It can also be seen in syringomyelia, Friedreich's ataxia, spina bifida, kyphoscoliotic Ehlers–Danlos syndrome (kEDS), and Duchenne muscular dystrophy due to asymmetric weakening of the paraspinal muscles.
[3] The decision to choose a particular treatment approach depends on multiple factors such as the age of the patient, understanding the root cause of the condition (i.e. postural, congenital, etc.
Physical therapy may also be advised for other causes as well, to delay the development of abnormal curvatures, such as in the case of elderly patients with a degenerative disease of bones and cartilage.
The primary objective of physical therapy is to strengthen the spinal tissues for either correcting the curvature to the maximum extent possible or limiting further damage.
Surgery is usually indicated when the extent of deformity is large, causes issues in physiological functions such as breathing, interferes with the daily activities or is cosmetically unacceptable to the adult.
[6] The decision to undergo surgery is usually complex, but may become inevitable when the deformity begins to interfere with crucial physiological functions like breathing or makes everyday activities extremely painful.
[citation needed] Sometimes, patients in their early adulthood may choose to have surgery because the presence of such deformity causes social issues such as rejection from their peers, or their disability prevents them from working.
In the case of elderly patients who have such deformity triggered at a later age, other factors are to be considered such as the presence of underlying disease that caused it, whether a progressive decline is expected, and if conservative treatments using physiotherapy or drugs have failed to give relief from debilitating pain.
A study which focused on elderly patients found that the rate of complications was much higher for a sample population of 72 cases with a mean age of 60.7 years.
The study points out that in the case of elderly patients, surgery should only be considered when there is no other option left, the disease is in progression stage, and the quality of life has degraded to an extent where conservative treatments can no longer help with pain.
[10] One of the studies which analyzed pVCR also noted the benefit of using a technique called neurogenic motor evoked potential (NMEP) monitoring in assisting the surgeon to avoid any neurological complications while performing a spine surgery.