SCOLIOSIS IN A TRACK AND SOCCER PLAYER

Abstract

HISTORY 14 y/o female who plays soccer and track/cross country presented with low back pain. She has a prior diagnosis of twenty degree levo scoliosis which was discovered one year ago when she had a prior episode of low back pain. This pain resolved after physical therapy and a course of NSAIDs. Current symptoms included right sided back pain after flexion, extension, and rotation of the spine while stretching. She denied any weakness, numbness, tingling of the lower extremities, but was experiencing increasing amounts of pain with running and with sitting and lying down. On occasion, she had experienced two to three/seconds of shooting pain down the lateral aspect of the right thigh. PHYSICAL EXAMINATION Right sided low back pain with lumbar extension and right single leg extension - there was less right sided low back pain with left single leg extension Full range of motion to flexion with right sided paraspinal fullness and tenderness L3-L5 Low back pain on the right with SLR of the right and left lower extremities to 70 degrees Sensation, propioception, motor strength, and reflexes were all normal. DIFFERENTIAL DIAGNOSIS Idiopathic Scoliosis. Paraspinal Spasm. Lumbar Strain. Spondylothiasis/Spondylolysis. TEST AND RESULTS Lateral/oblique/PA xrays of the spine- 22* scoliosis. Bilateral spondylolysis of L5/S1. CAT SCAN of the Lumbosacral Area. Bilateral L5 Spondylolysis. Levoscoliosis with Apex Curve at L3. No Level of Central Spinal Canal or Foraminal Stenosis. FINAL WORKING DIAGNOSIS L5/S1 Spondylolysis with 22* Scoliotic Curve. TREATMENT AND OUTCOMES Immobilition with custom LSO. Physical Therapy. NSAIDs.