Take this article and make it into a brief series of questions and answers. Don't use a bullet point list.

Scoliosis
What is Scoliosis?
Everyone's spine has subtle natural curves. But some people have different curves, side-to-side spinal curves that also twist the spine. This condition is called "scoliosis". On an x-ray with a front or rear view of the body, the spine of a person with scoliosis looks more like an "S" or a "C" than a straight line. These curves can make a person's shoulders or waist appear uneven. These curves can't be corrected simply by learning to stand up straight. You can't cause scoliosis; it does not come from carrying heavy backpacks, participating vigorously in sports, or poor posture.

Types of Adult Scoliosis
In addition to the two types of adult scoliosis discussed in this section—Adult Idiopathic Scoliosis and Adult Degenerative Scoliosis—types of scoliosis that develops early in life or that results from a separate syndrome also effect adults.

Adult Idiopathic Scoliosis
Adult idiopathic scoliosis is, in essence, a continuation of adolescent idiopathic scoliosis. Sometimes a spine curvature of an idiopathic (cause not known) nature that began during teenage years may progress during adult life. Curves may increase in size 0.5° to 2° per year. Adolescent curves less than 30° are unlikely to progress significantly into adulthood, while those over 50° are likely to get bigger, which is why adult scoliosis specialists should monitor the curves over time.

Locations
Occurs in the thoracic (upper) and lumbar (lower) spine, with the same basic appearance as that in teenagers, such as shoulder asymmetry, a rib hump, or a prominence of the lower back on the side of the curvature. Curves can worsen in the older patient due to disc degeneration and/or sagittal imbalance. Additionally, arthritis commonly affects joints of the spine and leads to the formation of bone spurs.

Symptoms
Adults with idiopathic scoliosis have more symptoms than teens because of degeneration in discs and joints leading to narrowing of the openings for the spinal sac and nerves (spinal stenosis). Some patients may lean forward to try and open up space for their nerves. Others may lean forward because of loss of their natural curve (lordosis, sway back) in their lumbar spine (low back). The imbalance causes the patients to compensate by bending their hips and knees to try and maintain an upright posture. Adult patients may have a variety of symptoms, which can lead to gradual loss of function:

Low back pain and stiffness are the 2 most common symptoms
Numbness, cramping, and shooting pain in the legs due to pinched nerves
Fatigue results from strain on the muscles of the lower back and legs
Imaging Evaluation
Scoliosis defined with radiographs that can include the following:

Standing x-ray of the entire spine looking both from the back as well as from the side so your physician can measure the radiographs to determine curve magnitude, measured in degrees using the Cobb method.
Magnetic resonance imaging (MRI) study of the spine is rarely used for patients experiencing minimal symptoms with adult idiopathic scoliosis. An MRI is usually ordered if you have leg pain, your physician finds some subtle neurologic abnormalities on physical examination, or if you have significant pain or an "atypical" curve pattern.

Treatment Options
Nonoperative treatment
The majority of adults with idiopathic scoliosis do not have disabling symptoms and can be managed with simple measures including the following:

Periodic observation
Over-the-counter pain relievers
Exercises aimed at strengthening the core muscles of the abdomen and back and improving flexibility
Braces, in short-term use for pain relief (long-term use in adults is discouraged because braces can weaken the core muscles)
Epidurals or nerve block injections for temporary relief if the patient has persistent leg pain and other symptoms due to arthritis and pinched nerves. Patients should track their response to the various injections to help define their pain generators.
Stronger pain medications can also be habit-forming and must be used with caution. If narcotics are needed to control the pain, see a scoliosis surgeon to learn more about the possible causes of pain.

