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Adult Scoliosis: When Conservative Management Is Sufficient and When Surgery May Be Needed

Adult Scoliosis: When Conservative Management Is Sufficient and When Surgery May Be Needed

This article was translated using machine translation.

Scoliosis in adults does not necessarily require surgical intervention, according to guidance published by Mayo Clinic. Treatment depends on symptom severity, the degree of spinal curvature, and the presence of contributing conditions such as arthritis or osteoporosis.

Scoliosis refers to an abnormal lateral, forward, or rotational curvature of the spine. In adults, it may represent a residual curve from childhood or, more commonly, result from age-related spinal degeneration occurring alongside arthritis or bone loss. Many older adults with significant spinal curvature remain asymptomatic. Where symptoms do occur, they typically include low back pain and postural changes, and often respond to non-surgical measures.

First-line management includes physical therapy, targeted exercises, stretching, and low-impact physical activity. Where osteoporosis is a contributing factor, bone health assessment and management become central to preventing curve progression. This may involve bone density scanning, weight-bearing exercise, and pharmacological agents to support bone repair and formation.

Surgery is considered when pain persists despite conservative treatment, or when symptoms significantly limit mobility or result in pronounced postural deformity. The primary surgical goal in adults is not complete curve correction but spinal balance, defined as proper alignment of the head over the pelvis in both planes. This approach achieves high rates of symptom relief and patient satisfaction.

Source: Huddleston P. Mayo Clinic Q&A: Scoliosis in adults. Mayo Clinic, 9 June 2026.

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