Effective nonoperative treatment in juvenile idiopathic scoliosis

Hessem, Lotte van; Schimmel, Janneke J. P.; Graat, Harm C.A.; Kleuver, Marinus de

doi:10.1097/bpb.0000000000000077

Cited by 12 publications

(11 citation statements)

References 28 publications

(36 reference statements)

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“…Serial EDF casting is able to modulate spinal growth and it can-at least in some cases-prevent the progression of the spinal deformity. Spinal growth can be guided by EDF casting ("positive force" to guide spinal growth) as it can influence the initially curved spine to grow straighter (8,9,22). However, serial EDF casting is not effective for all types of IS and JS.…”

Section: Serial Edf Casting: Delaying Tactic or Definitive Treatment Option?mentioning

confidence: 99%

Serial elongation derotation flexion casting in children with infantile and juvenile scoliosis

Canavese

Diméglio

2020

Ann Transl Med

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Infantile (IS) and juvenile scoliosis (JS) are among the most challenging conditions pediatric orthopedic surgeons are facing in the present days. However, the best treatment of IS and JS is still debated and it remains controversial, at least for some aspects. Untreated early onset spinal deformities may lead to pulmonary and heart compromise. Growth friendly surgical techniques imply multiple distractions with increased risk of auto-fusion, infection and curve stiffening. Serial casting has been proven to be a valuable option to treat children with early onset scoliosis (EOS) in an attempt to delay surgery (in most cases) or to cure the disease (in few cases). More than five decades ago, Cotrel and Morel from France, introduced the Elongation-Derotation-Flexion (EDF) casting technique. EDF cast is a custom-made thoracolumbar cast that corrects the deformed spine three-dimensionally. Serial EDF casting is able to modulate spinal growth and it can-at least in some cases-prevent the progression of the spinal deformity. Today, serial EDF casting technique has become one of the accepted treatment options for the management of children with IS and JS.The main objective of this work is to describe the EDF serial casting technique for the treatment of children with IS and JS, as well as to highlight its advantages and its limits by providing a review of the most recent literature.

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Section: Serial Edf Casting: Delaying Tactic or Definitive Treatment Option?mentioning

confidence: 99%

Serial elongation derotation flexion casting in children with infantile and juvenile scoliosis

Canavese

Diméglio

2020

Ann Transl Med

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“…In particular, Sanders et al found that derotational cast correction played a role in the treatment of progressive infantile scoliosis with cures in young patients and reductions in curve size with a delay in surgery in older and syndromic patients [10,14].…”

Section: Discussionmentioning

confidence: 98%

“…The number of patients included in our study is higher compared to van Hessem et al work [10]. Moreover, in addition to Cobb's angle, we also assessed apical vertebral rotation degree and rib vertebral angle which are expression of the tridimensional nature of the disease [15].…”

Section: Discussionmentioning

confidence: 99%

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Serial elongation, derotation and flexion (EDF) casting under general anesthesia and neuromuscular blocking drugs improve outcome in patients with juvenile scoliosis: preliminary results

Canavese¹,

Botnari²,

Diméglio

et al. 2015

Eur Spine J

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“…Recent reports of casting juvenile scoliosis describe a treatment protocol with only one or two casts and then transitioning to a brace, finding it could prevent surgery. 24 , 25 …”

Section: Discussionmentioning

confidence: 99%

Survey to describe variability in early onset scoliosis cast practices

Grzywna

McClung

Sturm

et al. 2018

Journal of Children's Orthopaedics

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PurposeTo investigate paediatric orthopaedists’ cast practices for early onset scoliosis regarding patient selection, cast application, radiographic evaluation, treatment cessation and adjunctive bracing.MethodsA casting survey was distributed to all paediatric orthopaedists in Children’s Spine and Growing Spine Study Groups (n = 92). Questions included physician and patient characteristics, technique, treatment, outcomes, radiographic measurements and comparison to other treatments. A total of 55 orthopaedists (60%) responded, and descriptive statistics were calculated on the subset who cast (n = 45).ResultsA majority of respondents use cast treatment for idiopathic and syndromic scoliosis patients, but not for neuromuscular or congenital scoliosis patients. Major curve angle ranked most important in orthopaedists’ decision to commence cast treatment, in comparison with rib-vertebra angle difference or clinical observations. The major curve angle threshold to initiate casting was a median of 30° (20° to 70°), and the minimum patient age was median ten months (3 to 24). First in-cast and out-of-cast radiographs are taken standing, supine, awake, under anesthesia and/or in traction. In all, 58% consistently cast over or under the arm, while 44% vary position by patient. Respondents were divided about the use of a brace after cast treatment: 22% do not prescribe a brace, 31% always do and 36% do in some patients.ConclusionsFuture multicentre research studies must standardize radiographic practices and consider age and major curve angle at cast initiation and termination, scoliosis aetiology, shoulder position and treatment duration. Practices need to be aligned or compared in these areas in order to distinguish what makes for the best cast treatment possible.Level of EvidenceV, Expert opinion

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Effective nonoperative treatment in juvenile idiopathic scoliosis

Cited by 12 publications

References 28 publications

Serial elongation derotation flexion casting in children with infantile and juvenile scoliosis

Serial elongation derotation flexion casting in children with infantile and juvenile scoliosis

Serial elongation, derotation and flexion (EDF) casting under general anesthesia and neuromuscular blocking drugs improve outcome in patients with juvenile scoliosis: preliminary results

Survey to describe variability in early onset scoliosis cast practices

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