Operative treatment
Surgical treatment is reserved for patients who have:

Failed all reasonable conservative (non-operative) measures.
Disabling back and/or leg pain and spinal imbalance.
Severely restricted functional activities and substantially reduced overall quality of life.
The goals of surgery are to restore spinal balance and reduce pain and discomfort by relieving nerve pressure (decompression) and maintaining corrected alignment by fusing and stabilizing the spinal segments. When patients are carefully chosen and mentally well-prepared for surgery, excellent functional outcomes can be achieved which can provide positive life-changing experience for a given individual patient. When larger surgeries—those greater than 8 hours—are necessary, surgery may be divided into 2 surgeries 5 to 7 days apart. Surgical procedures include:

Microdecompression relieves pressure on the nerves; A small incision is made and magnification loupes or a microscopic assists the surgeon in guiding tools to the operation site. This type of procedure is typically used only at one vertebra level, and carries a risk of causing the curve to worsen, especially in larger curves >30 degrees.
Surgical stabilization involves anchoring hooks, wires or screws to the spinal segments and using metal rods to link the anchors together. They stabilize the spine and allow the spine to fuse in the corrected position.
Fusion uses the patient's own bone or using cadaver or synthetic bone substitutes to "fix" the spine into a straighter position
Osteotomy is a procedure in which spinal segments are cut and realigned
Vertebral column resection removes entire vertebral sections prior to realigning the spine and is used when an osteotomy and other operative measures cannot correct the scoliosis.
system
Take this article and make it into a brief series of questions and answers. Don't use a bullet point list.

Scoliosis
What is Scoliosis?
Everyone's spine has subtle natural curves. But some people have different curves, side-to-side spinal curves that also twist the spine. This condition is called "scoliosis". On an x-ray with a front or rear view of the body, the spine of a person with scoliosis looks more like an "S" or a "C" than a straight line. These curves can make a person's shoulders or waist appear uneven. These curves can't be corrected simply by learning to stand up straight. You can't cause scoliosis; it does not come from carrying heavy backpacks, participating vigorously in sports, or poor posture.

Types of Adult Scoliosis
In addition to the two types of adult scoliosis discussed in this section—Adult Idiopathic Scoliosis and Adult Degenerative Scoliosis—types of scoliosis that develops early in life or that results from a separate syndrome also effect adults.

Adult Idiopathic Scoliosis
Adult idiopathic scoliosis is, in essence, a continuation of adolescent idiopathic scoliosis. Sometimes a spine curvature of an idiopathic (cause not known) nature that began during teenage years may progress during adult life. Curves may increase in size 0.5° to 2° per year. Adolescent curves less than 30° are unlikely to progress significantly into adulthood, while those over 50° are likely to get bigger, which is why adult scoliosis specialists should monitor the curves over time.

Locations
Occurs in the thoracic (upper) and lumbar (lower) spine, with the same basic appearance as that in teenagers, such as shoulder asymmetry, a rib hump, or a prominence of the lower back on the side of the curvature. Curves can worsen in the older patient due to disc degeneration and/or sagittal imbalance. Additionally, arthritis commonly affects joints of the spine and leads to the formation of bone spurs.

Symptoms
Adults with idiopathic scoliosis have more symptoms than teens because of degeneration in discs and joints leading to narrowing of the openings for the spinal sac and nerves (spinal stenosis). Some patients may lean forward to try and open up space for their nerves. Others may lean forward because of loss of their natural curve (lordosis, sway back) in their lumbar spine (low back). The imbalance causes the patients to compensate by bending their hips and knees to try and maintain an upright posture. Adult patients may have a variety of symptoms, which can lead to gradual loss of function:

Low back pain and stiffness are the 2 most common symptoms
Numbness, cramping, and shooting pain in the legs due to pinched nerves
Fatigue results from strain on the muscles of the lower back and legs
Imaging Evaluation
Scoliosis defined with radiographs that can include the following:

Standing x-ray of the entire spine looking both from the back as well as from the side so your physician can measure the radiographs to determine curve magnitude, measured in degrees using the Cobb method.
Magnetic resonance imaging (MRI) study of the spine is rarely used for patients experiencing minimal symptoms with adult idiopathic scoliosis. An MRI is usually ordered if you have leg pain, your physician finds some subtle neurologic abnormalities on physical examination, or if you have significant pain or an "atypical" curve pattern.

