Progressive senile scoliosis: seven cases of increasing spinal curves in elderly patients.

An increasing scoliosis was documented in seven elderly women. The average curve at the most recent examination was 43 degrees (range 26 degrees-78 degrees). Previous films, from 5 to 26 years before, demonstrated an average increase of 2.3 degrees/year (range 1 degree-4.8 degrees/year). There were three lumbar and four thoracolumbar curves. Three curves were to the right and four were to the left. Only one patient had osteoporotic vertebral body crush fractures. The common underlying mechanism in the progression of senile scoliosis appears to be asymmetric loading of the spine which can be caused by a previously established scoliosis, spondylolysis/spondylolisthesis, lumbosacral anomalies, or leg length discrepancy. Subsequently, factors that can cause a curve to increase include degenerative disc disease with lateral disc space narrowing, soft tissue failure, and osteoporosis. Since even minor scoliosis can potentially progress in the older adult, increased monitoring of scoliosis in patients over age 50 years may be warranted.