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I am a healthy and active senior (age 70-something). My doctor tells me I have degenerative scoliosis. I'm not going to let this get me down. Please tell me what I can do to stay in good health.

A basic health plan for any condition consists of staying adequately hydrated (clear liquids such as water, herbal teas), taking in good nutrition, and exercising daily. Your exercise program should include core (abdominal and trunk) strengthening. Stretching to maintain flexibility is important. And getting your heart rate up to improve cardiovascular endurance is advised. If your physician has approved going ahead with an exercise program, seek the help of a physical therapist. He or she can get you started and guide you through the process. An aquatics (pool) program can be especially helpful. You'll be able to work on all these components of exercise at the same time in a safe environment. The therapist will also evaluate you for a lumbar support (brace or corset). Supportive bracing can offer temporary relief from symptoms until you are able to build up your core muscles to stabilize your spine. If your pain and limitations are extreme, then surgery may be needed. Most physicians would recommend following a three-to-six month program of conservative (nonoperative) care first before considering surgery. When surgery is indicated, a decompressive laminectomy is performed. The piece of bone that is pressing on the spinal nerve is removed. Usually more than one level is done at a time. Spinal fusion is carried out at the same time. This restores stability while taking pressure off the nerve roots. The use of metal rods helps stabilize the spine and reduce or correct spinal deformity from the scoliosis. There are many factors to consider when doing this type of complex surgical procedure. And since most patients are 65 years old or older, there are often additional health concerns. The risk of complications, failed surgery, and need for a revision procedure make surgical treatment a distant second choice after nonoperative care.

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