Clinical efficacies of serial casting for early onset scoliosis

Abstract

Objective To evaluate the clinical efficacies of serial casting for early onset scoliosis (EOS) (not using casting bed) and assess its advantages and disadvantages. Methods We retrospectively reviewed a total of 76 serial castings for 13 cases with EOS from January 2008 to July 2013. There were 7 females and 6 males with an average age of 31.6 (5-60) months. They were divided into 2 groups of 2 years old (n=7). They had curves >25 or rib vertebrae angle difference (RVAD) >20 or phase II. The spinal Cobb angles pre and post-treatment as well as the peak inspiratory pressure under intubation anesthesia were measured to evaluate the respiratory functions. Results Each patient required casting at least 4 times. The follow-up period was over 1 year. The mean Cobb angle at pre-treatment was (43.5±12.8), (22.9±12.0) after the first casting and (20.5±7.5) at the final follow-up. There were significant statistical differences with pre-casting values (P 0.05). So did the correcting rate at the final follow-up(P=0.228). The mean peak inspiratory pressure was (17.3±4.7) cm H2O at pre-casting, (34.3±9.1) cm H2O after the first casting and (20.4±5.6) cm H2O after windowing. There was an increase of 22.5% after treatment. Three patients had skin irritation. No respiratory syndrome occurred. Conclusions Serial non-bed casting corrects the Cobb angle. It can also achieve derotating effect on vertebral body. Though not curing older and seriously deformed EOS patients, it may delay operation and reduce operative risks and difficulties. Follow-up till adolescence is needed for reliable clinical decision-making. Key words: Scoliosis; Casts, surgical; Non-operation