"Casting" call: A cure for scoliosis?
BACKGROUND: Scoliosis is a curvature of the spine that usually occurs most often during the growth spurt before puberty. The cause of scoliosis is unknown, but it can be caused by conditions like muscular dystrophy and cerebral palsy. Most cases are mild. However, some children develop spine deformities that continue to get more severe as they grow. Severe scoliosis is very disabling by reducing the amount of space in the chest, making it hard for the lungs to function. For many cases, no treatment is required, but others may need to wear a brace or have to get corrective surgery. Signs that a child has scoliosis include: uneven shoulders, one hip higher than the other, one shoulder blade that appears more prominent than the other, and an uneven waist. Also, if the condition worsens, the spine can rotate and twist, causing the ribs on one side to stick out abnormally. (Source: www.mayoclinic.com)
TREATMENT: Most cases of scoliosis are mild and children won’t need treatment with surgery or a brace. However, the may need checkups every four to six months to monitor the curvature of their spines. If the child’s bones are still growing and they have been diagnosed with a moderate case, then the doctor will suggest a brace to prevent progression. They are usually discontinued after the bones stop growing. There are two types: underarm (low-profile) brace and Milwaukee brace. The underarm brace is plastic and is contoured to fit the body. The Milwaukee brace is a full-torso brace with a neck ring that rests the chin and the back of the head. Surgery is necessary for cases that get worse over time to prevent the severity of scoliosis. The most common type of surgery is spinal fusion. Spinal fusion connects two or more of the bones in the spine together. Pieces of the bone or a similar material are then placed between the vertebrae. Surgery is usually put off until the child is done growing. (Source: www.mayoclinic.com)
NEW TECHNOLOGY: There are various treatment options for scoliosis, but there is a certain technique that could cure it in some kids. It’s a retired method by most, called plaster casting. Parents like this method because it eliminates problems of compliance and the difficulties of an uncooperative child. A study in the UK shows that treating non-congenital scoliosis with casts beginning in children at 12 months with an average curve of 32 degrees, have reduced up to 10 degree at maturity. Patients starting treatment at 18 months, with larger curves averaging 52 degrees achieve less correction, but their deformities can be maintained at a similar degree of magnitude. The goal of casting in children under two years old is curing the scoliosis all together. In order to do so, the cast must be changed every 2 to 3 months. After the casting period is over the child will have to wear a brace. Children who are older can be re-casted for four months to re-correct the deformity before continuing their brace treatment. (Source: Scoliosis Research Society) For parents who are interested, there is a website called infantilescoliosis.org. The Infantile Scoliosis Outreach Program is connecting families of children with infantile scoliosis. ISOP is heightening awareness among the medical community and general public about the importance of early treatment for progressive infantile scoliosis, and helping to provide access to the most progressive care options available to infants and children affected by this condition.
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FOR MORE INFORMATION, PLEASE CONTACT:
James Sanders, MD
Chief of Pediatric Orthopedics
University of Rochester Medical Center
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