Concluded Case

Lumbar spondylosis with compensatory scoliosis

63yrs/M scoliosis of lumbar spine alongwith lumbar spine spondylosis with multiple level degenerative discs. Experts opinion regarding treatment...

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C/O Back pain since 4 yrs Past medical history: oral cancer Aggravating factors: prolonged sitting,long standing and in extension. Relieving factors: while lying . O/E motor weakness is noted on upper limb, there is no involvement of bowel bladder, L4 dermatome is noted, breathing insufficiency is noted, decreased chest expansion, forward head posture is present. Occupation: retired professor Thank You Doctor

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C/O Back pain since 4 yrs Past medical history: oral cancer Aggravating factors: prolonged sitting,long standing and in extension. Relieving factors: while lying . O/E motor weakness is noted on upper limb, there is no involvement of bowel bladder, L4 dermatome is noted, breathing insufficiency is noted, decreased chest expansion, forward head posture is present. Occupation: retired professor Thank You Doctor

In view of this history, check for Vit D levels and start with gentle stretching of pectorals, chin tucks or teaching a more neutral neck posture, work on scapular strength and pelvic strength by simple bridging and core muscle work. Avoid abdominal crunches or deep extension exercises, work in midrange isometrics.. more of functional training and breathing exercises, chest expansion. If patient needs a lumbar corset you can prescribe one and teach the correct method of wearing it in lying down posture. I am not good at MRI reading so suggest Dr. Riju N to comment if any metastasis is seen or suspected and then the medical management will change accordingly. Physiotherapy management more like geriatric case of deconditioning.
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Thank you for your query... What are the patients symptoms , chief complaints , occupation ? Does he have any motor weakness, sensory loss, bowel bladder involvement, which dermatomes, which myotomes ? All these answers in conjunction with MRI and Xray report will be used to plan treatment...

Please specify symptoms Need sagittal sections of MRI for further comments

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