The Role of Serial Casting in Early-onset Scoliosis (EOS)

Baulesh, David M.; Huh, Jeannie; Judkins, Timothy R.; Garg, Sumeet; Miller, Nancy H.; Erickson, Mark

doi:10.1097/bpo.0b013e318269c438

Cited by 82 publications

(51 citation statements)

References 12 publications

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“…If left untreated, this condition places the patient at risk for further curve progression, pulmonary insufficiency, and early demise. Nonsurgical treatment such as casting can be beneficial to select patients when a temporary delay in surgical intervention is needed, but it may be less effective in patients with more severe and progressive curves [1][2][3]. Spinal fusion in skeletally immature patients may adequately correct the spinal deformity; however, early fusion is known to prevent normal spinal growth and may have deleterious effects on pulmonary development in the growing child [4,5].…”

Section: Introductionmentioning

confidence: 99%

Traditional Growing Rods Versus Magnetically Controlled Growing Rods for the Surgical Treatment of Early-Onset Scoliosis: A Case-Matched 2-Year Study

et al. 2014

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Section: Introductionmentioning

confidence: 99%

Traditional Growing Rods Versus Magnetically Controlled Growing Rods for the Surgical Treatment of Early-Onset Scoliosis: A Case-Matched 2-Year Study

et al. 2014

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“…Normal longitudinal growth of the spine was observed while the patient was in the cast. 28 Based on current evidence, a trial of casting in EOS regardless of curve etiology is considered a treatment option. The specific indications for the threshold to institute cast treatment continue to vary between institutions but are generally considered for EOS curves >25°, with >10° of documented progression.…”

Section: Current Treatment Strategies: Nonoperativementioning

confidence: 99%

“…Serial casting applied to young children with nonidiopathic EOS has been shown to be an effective way to delay surgical treatment. [26][27][28] In 1 study, curve resolution was rare with serial casting in the nonidiopathic EOS, but progression of the curve was controlled sufficiently to delay spine surgery for at least 2 years. Normal longitudinal growth of the spine was observed while the patient was in the cast.…”

Section: Current Treatment Strategies: Nonoperativementioning

confidence: 99%

Early-Onset Scoliosis: A Review of History, Current Treatment, and Future Directions

et al. 2016

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Early-onset scoliosis (EOS) is defined as curvature of the spine in children >10° with onset before age 10 years. Young children with EOS are at risk for impaired pulmonary function because of the high risk of progressive spinal deformity and thoracic constraints during a critical time of lung development. The treatment of EOS is very challenging because the population is inhomogeneous, often medically complex, and often needs multiple surgeries. In the past, early spinal fusion was performed in children with severe progressive EOS, which corrected scoliosis but limited spine and thoracic growth and resulted in poor pulmonary outcomes. The current goal in treatment of EOS is to maximize growth of the spine and thorax by controlling the spinal deformity, with the aim of promoting normal lung development and pulmonary function. Bracing and casting may improve on the natural history of progression of spinal deformity and are often used to delay surgical intervention or in some cases obviate surgery. Recent advances in surgical implants and techniques have led to the development of growth-friendly implants, which have replaced early spine fusion as the surgical treatment of choice. Treatment with growth-friendly implants usually requires multiple surgeries and is associated with frequent complications. However, growth-friendly spine surgery has been shown to correct spinal deformity while allowing growth of the spine and subsequently lung growth.

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“…It is associated with fewer complications than surgical methods of treatment and promotes normal T1eT12 spinal growth during treatment [12]. Complications include skin irritation, prolonged treatment to obtain curve resolution, and the possibility of chest wall constriction with tight casts [2].…”

Section: Discussionmentioning

confidence: 99%