Published on January 24, 2024

A doctor and patient with spinal deformity.

Surgical options for spinal deformity

Spinal deformities impact as many as 32% of all adults, and the prevalence increases with age. The Journal of Spine Surgery notes that 30% to 68% percent of adults 65 and older are affected. Treatment plans generally begin with activity modification, physical therapy, bracing, medication management or injections. When long-term relief cannot be achieved, surgery may be a consideration.

Vikas Parmer, MD, a neurosurgeon and member of ProHealth Neuroscience Care’s spine team, describes a healthy spine as a stack of vertebrae and disks, designed to hold the body upright and the head level. It is balanced for optimal flexibility, and when viewed from the side, it has three gentle curves.

  • The cervical spine (neck) has an inward curvature, or lordosis.
  • The thoracic spine (middle) has an outward curvature, or kyphosis.
  • The lumbar spine (lower) also has an inward curvature, or lordosis.

"Spinal deformity occurs when there is an abnormal curve or rotation in the spine resulting in misalignment," Dr. Parmer said. "Causes vary, but birth defects, disease, aging, degeneration and trauma can all impact the spine’s structure and ability to function as designed."

People with spinal deformity often experience significant pain and have difficulty walking and standing. Mike Jones, MD, a neurosurgeon and fellow member of the spine team, notes that some people may be hunched over with a visible curve while others have neurologic issues including difficulty balancing, weakness, numbness or tingling in an arm or leg if the deformity interferes with the spinal cord and nerves.

There are four primary types of spinal deformity:

  • Excessive kyphosis, when the upper back curves forward, often causing a visible hump or hunchback.
  • Excessive lordosis, when the lower back curves inward, possibly to compensate for kyphosis elsewhere. This condition is also known as swayback.
  • Scoliosis, when a twisting or side-to-side curvature occurs.
  • Flat back syndrome, a condition that occurs when the lower spine loses its normal lordosis and flattens.

"When pain or other symptoms affect a person's ability to perform routine activities and non-invasive options are not successful, surgery may be recommended," Dr. Jones said. "It is also considered if the condition has caused compression of the spinal cord or nerve roots, or if the deformity has caused fractures."