Treatment Options
Nonoperative treatment
The majority of adults with idiopathic scoliosis do not have disabling symptoms and can be managed with simple measures including the following:

Periodic observation
Over-the-counter pain relievers
Exercises aimed at strengthening the core muscles of the abdomen and back and improving flexibility
Braces, in short-term use for pain relief (long-term use in adults is discouraged because braces can weaken the core muscles)
Epidurals or nerve block injections for temporary relief if the patient has persistent leg pain and other symptoms due to arthritis and pinched nerves. Patients should track their response to the various injections to help define their pain generators.
Stronger pain medications can also be habit-forming and must be used with caution. If narcotics are needed to control the pain, see a scoliosis surgeon to learn more about the possible causes of pain.

Operative treatment
Surgical treatment is reserved for patients who have:

Failed all reasonable conservative (non-operative) measures.
Disabling back and/or leg pain and spinal imbalance.
Severely restricted functional activities and substantially reduced overall quality of life.
The goals of surgery are to restore spinal balance and reduce pain and discomfort by relieving nerve pressure (decompression) and maintaining corrected alignment by fusing and stabilizing the spinal segments. When patients are carefully chosen and mentally well-prepared for surgery, excellent functional outcomes can be achieved which can provide positive life-changing experience for a given individual patient. When larger surgeries—those greater than 8 hours—are necessary, surgery may be divided into 2 surgeries 5 to 7 days apart. Surgical procedures include:

Microdecompression relieves pressure on the nerves; A small incision is made and magnification loupes or a microscopic assists the surgeon in guiding tools to the operation site. This type of procedure is typically used only at one vertebra level, and carries a risk of causing the curve to worsen, especially in larger curves >30 degrees.
Surgical stabilization involves anchoring hooks, wires or screws to the spinal segments and using metal rods to link the anchors together. They stabilize the spine and allow the spine to fuse in the corrected position.
Fusion uses the patient's own bone or using cadaver or synthetic bone substitutes to "fix" the spine into a straighter position
Osteotomy is a procedure in which spinal segments are cut and realigned
Vertebral column resection removes entire vertebral sections prior to realigning the spine and is used when an osteotomy and other operative measures cannot correct the scoliosis.
user
What is scoliosis? Subtle curves in the spine are normal. When different curves are present, like side-to-side curves which also twist the spine, this is the condition called Scoliosis.

What are the types of adult scoliosis? Adult Idiopathic Scoliosis and Adult Degenerative Scoliosis. The latter develops later in life and the first one usually early in life. These are two different syndromes of scoliosis.

Where are the locations of scoliosis? Scoliosis occurs in several locations. Those include the thoracic, upper spine, lumbar, and lower spine. They appear as shoulder asymmetry, a rib hump, or a prominence where the lower back is located in front of the curvature. 

What causes curves to worsen in older patients? Disc degeneration and/or sagittal imbalance, arthritis which affects joints of the spine. This leads to the formation of bone spurs.

What are the symptoms of adult idiopathic scoliosis? Adults have more symptoms than teens because of the degeneration of discs and joints. Because of this, there is a narrowing of the openings for the spinal sac and nerves which is called spinal stenosis. To alleviate this some patients may lean forward in an attempt to open up space for their nerves. Or they man lean forward because of loss of the natural curve in their lumbar spine which is the lower back. As a result of this imbalance, patients compensate by bending their hips and knees trying to hold an upright position. These symptoms can lead to gradual loss of function. Lower back pain. Lower back stiffness. Numbness, shooting pain in the legs, and or cramping. As a result of fatigue, because of the strain on the muscles of the lower back and legs.

What sort of imaging evaluation is used? A standing X-ray looks at the entire spine from the back and side. This allows the physician to determine the curve magnitude using the Cobb method. Another type of imaging is an MRI (magnetic resonance imaging). This is rarely used unless the patient has more than minimal symptoms of idiopathic scoliosis. If the patient is having leg pain or subtle neurologic abnormalities noticed during physical examination or if the patient is complaining of significant pain or has an atypical curve pattern.

What are the nonoperative treatment options? Periodic observation, over-the-counter pain relievers, exercises to strengthen the core muscles of the back and abdomen as well as stretching for flexibility. Braces are another option but only for short-term pain relief. Long-term usage is not recommended because it weakens the muscles. Epidurals or nerve block injections for temporary relief of leg pain and other symptoms of pinched nerves or arthritis. Narcotics are addicting and should only be used after seeing a scoliosis surgeon to pinpoint the possible causes of the pain.

