title: The therapeutic characteristics of serial casting on congenital scoliosis: a comparison with non-congenital cases from a single-center experience.
abstract: BACKGROUND
  The therapeutic efficacy of serial casting on idiopathic scoliosis has been gradually documented. However, literatures on serial casting for congenital scoliosis (CS) remain extremely rare. This paper aimed to compare the treatment outcomes of serial casting between CS and non-CS patients to comprehensively evaluate the therapeutic characteristics of serial casting on CS patients.
  
  
  METHODS
  A total of 23 early-onset scoliosis cases were included and divided into congenital scoliosis (CS, n = 8) and non-congenital group (non-CS, n = 15). Therapeutic outcomes including the major curve Cobb angle, thoracic kyphosis angle, lumbar lodosis angle, and thoracic spine growing rate were compared between groups at precast, after the first cast, and at the latest follow-up, respectively.
  
  
  RESULTS
  All patients received the first cast at the age of 3.25 ± 1.20 years and 5.70 ± 1.18 times of cast corrections. The average casting time was 17.17 ± 3.38 months, and the mean follow-up time was 23.91 ± 12.28 months. Both CS and non-CS groups had significant decrease in Cobb angle after the first cast and at the latest follow-up (all P < 0.05). Cobb angle was significantly lower in non-CS group than in CS group at both time points (all P < 0.01). The correction rate of Cobb angle was significantly higher in non-CS group than in CS group (around 50 vs. 20%, both P < 0.01). The mean thoracic growth rate was significantly lower in CS group than in non-CS group (0.72 ± 0.20 vs. 1.42 ± 0.22 cm/year, P < 0.001). At the latest follow-up, there are 2 cases receiving growing rod surgery, 8 cases wearing a brace, and 13 cases continuing serial casting.
  
  
  CONCLUSIONS
  Although the therapeutic efficacy of casting on CS patients is not as good as that on non-CS patients, casting is still an efficient treatment option for CS patients to delay the need for initial surgery.
authors.affiliation: Orthopedics Department, Beijing Children's Hospital, Capital Medical University, No. 56 NanLiShi Road, West district, Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Cao
authors.affiliation: Orthopedics Department, Beijing Children's Hospital, Capital Medical University, No. 56 NanLiShi Road, West district, Beijing, China. zhang-x-j04@163.com.
authors.forename: Xue-Jun
authors.initials: XJ
authors.lastname: Zhang
authors.affiliation: Orthopedics Department, Beijing Children's Hospital, Capital Medical University, No. 56 NanLiShi Road, West district, Beijing, China. sunning@bcn.com.cn.
authors.forename: Ning
authors.initials: N
authors.lastname: Sun
authors.affiliation: Orthopedics Department, Beijing Children's Hospital, Capital Medical University, No. 56 NanLiShi Road, West district, Beijing, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Sun
authors.affiliation: Orthopedics Department, Beijing Children's Hospital, Capital Medical University, No. 56 NanLiShi Road, West district, Beijing, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Guo
authors.affiliation: Orthopedics Department, Beijing Children's Hospital, Capital Medical University, No. 56 NanLiShi Road, West district, Beijing, China.
authors.forename: Xin-Yu
authors.initials: XY
authors.lastname: Qi
authors.affiliation: Orthopedics Department, Beijing Children's Hospital, Capital Medical University, No. 56 NanLiShi Road, West district, Beijing, China.
authors.forename: Yun-Song
authors.initials: YS
authors.lastname: Bai
authors.affiliation: Orthopedics Department, Beijing Children's Hospital, Capital Medical University, No. 56 NanLiShi Road, West district, Beijing, China.
authors.forename: Bao-Sheng
authors.initials: BS
authors.lastname: Sun
mesh_terms: D002370:Casts, Surgical / Q000009:adverse effects / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012600:Scoliosis / Q000151:congenital / Q000628:therapy*; D016896:Treatment Outcome
keywords: Congenital scoliosis; Early-onset scoliosis; Serial casting