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Where surgery was the standard, casting may be the future
Date:9/30/2009

When parents are told their babies' scoliosis needs treatment, they often try bracing first. If that fails, they need surgery to place metal rods in their backs with spinal fusion later on. These children face the risk of complications from the surgery and their backs and chests may be stiff for life.

New research from the University of Rochester Medical Center (URMC) challenges that treatment convention and may lead doctors to choose to tweak an old technology casting over using high-tech implantable devices. Casting has fewer, and less serious, potential complications, and it requires no surgery. In fact, with the right training and equipment, the specialized, series of casts can be done as outpatient procedures.

"Best of all, we can cure some children with progressive infantile scoliosis, something we can't do with surgery and devices," said James O. Sanders, M.D., chief of Pediatric Orthopaedics at the URMC and author of the research published in this month's Journal of Pediatric Orthopedics. "If we cast these children before their curvatures become severe and before they turn 2, our chances of avoiding surgery and potentially curing them are much better."

The study followed 55 patients with progressive infantile scoliosis (or early-onset scoliosis) a rare and potentially fatal form of spinal curvature, at Shriners Hospitals for Children in Erie, Pa., Salt Lake City and Chicago. Pediatric orthopaedic specialists used a method of casting, called EDF (for extension, derotation and flexion) that capitalizes on children's rapid growth to untwist and un-curve their spines over time. The method uses a specialized table and casts with strategically placed holes Sanders and URMC colleague Paul Rubery, M.D., an orthopaedic surgeon, are two of only a handful of surgeons nationwide who use this specialized method with the goal of curing, not just delaying surgery.

Children are given anesthesia and ventilated during the ca
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Contact: Heather Hare
heather_hare@urmc.rochester.edu
585-273-2840
University of Rochester Medical Center
Source:Eurekalert

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