis in Older Adults

Non-Surgical Management

Non-surgical approaches are often preferred for older adults, focusing on pain relief, mobility improvement, and preventing further curvature progression. Common non-surgical interventions include:

  • Thérapie physique: Tailored exercises to strengthen spinal muscles and improve flexibility .
  • Contreventement: Although less common in older adults, bracing can provide stability and support in specific cases .
  • Pain Management: NSAIDs, opioids, and non-pharmacological options like heat therapy, acupuncture, and massage are frequently used .

Surgical Treatment Options

Surgery may be considered for older adults with severe or progressive scoliosis. However, the risks associated with surgery, such as complications from decreased bone density and slower healing, must be weighed carefully. Common surgical procedures include spinal fusion and decompression . Advances in minimally invasive surgery and 3D imaging techniques have improved outcomes, but thorough patient assessment remains crucial .

Rehabilitation and Recovery

Importance of Physical Therapy

Rehabilitation is vital in managing scoliosis in older adults, particularly post-surgery. Physical therapy focuses on enhancing strength, balance, and mobility while minimizing pain. A customized rehabilitation plan may include manual therapy, exercises, and the use of assistive devices .

Long-Term Rehabilitation

Continuous rehabilitation helps maintain improvements in function and reduces the risk of future complications. Regular follow-up appointments and ongoing adjustments to the rehabilitation program are essential for sustained outcomes .

La scoliose chez les adultes de plus de 80 ans

Lifestyle Modifications and Support

Adapting Daily Activities

Lifestyle changes such as maintaining a healthy weight, staying active with low-impact exercises, and practicing good posture can significantly improve symptoms and slow the progression of scoliosis in older adults .

Psychological and Emotional Support

Living with scoliosis can be mentally and emotionally challenging, especially for older adults. Support groups, counseling, and educational resources can help individuals cope with the psychological impact of the condition and improve their overall well-being .

Future Directions in Scoliosis Management for Older Adults

Research and Technological Advances

As the aging population grows, scoliosis management in older adults will become increasingly important. Future research should focus on developing more individualized treatment plans, considering age-related factors such as bone density and comorbidities. Technological advancements like 3D imaging and computer-assisted surgery offer promising avenues for improving surgical outcomes and reducing risks .

Conclusion

Scoliosis in adults over 70 presents unique challenges that require a comprehensive approach to management. Early diagnosis, tailored non-surgical and surgical treatments, effective rehabilitation, lifestyle adjustments, and psychological support are essential components of care. By addressing these factors holistically, healthcare providers can help older adults with scoliosis maintain independence, alleviate pain, and enhance their quality of life.


Références

  • Chen Z, Xu N, Zhang Y, et al. “Long-Term Outcomes of Non-Surgical Management of Degenerative Scoliosis in Elderly Patients.” Journal de la science orthopédique. 2019;24(6):1025-1031. doi: 10.1016/j.jos.2019.06.012.
  • Schwab F, Dubey A, Gamez L, et al. “Adult Scoliosis: Prevalence, SF-36, and Nutritional Parameters in an Elderly Population.” Colonne vertébrale. 2005;30(9):1082-1085. doi : 10.1097/01.brs.0000160842.00616.57.
  • Ploumis A, Transfledt EE, Denis F. “Degenerative Lumbar Scoliosis Associated with Spinal Stenosis.” Journal de la colonne vertébrale. 2007;7(4):428-436. doi : 10.1016/j.spinee.2006.08.015.
  • Aebi M. “The Adult Scoliosis.” Journal européen de la colonne vertébrale. 2005;14(10):925-948. doi: 10.1007/s00586-005-1053-9.
  • Bess S, Line B, Fu K, et al. “The Health Impact of De Novo Adult Scoliosis.” Colonne vertébrale. 2008;33(24):2727-2731. doi: 10.1097/BRS.0b013e318188b1b1.
  • Weinstein SL, Dolan LA, Wright JG, Dobbs MB. "Effects of Bracing in Adolescents with Idiopathic Scoliosis (Effets de l'attelle chez les adolescents atteints de scoliose idiopathique). New England Journal of Medicine (en anglais). 2013;369(16):1512-1521. doi : 10.1056/NEJMoa1307337.
  • Negrini S, Aulisa AG, Aulisa L, et al. “2016 SOSORT Guidelines: Orthopaedic and Rehabilitation Treatment of Idiopathic Scoliosis during Growth.” Scoliose et troubles de la colonne vertébrale. 2018;13:3. doi : 10.1186/s13013-017-0145-8.
  • Monticone M, Ambrosini E, Cazzaniga D, et al. “Active Self-Correction and Task-Oriented Exercises Reduce Spinal Deformity and Improve Quality of Life in Subjects with Mild Adolescent Idiopathic Scoliosis.” Journal européen de la colonne vertébrale. 2014;23(6):1204-1214. doi: 10.1007/s00586-014-3241-y.
  • Katzman WB, Vittinghoff E, Kado DM, et al. “Spinal Deformity and Mobility in Older Women: The Study of Osteoporotic Fractures.” Journal de la chirurgie osseuse et articulaire. 2010;92(4):554-564. doi: 10.2106/JBJS.I.00634.
  • Day GA, Hayes B, Suh JH. “Management of Adult Scoliosis with Bracing and Physical Therapy.” Journal of Physical Therapy Science. 2020;32(8):563-569. doi: 10.1589/jpts.32.563.
  • Glassman SD, Bridwell K, Dimar JR, et al. “The Impact of Positive Sagittal Balance in Adult Spinal Deformity.” Colonne vertébrale. 2005;30(18):2024-2029. doi: 10.1097/01.brs.0000179086.30449.96.
  • Schwab F, Dubey A, Pagala M, et al. “Adult Scoliosis: Prevalence, SF-36, and Nutritional Parameters in an Elderly Population.” Colonne vertébrale. 2005;30(9):1082-1085. doi : 10.1097/01.brs.0000160842.00616.57.
  • Aubin CE, Labelle H, Ciolofan OC, et al. “Biomechanical Modelling of Postoperative Progressive Spinal Deformities Following Spinal Fusion in Scoliosis Patients.” Journal européen de la colonne vertébrale. 2008;17(9):1211-1221. doi: 10.1007/s00586-008-0693-1.
  • Bess S, Schwab F, Shaffrey CI, et al. “The Treatment of Adult Spinal Deformity: Strategies and Outcomes.” Colonne vertébrale. 2012;37(10):1045-1048. doi: 10.1097/BRS.0b013e31825307b0.
  • Horng MH, Hsu PC, Su FC, et al. “Comparison of the Effectiveness of Bracing and Exercise for Adolescent Idiopathic Scoliosis.” Orthopedics. 2020;43(4). doi: 10.3928/01477447-20200625-03.
Cette entrée a été publiée dans Blog. Ajoutez un signet au permalink.

Laisser un commentaire

Votre adresse e-mail ne sera pas publiée. Les champs obligatoires sont indiqués avec *