My approach to spinal disorders in adults is quite different than children. It needs to be approached first by the cause of the problem. Back pain versus leg or arm pain versus spinal deformities like scoliosis and kyphosis (round back).
It is essential, particularly in adult spinal disorders, to understand the cause of the problem. Most x-rays and MRIs of adults have abnormalities such as bulging discs and arthritis. The crucial part is to understand which, if any, of these abnormalities seen is causing the pain.
Surgical intervention is always the last resort with exercises/physical therapy and injections being the first line of treatment. This is not the case when one has an acute neurologic deterioration such as severe weakness. In those cases, surgery is often urgently needed.