Case Study on Right Side Scoliosis Treatment

The following case study demonstrates the effectiveness of physiotherapy to treat and correct spinal deformities present at birth.

Introduction

A young male was diagnosed with Congenital idiopathic scoliosis (CIS) and back pain, localized to the mid-thoracic region. The pain was exacerbated by sporting activities and had been present for a year.

Physical Examination

➢    Right shoulder slightly higher with minimal waistline asymmetry.

➢     Scoliometer measurements: thoracic curve 16°, lumbar 7°.

➢     No clinical leg-length discrepancy or neurological abnormalities.

➢    S.L.R (+) right side

➢    Hip girdle (+ rt side +sd)

➢    Anterior rotator (right side)

➢    Scapular right side

➢    Right side trunk and neck rotation

➢    Q angle decreases

➢    Right side lining on knee

➢    Trunk

➢    Trapezius-spasicity

➢    Lattismus dorsi-spasticity

➢    Right gluteus maximus and minimus found spastic

➢    Right hamstrings and quadriceps also spastic

➢    Right tibial ankle spastic

➢    Right foot dorsiflexion spastic

Radiological Evaluation

•       Digital x ray spine

•       Digital x ray right side scapula

•       Digital x ray neck

•       Digital x ray right knee joint

Diagnosis

The patient was diagnosed with CIS, Lenke 1CN, and underwent posterior spinal fusion (PSF) T4-T12. Pre-operative images showed:-

•        Main thoracic curve Cobb measure: 54 degrees

•       Lumbar curve Cobb measure: 48 degrees

•        Risser 5 (indicating skeletal maturity)

Physiotherapy Management

•       Specific Exercises: Schroth exercises, which focus on correcting spinal alignment and improving posture

•       Strengthening and Stretching: exercises to improve flexibility and strength in the muscles surrounding the spine

•       Breathing Techniques: to improve lung capacity and overall respiratory function

•       Spinal extension

•       Bridging exercise 

•       S.L.R

•       Static quadriceps

•       A.T.M

•       Side lying abduction

•       Spinal rotation exercise

•       Shoulder shrug

•       Isometric neck

•       Standing side lying stretch

•       Palenque

•       Prone S.L.R

Advance Physiotherapy

•       Tapping-on side lying

•       Cupping-latismus dorsi

•       Hydro collateral

•       Rotation exercise

•       Spinal manipulation

•       Spinal adjuscnter-orthotics

•       Trunk socket

•       Opposite hip adjuscment by footwear

Outcome

At the 2-year follow-up, the patient:

•       Participated in athletic activities without back pain or limitation

•        Was satisfied with overall body alignment and shoulder balance

•        Thoracic scoliometer measurement: 5°, lumbar 2°  

Conclusion

The patient was diagnosed with congenital idiopathic scoliosis.We did all physical and radiological examinations and found increased thoracic curve and lumbar curve angle increases. We also found spasticity in upper back and muscles of lower limb. Now, after the 6 years of continuous physiotherapy sessions, the spasticity of upper trunks muscles and lower limbs muscles has reduced. The angle of thoracic curve and lumbar curve has also reduced. The overall quality of life and functional ability has been enhanced.

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About the Author

Dr. Mukesh Kumar is an accomplished healthcare and public health professional with a career spanning physiotherapy, public health, the yoga sciences, and sports medicine. His degrees and certifications include Master’s in Public Health from Lucknow University, Master’s in Physiotherapy (Orthopedics) from Utkal University, PG Diploma in Sports Medicine and Rehabilitation and M.Sc. in Yogic Sciences. Dr. Kumar’s expertise lies in orthopedic rehabilitation, holistic wellness, and grassroots health awareness initiatives. He has worked with organizations such as Health City Hospital, PYSSUM, AKTU, and SGPGIMS, Lucknow. He has served as a guest lecturer in various reputed institutions, mentoring aspiring professionals in hospital administration, physiotherapy, and public health.