OrthoNet

Spinal Deformity-approach
Approach to Spinal Deformity

History
- who picked it up? - family history
- when was it discovered? - functional disability
- any pain associated with it? ** automatic red flag!
- any weakness or sensory changes?
- any bowel or bladder disturbance?

Physical Examination

- general physical exam
- inspection - shoulder asymmetry, head centered, plumb line
- hairy patches, cutaneous lesions, midline sinuses or clefts
- leg length, pelvic obliquity, foot deformities
- palpation
- flexibility - forward bending (rotation?); lumbosacral increment
- side bending (correctability? Is this thing rigid???), extension
- neurology - gait, toe walking, heel walking, tandem gait, single leg stance and raise
- motor function
- sensory function: light touch, pin prick, vibration and proprioception
- deep tendon reflexes
- abdominal reflexes - stroke the skin towards the umbilicus; lack of umbilical deviation towards the tested
quadrant reflects an upper motor neuron lesion
- plantar response and Hoffman response