Outcomes for patients with infantile idiopathic scoliosis by casting table type

Abstract

Purpose: Serial casting is an effective treatment for infantile idiopathic scoliosis. The most common casting table types are Mehta, Risser, and spica tables. We compared major curve correction between patients with infantile idiopathic scoliosis treated using pediatric hip spica tables versus Risser or Mehta tables. Methods: In this multicenter retrospective study, we included 52 children younger than 3 years (mean ± standard deviation age, 1.6 ± 0.68 years) treated with ≥2 consecutive casts for infantile idiopathic scoliosis between September 2011 and July 2018. We compared major curve angle (measured using the Cobb method) before and after treatment and improvement in curve angle between the spica tables group ( n = 12) and the Risser or Mehta tables group ( n = 40). The primary outcome was the difference in percentage correction of the major curve according to radiographs taken after first casting and at final follow-up. Results: The mean major curve was 47° ± 18° before casting. A median of six casts (range: 2–14) were applied. Mean follow-up after treatment initiation was 22 months (range: 7–86 months). At baseline, the major curve was significantly larger in the spica tables group (58°) than in the Risser or Mehta tables group (43°) ( p = 0.01). We found no differences in the percentage curve correction in the spica tables group versus Risser or Mehta tables group after first casting or at final follow-up. Conclusion: Serial casting was associated with substantial major curve correction in patients with infantile idiopathic scoliosis. Curve correction did not differ between patients treated with a spica table versus a Risser or Mehta table. Level of Evidence: Level III, retrospective cohort study

Institutional Variability in Anesthesia Time for Mehta Casting in Early-Onset Scoliosis (EOS)

“…While the Mehta protocol is well established, there are some institutions that have opted for non-Mehta tables including Traction Frames, Spica tables, Risser, and OSI tables due to the high costs of purchasing Mehta tables or physician preference. 17,[19][20][21] Physicians have reported successful applications of Mehta castings without using specialized tables, however, these results do not take anesthesia time into consideration. 17,19 Mehta tables are specifically designed to allow for easy access to the pa-tient's body while supporting the head and limbs.…”