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Outcomes for patients with infantile idiopathic scoliosis by casting table type
Authors:Majd Marrache  Niyathi Prasad  George H Thompson  Ying Li  Michael Glotzbecker  Paul D Sponseller
Affiliation:1.Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA;2.Rainbow Babies and Children’s Hospital, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA;3.Department of Orthopaedic Surgery, C. S. Mott Children’s Hospital, Michigan Medicine, Ann Arbor, MI, USA;4.Department of Orthopaedic Surgery, Boston Children’s Hospital, Boston, MA, USA
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
Keywords:Curve correction   infantile idiopathic scoliosis   Mehta table   Risser table   serial casting   spica table
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