What is degenerative (de novo) scoliosis?

Degenerative scoliosis develops in adulthood — typically after age 50 — when the discs and facet joints wear unevenly, allowing the spine to curve sideways. It differs from adolescent scoliosis carried into adulthood, and it frequently occurs together with spinal stenosis, which is why leg pain and difficulty walking are often the symptoms that bring patients in.

What does spinal deformity surgery involve?

It depends on the problem. When leg symptoms from stenosis dominate, a focused decompression may be enough. When the curve itself must be corrected, Dr. Hobbs performs deformity correction using image-guided navigation and personalized technology — including UNiD patient-specific rods, which are custom-bent from the patient's own imaging and alignment plan before surgery, and aprevo personalized interbody implants designed for the patient's anatomy.

What is flatback syndrome?

Flatback (sagittal imbalance) is the loss of the spine's natural forward-and-backward curves, leaving the patient pitched forward and struggling to stand upright — often with fatigue and pain that worsen through the day. It can develop from degeneration or after prior fusion surgery. Restoring sagittal alignment is a central goal of modern deformity surgery, and it is exactly what AI-assisted alignment planning is designed to achieve.

Adult Scoliosis & Spinal Deformity Treatment | Jonathan G. Hobbs, M.D.

What Is Adult Scoliosis?

Adult scoliosis is a sideways curvature of the spine in a skeletally mature person. Some adults carry a curve from adolescence; many others develop degenerative ("de novo") scoliosis later in life, as uneven wear in the discs and facet joints lets the spine drift out of alignment. Deformity also includes problems in the front-to-back plane — kyphosis (excess forward rounding) and flatback (loss of the spine’s natural curves).

Unlike adolescent scoliosis, adult deformity usually announces itself with pain and function problems — not just appearance. Because degenerative curves often narrow the spinal canal at the same time, leg pain, numbness, and difficulty walking are common companions. Dr. Hobbs is specialty-trained in diagnosing and surgically treating complex spinal deformities, with a conservative-first philosophy and personalized surgical technology when correction is needed.

Interactive: Types of Adult Spinal Deformity

Tap each type to see how the spine’s shape changes. (Educational — not a diagnosis.)

Degenerative (de novo) scoliosis Develops in adulthood — typically after 50 — as discs and facet joints wear unevenly and the lumbar spine drifts into a curve. It very often occurs together with spinal stenosis, which is why leg pain and trouble walking are frequently the first symptoms patients notice.

Symptoms of Adult Scoliosis & Deformity

Back pain that worsens with standing or activity and eases when sitting or lying down
A visible change in posture — leaning to one side or pitching forward
Uneven shoulders, waistline, or hips; clothes fitting differently
Loss of height over time
Leg pain, numbness, or cramping with walking (from accompanying stenosis)
Fatigue and difficulty standing upright as the day goes on

Quick Symptom Self-Check

Check any that apply. This is an educational guide only — it is not a diagnosis, and a licensed clinician makes all care decisions.

My posture has visibly changed — leaning sideways or forward I’ve lost noticeable height Leg pain, numbness, or cramping when I walk or stand Hard to stand fully upright, especially late in the day Back pain that hasn’t improved over several weeks New loss of bladder or bowel control

Select any symptoms above to see general guidance.

How Adult Deformity Is Evaluated

The cornerstone is standing, full-length spine X-rays, which show how the spine behaves under gravity — the curve’s size, the spine’s overall balance, and how alignment changes over time. MRI evaluates the discs and any nerve compression driving leg symptoms, and bone-density testing matters because bone quality shapes every treatment decision.

Just as important is understanding what bothers you most — pain, walking distance, standing tolerance, posture — because treatment targets the symptoms, not the X-ray.

Treatment Options

Dr. Hobbs strongly believes nonsurgical solutions should be explored first — most adults with scoliosis are managed without surgery.

Conservative Care

Physical therapy & core strengthening — supporting the spine and improving standing tolerance
Anti-inflammatory medication and activity modification
Targeted injections — relief for the stenosis-related leg symptoms that often accompany degenerative curves

Surgical Treatment

When the deformity progresses, pain becomes disabling, or nerve compression can’t be relieved conservatively, Dr. Hobbs tailors surgery to the true problem:

Focused decompression — when stenosis symptoms dominate and the curve itself is stable
Deformity correction — realigning and stabilizing the spine with image-guided navigation

Personalized to Your Alignment

Deformity surgery is where personalized technology matters most. Dr. Hobbs uses UNiD™ patient-specific rods — custom-bent before surgery from your imaging and an AI-assisted alignment plan — and aprevo® personalized interbody implants designed for your anatomy, so the correction is planned around your spine, not a standard template.

UNiD patient-specific rods aprevo personalized implants

Why Choose Dr. Hobbs for Deformity Care

Deformity Specialty Training
Specialty-trained in diagnosing and surgically treating complex spinal deformities

Elite Training
University of Kentucky medical degree; University of Chicago neurosurgery residency, chief resident

Personalized Technology
AI-assisted alignment planning, UNiD™ patient-specific rods, aprevo® personalized implants

Conservative-First
Most adult scoliosis is managed without surgery — surgery only when it clearly helps

Frequently Asked Questions About Adult Scoliosis

It can progress slowly as the discs and joints continue to degenerate, though the rate varies widely. Warning signs include a visible change in posture, loss of height, increasing lean, and new or worsening leg symptoms. Periodic monitoring with standing X-rays lets Dr. Hobbs track change and adjust the plan before symptoms escalate.

A curve that develops in adulthood — typically after 50 — when discs and facet joints wear unevenly. It frequently occurs together with spinal stenosis, which is why leg pain and difficulty walking are often the first symptoms patients notice.

Yes — most adults with scoliosis never need surgery. Physical therapy, core strengthening, medication, and targeted injections manage symptoms effectively for many patients. Surgery is considered when the deformity is progressing, pain is uncontrolled, or nerve compression can’t be relieved conservatively.

It depends on the problem. When leg symptoms dominate, a focused decompression may be enough. When the curve must be corrected, Dr. Hobbs performs deformity correction using image-guided navigation and personalized technology — UNiD™ rods custom-bent from your alignment plan and aprevo® implants designed for your anatomy.

Flatback (sagittal imbalance) is the loss of the spine’s natural front-to-back curves, leaving you pitched forward and struggling to stand upright — often with fatigue that worsens through the day. Restoring that alignment is a central goal of modern deformity surgery and exactly what AI-assisted planning is designed to achieve.

Stand Taller. Move Easier.

Adult scoliosis doesn’t have to set the limits of your day. Specialty-trained deformity care — personalized to your spine — is right here in Northwest Indiana.

(219) 250-5010

Monday – Friday · 8:00 AM – 5:00 PM

Crown Point Office

500 E. 109th Avenue
Crown Point, IN 46307

Chesterton Office

601 Gateway Boulevard
Chesterton, IN 46304