What are the operative treatments? Operative treatments are only recommended for patients who have not seen improvement using nonoperative treatments or have disabling back or leg pain and spinal imbalance. Another reason would be a greatly reduced overall quality of life. Here are the procedures, Microdecompression, Surgical Stabilization, Fusion, Osteotomy, and Vertebral column resection.

assistant
<|system|>
</s>
<|user|>
Take this article and make it into a brief series of questions and answers. Don't use a bullet point list.

Scoliosis
What is Scoliosis?
Everyone's spine has subtle natural curves. But some people have different curves, side-to-side spinal curves that also twist the spine. This condition is called "scoliosis". On an x-ray with a front or rear view of the body, the spine of a person with scoliosis looks more like an "S" or a "C" than a straight line. These curves can make a person's shoulders or waist appear uneven. These curves can't be corrected simply by learning to stand up straight. You can't cause scoliosis; it does not come from carrying heavy backpacks, participating vigorously in sports, or poor posture.

Types of Adult Scoliosis
In addition to the two types of adult scoliosis discussed in this section—Adult Idiopathic Scoliosis and Adult Degenerative Scoliosis—types of scoliosis that develops early in life or that results from a separate syndrome also effect adults.

Adult Idiopathic Scoliosis
Adult idiopathic scoliosis is, in essence, a continuation of adolescent idiopathic scoliosis. Sometimes a spine curvature of an idiopathic (cause not known) nature that began during teenage years may progress during adult life. Curves may increase in size 0.5° to 2° per year. Adolescent curves less than 30° are unlikely to progress significantly into adulthood, while those over 50° are likely to get bigger, which is why adult scoliosis specialists should monitor the curves over time.

Locations
Occurs in the thoracic (upper) and lumbar (lower) spine, with the same basic appearance as that in teenagers, such as shoulder asymmetry, a rib hump, or a prominence of the lower back on the side of the curvature. Curves can worsen in the older patient due to disc degeneration and/or sagittal imbalance. Additionally, arthritis commonly affects joints of the spine and leads to the formation of bone spurs.

Symptoms
Adults with idiopathic scoliosis have more symptoms than teens because of degeneration in discs and joints leading to narrowing of the openings for the spinal sac and nerves (spinal stenosis). Some patients may lean forward to try and open up space for their nerves. Others may lean forward because of loss of their natural curve (lordosis, sway back) in their lumbar spine (low back). The imbalance causes the patients to compensate by bending their hips and knees to try and maintain an upright posture. Adult patients may have a variety of symptoms, which can lead to gradual loss of function:

Low back pain and stiffness are the 2 most common symptoms
Numbness, cramping, and shooting pain in the legs due to pinched nerves
Fatigue results from strain on the muscles of the lower back and legs
Imaging Evaluation
Scoliosis defined with radiographs that can include the following:

Standing x-ray of the entire spine looking both from the back as well as from the side so your physician can measure the radiographs to determine curve magnitude, measured in degrees using the Cobb method.
Magnetic resonance imaging (MRI) study of the spine is rarely used for patients experiencing minimal symptoms with adult idiopathic scoliosis. An MRI is usually ordered if you have leg pain, your physician finds some subtle neurologic abnormalities on physical examination, or if you have significant pain or an "atypical" curve pattern.

Treatment Options
Nonoperative treatment
The majority of adults with idiopathic scoliosis do not have disabling symptoms and can be managed with simple measures including the following:

Periodic observation
Over-the-counter pain relievers
Exercises aimed at strengthening the core muscles of the abdomen and back and improving flexibility
Braces, in short-term use for pain relief (long-term use in adults is discouraged because braces can weaken the core muscles)
Epidurals or nerve block injections for temporary relief if the patient has persistent leg pain and other symptoms due to arthritis and pinched nerves. Patients should track their response to the various injections to help define their pain generators.
Stronger pain medications can also be habit-forming and must be used with caution. If narcotics are needed to control the pain, see a scoliosis surgeon to learn more about the possible causes of pain.

