Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for evaluation of adolescent idiopathic scoliosis (AIS) involving the lumbar spine. Patient reports [asymptomatic/mild localized back pain]. No history of trauma, neurological deficits, bowel/bladder dysfunction, or radicular symptoms. Family history is [positive/negative] for scoliosis. Menarchal status: [pre-menarchal/post-menarchal].
Clinical Examination Findings
Physical examination reveals a lumbar curvature with [right/left] convexity. Adam’s forward bend test demonstrates a [number] mm rib/lumbar prominence. Shoulder height is [symmetric/asymmetric]. Pelvic tilt is [neutral/tilted]. Neurological exam: motor strength 5/5 in bilateral lower extremities, intact sensation to light touch, and symmetric deep tendon reflexes. No cutaneous stigmata of dysraphism.
Treatment Protocol
Treatment plan: [Observation with serial radiographs every 4-6 months / Bracing (TLSO) for 18-23 hours daily / Surgical consultation for spinal fusion]. Physical therapy initiated for core stabilization and postural awareness. Follow-up scheduled to monitor Cobb angle progression and skeletal maturity (Risser sign).