Evaluation of the Functional and Radiological Outcomes of Serial Casting as an Initial Treatment of Congenital Scoliosis

Abstract

Introduction:It has been reported that serial casting is an effective treatment method in early-onset idiopathic scoliosis, but its role in congenital scoliosis has not been clarified. This study aimed to evaluate the efficacy of serial castings in young children with congenital scoliosis and to discuss whether serial casting can be used effectively to delay surgical procedures.Methods:Patients between the ages 2 and 5 years with congenital scoliosis who had a Cobb angle above 25 degrees and had not undergone any surgical treatment between 2016 and 2019 were included in this study. Cast changes were performed at 3-month intervals. Radiographic evaluations were performed on posteroanterior and lateral orthoroentgenograms in the cast on the first day after the cast application and at the last follow-up visit.Results:A total of 10 patients (6 female, 4 male) with long congenital curves with mixed type formation or segmentation anomalies were included in the study. The mean number of cast applications was 4 for each patient (range: 3 to 6). The initial casting age was 3.2 (range: 2-4 years). The mean follow-up period was 15.1 months (range: 12-23 months). The mean precasting Cobb angle was 61.9±13.7 degrees (range: 38-76 degrees), which was reduced to 43.4±12.8 degrees (range: 24-58 degrees) after the initial casting, and it was 48.4±12.6 degrees (range: 28-63 degrees) at the latest follow-up. The mean precasting T1-T12 length was 223±27.3 mm (range: 176-271 mm). After the initial cast application, T1-T12 length was 241.8±27.5 mm (range: 189-285 mm). At the last follow-up, the average T1-T12 length was 254±27.6 mm (198, 290 mm).Conclusion:In early-onset scoliosis, even when growth-friendly methods were occupied, spontaneous fusion may develop. Serial casting under anesthesia allows for lengthening by controlling the progression of the deformity. This method can provide more time for the patient to delay surgical interventions.

Keywords

• congenital scoliosis
• serial casting
• non-surgical scoliosis treatment