Serial Derotational Casting in Congenital Scoliosis as a Time-buying Strategy

Demirkiran, H. Gokhan; Bekmez, Şenol; Celilov, Rustem; Ayvaz, Mehmet; Dede, Özgür; Yazıcı, Muharrem

doi:10.1097/bpo.0000000000000229

Cited by 65 publications

(44 citation statements)

References 25 publications

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“…The mean correction rate was 20.52 ± 9.30% for CS group, which was far below than that of non-CS patients (47.53 ± 13.40%). Consistently, Demirkiran et al have reported a similar correction rate of 22% in 11 CS patients receiving casting treatment [18]. It is worth mentioning that even though the difference in precast Cobb angle between groups did not reach statistical significance, the degree of scoliosis was larger in CS group than in non-CS group by about 10° (58.54 ± 17.55 vs. 48.97 ± 13.98, P = 0.175).…”

Section: Discussionsupporting

confidence: 58%

“…Serial casting has been regarded as an effective treatment to delay the need for first surgery for EOS patients [17, 18]. Fletcher et al have reported that 8 out of 29 EOS patients receiving casting correction have an average of 39 months of delayed surgery [17].…”

Section: Discussionmentioning

confidence: 99%

“…The results show that the major curve Cobb angle and compensatory curve were significantly improved and the mean T1-T12 height also significantly increased at the latest follow-up. Only two patients required growing rod surgery at the latest follow-up, and all patients have an average of 26.3 months of delayed surgery [18]. However, therapeutic efficacy of serial casting on CS was not directly compared with other types of non-CS EOS in the above studies.…”

Section: Introductionmentioning

confidence: 99%

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The therapeutic characteristics of serial casting on congenital scoliosis: a comparison with non-congenital cases from a single-center experience

et al. 2017

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BackgroundThe therapeutic efficacy of serial casting on idiopathic scoliosis has been gradually documented. However, literatures on serial casting for congenital scoliosis (CS) remain extremely rare. This paper aimed to compare the treatment outcomes of serial casting between CS and non-CS patients to comprehensively evaluate the therapeutic characteristics of serial casting on CS patients.MethodsA total of 23 early-onset scoliosis cases were included and divided into congenital scoliosis (CS, n = 8) and non-congenital group (non-CS, n = 15). Therapeutic outcomes including the major curve Cobb angle, thoracic kyphosis angle, lumbar lodosis angle, and thoracic spine growing rate were compared between groups at precast, after the first cast, and at the latest follow-up, respectively.ResultsAll patients received the first cast at the age of 3.25 ± 1.20 years and 5.70 ± 1.18 times of cast corrections. The average casting time was 17.17 ± 3.38 months, and the mean follow-up time was 23.91 ± 12.28 months. Both CS and non-CS groups had significant decrease in Cobb angle after the first cast and at the latest follow-up (all P < 0.05). Cobb angle was significantly lower in non-CS group than in CS group at both time points (all P < 0.01). The correction rate of Cobb angle was significantly higher in non-CS group than in CS group (around 50 vs. 20%, both P < 0.01). The mean thoracic growth rate was significantly lower in CS group than in non-CS group (0.72 ± 0.20 vs. 1.42 ± 0.22 cm/year, P < 0.001). At the latest follow-up, there are 2 cases receiving growing rod surgery, 8 cases wearing a brace, and 13 cases continuing serial casting.ConclusionsAlthough the therapeutic efficacy of casting on CS patients is not as good as that on non-CS patients, casting is still an efficient treatment option for CS patients to delay the need for initial surgery.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The therapeutic characteristics of serial casting on congenital scoliosis: a comparison with non-congenital cases from a single-center experience

et al. 2017

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“…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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“…Korsette werden die durch Fehlbildungen entwickelten Krümmungen nicht beeinflussen, sie eignen sich nicht zur Wachstumslenkung. Es finden sich wenige Literaturhinweise zur konservativen Behandlung dieses Krankheitsbildes [5,35]. Die Wirksamkeit einer Korsettbehandlung kann bei diesen Krankheitsbildern nicht die einer Operation erreichen.…”

Section: Korsetttherapieunclassified

Kongenitale Fehlbildungen der Wirbelsäule im Wachstum

et al. 2016

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Congenital malformations of the spine are caused by genetic and teratogenic factors. By means of asymmetrical longitudinal growth of the spine they can lead to deformity, most commonly to scoliosis. The malformations can be classified as failure of formation, failure of segmentation and mixed-type malformations. The extent of the deformity and its progression are determined by the remaining growth potential and the location and type of malformation. Up to one third of such deformities are associated with some sort of cardiac or urogenital malformation. The treatment concept is typically determined on an individual basis. Mild deformities often remain undetected. Conservative treatment using a brace has no substantial effect on the primary curve but might be helpful in the treatment of long sweeping, flexible, secondary curves. If rapid progression is documented or expected, surgical intervention as early as possible is warranted to prevent secondary structural changes. The surgical treatment should be focused on and limited to the site of malformation. The aim of surgery is the correction of the deformity at the site of asymmetrical growth. This can be achieved either by resection of a hemivertebra or by performing a vertebral column resection or other type of osteotomy. If notable compensatory, secondary curves are present, these can be corrected with growing rod constructs. The aim of all types of treatment is the correction of existing deformity or the prevention of its progression, in order to ensure balanced growth of the healthy regions of the spine. The present paper discusses the conservative and surgical treatment modalities available to achieve these aims.

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Serial Derotational Casting in Congenital Scoliosis as a Time-buying Strategy

Abstract: Level IV, case series.

Cited by 65 publications

References 25 publications

The therapeutic characteristics of serial casting on congenital scoliosis: a comparison with non-congenital cases from a single-center experience

The therapeutic characteristics of serial casting on congenital scoliosis: a comparison with non-congenital cases from a single-center experience

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

Kongenitale Fehlbildungen der Wirbelsäule im Wachstum

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