Operative treatment
Surgical treatment is reserved for patients who have:

Failed all reasonable conservative (non-operative) measures.
Disabling back and/or leg pain and spinal imbalance.
Severely restricted functional activities and substantially reduced overall quality of life.
The goals of surgery are to restore spinal balance and reduce pain and discomfort by relieving nerve pressure (decompression) and maintaining corrected alignment by fusing and stabilizing the spinal segments. When patients are carefully chosen and mentally well-prepared for surgery, excellent functional outcomes can be achieved which can provide positive life-changing experience for a given individual patient. When larger surgeries—those greater than 8 hours—are necessary, surgery may be divided into 2 surgeries 5 to 7 days apart. Surgical procedures include:

Microdecompression relieves pressure on the nerves; A small incision is made and magnification loupes or a microscopic assists the surgeon in guiding tools to the operation site. This type of procedure is typically used only at one vertebra level, and carries a risk of causing the curve to worsen, especially in larger curves >30 degrees.
Surgical stabilization involves anchoring hooks, wires or screws to the spinal segments and using metal rods to link the anchors together. They stabilize the spine and allow the spine to fuse in the corrected position.
Fusion uses the patient's own bone or using cadaver or synthetic bone substitutes to "fix" the spine into a straighter position
Osteotomy is a procedure in which spinal segments are cut and realigned
Vertebral column resection removes entire vertebral sections prior to realigning the spine and is used when an osteotomy and other operative measures cannot correct the scoliosis.</s>
<|assistant|>
What is scoliosis? Subtle curves in the spine are normal. When different curves are present, like side-to-side curves which also twist the spine, this is the condition called Scoliosis.

What are the types of adult scoliosis? Adult Idiopathic Scoliosis and Adult Degenerative Scoliosis. The latter develops later in life and the first one usually early in life. These are two different syndromes of scoliosis.

Where are the locations of scoliosis? Scoliosis occurs in several locations. Those include the thoracic, upper spine, lumbar, and lower spine. They appear as shoulder asymmetry, a rib hump, or a prominence where the lower back is located in front of the curvature. 

What causes curves to worsen in older patients? Disc degeneration and/or sagittal imbalance, arthritis which affects joints of the spine. This leads to the formation of bone spurs.

What are the symptoms of adult idiopathic scoliosis? Adults have more symptoms than teens because of the degeneration of discs and joints. Because of this, there is a narrowing of the openings for the spinal sac and nerves which is called spinal stenosis. To alleviate this some patients may lean forward in an attempt to open up space for their nerves. Or they man lean forward because of loss of the natural curve in their lumbar spine which is the lower back. As a result of this imbalance, patients compensate by bending their hips and knees trying to hold an upright position. These symptoms can lead to gradual loss of function. Lower back pain. Lower back stiffness. Numbness, shooting pain in the legs, and or cramping. As a result of fatigue, because of the strain on the muscles of the lower back and legs.

What sort of imaging evaluation is used? A standing X-ray looks at the entire spine from the back and side. This allows the physician to determine the curve magnitude using the Cobb method. Another type of imaging is an MRI (magnetic resonance imaging). This is rarely used unless the patient has more than minimal symptoms of idiopathic scoliosis. If the patient is having leg pain or subtle neurologic abnormalities noticed during physical examination or if the patient is complaining of significant pain or has an atypical curve pattern.

What are the nonoperative treatment options? Periodic observation, over-the-counter pain relievers, exercises to strengthen the core muscles of the back and abdomen as well as stretching for flexibility. Braces are another option but only for short-term pain relief. Long-term usage is not recommended because it weakens the muscles. Epidurals or nerve block injections for temporary relief of leg pain and other symptoms of pinched nerves or arthritis. Narcotics are addicting and should only be used after seeing a scoliosis surgeon to pinpoint the possible causes of the pain.

What are the operative treatments? Operative treatments are only recommended for patients who have not seen improvement using nonoperative treatments or have disabling back or leg pain and spinal imbalance. Another reason would be a greatly reduced overall quality of life. Here are the procedures, Microdecompression, Surgical Stabilization, Fusion, Osteotomy, and Vertebral column resection.
</s>
