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Serial Derotational Casting in Idiopathic and Non-Idiopathic Progressive Early-Onset Scoliosis

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Abstract

Introduction

Serial derotational casting has been used as a definitive treatment or as delaying strategy in progressive idiopathic (IS) and non-idiopathic (NIS) early-onset scoliosis (EOS).

Methods

Retrospective chart and radiographic review of patients who underwent serial casting for progressive EOS between 2005 and 2012 at a single institution.

Results

A total of 74 consecutive patients entered serial cast treatment. Twenty-eight were currently being casted, 30 completed cast treatment and were converted to thoracolumbosacral orthosis (TLSO), 9 were treated surgically, 6 were lost to follow-up, and 1 had no further treatment. The researchers diagnosed IS in 41 patients; 33 had NIS. At presentation the IS group had an average Cobb angle (CA) of 49° and a rib vertebral angle difference (RVAD) of 37°. The NIS group had a CA of 51° (p =.69) and RVAD of 37° (p =.94). In patients currently being casted, 19 IS patients had a decreased CA, from 47° to 27°. The 9 NIS patients had a decreased CA, from 62° to 57° (p =.0002). Cobb angle improvement was significantly better in IS (p =.0005). In the TLSO group the 17 IS patients had a decreased average CA, from 46° to 18°, after serial casting and the 13 NIS patients decreased CA from 42° to 32°. Patients with IS had better improvement in CA than the NIS group (p <.001). At last follow-up, this was reduced to 11° in the IS group and maintained at 32° in the NIS. In the IS group, 5 of 41 patients were converted to growth constructs, and 4 of 26 in the NIS group. Casting initiated before age 2 years yielded better curve correction for IS (p <.01) compared with NIS.

Conclusions

Progressive idiopathic scoliosis patients had better curve correction with casting than NIS patients. Casting in IS patients before age 24 months yielded better curve correction. Patients who required surgery had a higher age and Cobb angle at presentation than those who transitioned to a TLSO. The surgical group was observed for a similar duration of time and there was no significant statistical difference. Although RVAD is a predictor of progression in infantile IS, it did not show a predictive value in the response to casting of either the IS or NIS groups.

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References

  1. Mehta MH. Growth as a corrective force in the early treatment of progressive infantile scoliosis. J Bone Joint Surg Br 2005;87:1237–47.

    Article  CAS  Google Scholar 

  2. Cotrel Y, Morel G. The elongation-derotation-flexion technique in the correction of scoliosis. Rev Chir Orthop Réparatrice Appar Mot 1964;50:59–75.

    CAS  PubMed  Google Scholar 

  3. Karol LA. Early definitive spinal fusion in young children: what we have learned. Clin Orthop Relat Res 2011;469:1323–9.

    Article  Google Scholar 

  4. Karol LA, Johnston C, Mladenov K, et al. Pulmonary function following early thoracic fusion in non-neuromuscular scoliosis. J Bone Joint Surg Am 2008;90:1272–81.

    Article  Google Scholar 

  5. Tis JE, Karlin LI, Akbarnia BA, et al. Early onset scoliosis: modern treatment and results. J Pediatr Orthop 2012;32:647–57.

    Article  Google Scholar 

  6. Sankar WN, Skaggs DL, Yazici M, et al. Lengthening of dual growing rods and the law of diminishing returns. Spine (Phila Pa 1976) 2011;36:806–9.

    Article  Google Scholar 

  7. Campbell Jr RM, Smith MD, Mayes TC, et al. The characteristics of thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis. J Bone Joint Surg Am 2003;85:399–408.

    Article  Google Scholar 

  8. James JI, Lloyd-Roberts GC, Pilcher MF. Infantile structural scoliosis. J Bone Joint Surg Br 1959;41:719–35.

    Article  Google Scholar 

  9. Mehta MH. The rib-vertebra angle in the early diagnosis between resolving and progressive infantile scoliosis. J Bone Joint Surg Br 1972;54:230–43.

    Article  CAS  Google Scholar 

  10. Baulesh DM, Huh J, Judkins T, et al. The role of serial casting in early-onset scoliosis (EOS). J Pediatr Orthop 2012;32:658–63.

    Article  Google Scholar 

  11. Sanders JO, D’Astous J, Fitzgerald M, et al. Derotational casting for progressive infantile scoliosis. J Pediatr Orthop 2009;29:581–7.

    Article  Google Scholar 

  12. Fletcher ND, McClung A, Rathjen KE, et al. Serial casting as a delay tactic in the treatment of moderate-to-severe early-onset scoliosis. J Pediatr Orthop 2012;32:664–71.

    Article  Google Scholar 

  13. D’Astous JL, Sanders JO. Casting and traction treatment methods for scoliosis. Orthop Clin North Am 2007;38:477–84. v.

    Article  Google Scholar 

  14. Bess S, Akbarnia BA, Thompson GH, et al. Complications of growing-rod treatment for early-onset scoliosis: analysis of one hundred and forty patients. J Bone Joint Surg Am 2010;92:2533–43.

    Article  Google Scholar 

  15. Badlani N, Korenblit A, Hammerberg K Subclavian vein thrombosis after application of body cast. J Pediatr Orthop 2013;33:e1–3.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedic Surgery, University of Illinois at Chicago, 1801 W Taylor Street, Chicago, IL, 60612, USA

    Yazeed M. Gussous MBBS

  2. Division of Biostatistics, Medical College of Wisconsin, 8701 Watertown Plank Rd, Wauwatosa, WI, 53226, USA

    Sergey Tarima PhD & Shi Zhao MS

  3. Department of Orthopedic Surgery, Ohio State University, 2237 Oxford Rd, Columbus, OH, 43221, USA

    Safdar Khan MD

  4. Shriners Hospitals for Children, 2211 N. Oak Park Avenue, Chicago, IL, 60607, USA

    Angela Caudill MPT & Kim W. Hammerberg MD

  5. Cincinnati Children’s Hospital, 3333 Burnet Avenue, Cincinnati, Ohio, 45229-3026, USA

    Peter Sturm MD

  6. Department of Orthopaedics, Rush University Medical Center, Chicago, IL, USA

    Kim W. Hammerberg MD

Authors
  1. Yazeed M. Gussous MBBS
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  2. Sergey Tarima PhD
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  3. Shi Zhao MS
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  4. Safdar Khan MD
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  5. Angela Caudill MPT
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  6. Peter Sturm MD
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  7. Kim W. Hammerberg MD
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Corresponding author

Correspondence to Kim W. Hammerberg MD.

Additional information

Author disclosures: YMG (none); ST (none); SZ (none); SK (none); AC (none); PS (none); KWH (none).

This study was supported, in part, by Grant 1UL1RR021973 from the Clinical and Translational Science Award program of the National Center for Research Resources, National Institutes of Health.

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Gussous, Y.M., Tarima, S., Zhao, S. et al. Serial Derotational Casting in Idiopathic and Non-Idiopathic Progressive Early-Onset Scoliosis. Spine Deform 3, 233–238 (2015). https://doi.org/10.1016/j.jspd.2014.10.001

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  • DOI: https://doi.org/10.1016/j.jspd.2014.10.001

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