Scoliosis After 50: What Changes With Age

Why does scoliosis appear later in life?

Adult scoliosis has two main sources. One is a curve from childhood that slowly progresses in adulthood. The other is a new "degenerative" (de novo) curve caused by uneven wear of the discs and joints. Degenerative scoliosis and flatback after earlier surgery are among the most common causes of adult spinal deformity.

How common is scoliosis in older adults?

It is very common. One study found curves in 68% of healthy volunteers over 60. A pooled analysis found scoliosis in about 36% of people over 60, compared with 13% of younger adults. In another large study, prevalence rose from about 3% at ages 40–50 to 50% at age 90 and older.

Can scoliosis get worse with age?

Yes, but usually slowly. Degenerative curves progress about 1.6 degrees per year on average, and older childhood curves about 0.8 degrees per year. Some studies report averages near 3 degrees per year in symptomatic patients. The years around menopause can be a period of faster change.

Which curves are most likely to progress?

Studies point to several X-ray findings:

• A vertebra slipping sideways by 6 mm or more (lateral listhesis)
• A curve of 30 degrees or more
• Significant rotation at the top of the curve
• Uneven disc collapse
• An L5 vertebra positioned high relative to the pelvis

Surprisingly, osteoporosis by itself has not been strongly linked to curve progression, although it matters greatly for surgery.

Can scoliosis get worse after pregnancy?

Pregnancy usually causes only small changes. A 2024 review found an average curve increase of 3.6 degrees across pregnancy, and about 5 degrees in unfused spines. Larger curves (over 50 degrees) are more likely to progress.

Can scoliosis get worse after spinal fusion?

The fused section does not curve further. However, problems can develop above or below the fusion. See Problems after spinal fusion.

What symptoms matter most?

The curve size matters less than how you function. Important symptoms include:

• Back pain that worsens through the day
• Leg pain or heaviness when walking (often from spinal stenosis)
• Leaning forward, or getting tired quickly when standing

See Leaning forward when walking.

Is surgery an option at 70 or 80?

It can be. Age alone is not the deciding factor. In a multicenter study of patients 60 and older, disability scores improved from about 46 to 27 at two years, and the gains held at five years. Risks do rise with age. Among patients 65 and older, about 1.8% died within two years of deformity surgery. Overall health, bone strength, and your goals should guide the decision.

How often should my curve be checked?

I usually recheck at 4 months, at 6 months if needed, then at 1, 2, 5 and 10 years. A change of 5 degrees or more between X-rays is generally considered real progression. Smaller differences can come from measurement error.

When to see a specialist. If your curve is progressing or symptoms are limiting your life, request an appointment.

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