title: Focused Molding Using Adhesive Pads in Mehta Casting for Early-Onset Scoliosis.
abstract: METHODS
  Prospective clinical series.
  
  
  OBJECTIVE
  To determine the effect of adhesive pads placed over the apex of scoliosis curves on curve correction 1) after the first cast and 2) after the final cast.
  
  
  BACKGROUND
  Early-onset scoliosis is often effectively managed by serial casting. Properly localizing the apex of the molds with the cast in place is challenging. The authors explored the effectiveness of a novel technique: incorporation of adhesive pads placed over the major curve apex before Mehta casting.
  
  
  METHODS
  The 27 patients who received body casts (2000-2013) were divided into 2 groups: those without and with apical adhesive pads (5-6 layers of pads placed on the major curve's apex during casting): non-pad (NP) group (n = 12) and pad (P) group (n = 15), respectively. Groups were compared regarding the percentage of Cobb angle change from the first cast and curve correction to a Cobb angle of <25° with Student t and chi-square tests (significance was p < .05).
  
  
  RESULTS
  The mean percentage of major first-cast curve correction was 39% ± 18% and 56% ± 17% in the NP and P groups, respectively. Of the 26 patients out of a cast, 11 (42%) had a Cobb angle of <25°: 3 (25%) and 8 (57%) in the NP and P groups, respectively. The mean differences between the 2 groups in percentage of major curve correction and this Cobb angle correction were significant: p = .023 and .005, respectively.
  
  
  CONCLUSIONS
  Adhesive pads placed over major curve(s) during Mehta casting were effective in increasing the amount of major curve correction from the first cast for idiopathic early-onset scoliosis and in decreasing curves to <25° at final follow-up.
authors.affiliation: SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.
authors.forename: Roby
authors.initials: R
authors.lastname: Abraham
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287, USA. Electronic address: ehenze1@jhmi.edu.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Sponseller
keywords: Adhesive pads; Casting technique; Early-onset scoliosis; Mehta casting