Treated conditions

Scoliosis

Scoliosis is a deformity of the spine characterized by a rotation of the vertebral bodies, which can alter the shape of the spine in all three spatial planes. It is considered pathological when the scoliotic curve exceeds 10° Cobb.

Unlike adolescent scoliosis, which in the vast majority of cases is idiopathic (of unknown origin), adult scoliosis is primarily related to degenerative phenomena affecting the spine, such as intervertebral disc degeneration, spondylolisthesis, lumbar stenosis, or disc herniations.

Adult scoliosis is classified into three groups:

1. De novo scoliosis (not present in adolescence)
2. Idiopathic adult scoliosis (secondary to adolescent scoliosis)
3. Scoliosis secondary to pre-existing conditions (neuromuscular, rheumatological, etc.).

Symptoms

Adult scoliosis manifests with:

• Back pain, particularly in the lumbar region, persistent lumbar sciatica, radiating leg pain, dysesthesias, muscle cramps;
• Difficulty in walking and reduced walking autonomy;
• Progressive spinal deformities with body inclination to one side and forward.

Diagnosis

To accurately diagnose scoliosis, certain diagnostic tests are essential:

• Full-spine X-ray in standing position, with anteroposterior and lateral projections, to observe deformities in different spatial axes and understand the origin of scoliosis, measuring its degrees and thus its severity.
• Full-spine MRI, which provides images of the soft parts of the spine affected by the deformity (intervertebral discs, spinal cord, nerve roots);
• Possible control CT scan.

Treatment

The therapeutic approach to adult scoliosis varies according to the severity of the clinical and radiographic picture and the comorbidities present.

The treatment proposed to the patient can be of two types:

1. Conservative: through the use of physical therapies, infiltrations, or corrective braces. This approach is generally recommended in cases of mild deformity or for patients for whom surgical treatment is not advisable due to other concomitant conditions.
2. Surgical: proposed to patients with significant scoliotic curves, destined for further degenerative progression over time. Surgical techniques can vary and aim to realign and stabilize the correction of the deformity through arthrodesis, which involves the implantation of screws and rods. The use of robotic spinal surgery can also be indicated in cases of spinal deformities to enhance the precision of the implant of the synthesis devices, reduce the invasiveness of the procedure, and shorten postoperative recovery times.