title: Serial derotational casting in congenital scoliosis as a time-buying strategy.
abstract: BACKGROUND
  Serial casting is an effective treatment modality in early-onset idiopathic scoliosis; however, the role of this method in congenital scoliosis is not well studied.
  
  
  METHODS
  A total of 11 patients with progressive congenital scoliosis were treated with serial cast application. Age at initial cast application, magnitudes of the congenital, compensatory and sagittal deformities, coronal balance, T1 to T12 height, number of casts and time-in cast per patient, subsequent surgical interventions, and complications were evaluated.
  
  
  RESULTS
  Mean age at the first cast application was 40 months, and the average number of cast changes was 6.2 per patient. There were no major complications. The average precasting curve magnitude was 70.7 degrees (range, 44 to 88 degrees) and was significantly reduced to 55.1 degrees (range, 16 to 78 degrees) at the latest follow-up (P=0.005). The average precasting compensatory curve was 55.8 degrees (range, 38 to 72 degrees) and was significantly reduced to 39.8 degrees (range, 23 to 62 degrees) at the latest follow-up (P=0.017). Average T1 to 12 height increased from 12.8 cm at post-first cast to a 14.6 cm at the latest follow-up (P=0.04). Average time in cast was 26.3 months (range, 13 to 49 mo). During the treatment period, none of the patients required surgery for curve progression.
  
  
  CONCLUSIONS
  Serial derotational casting is a safe and effective time-buying strategy to delay the surgical interventions in congenital deformities in the short-term follow-up.
  
  
  METHODS
  Level IV, case series.
authors.affiliation: *Department of Orthopaedics and Traumatology, Hacettepe University Faculty of Medicine †Department of Orthopaedics and Traumatology, Dr Sami Ulus Children's Hospital, Ankara, Turkey ‡Department of Orthopaedic Surgery, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA.
authors.forename: Halil G
authors.initials: HG
authors.lastname: Demirkiran
authors.forename: Senol
authors.initials: S
authors.lastname: Bekmez
authors.forename: Rustem
authors.initials: R
authors.lastname: Celilov
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ayvaz
authors.forename: Ozgur
authors.initials: O
authors.lastname: Dede
authors.forename: Muharrem
authors.initials: M
authors.lastname: Yazici
mesh_terms: D002370:Casts, Surgical; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods; D018579:Patient Selection; D012189:Retrospective Studies; D012600:Scoliosis / Q000151:congenital / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome; D014421:Turkey