Re: Risser vs Mehta

October 27, 2010

I am unaware of a Resource online that describes the differences between

Risser and Mehta yet......But Im working on it.

Risser casting was developed first and is a 2 dimensional approach to

spine correction/maintenance applied on a huge Risser frame. The frame

doesnt have the ability to control/maintain lordosis. Risser was not

developed to cure infants w/ PIS...Back then, it was used mostly to

hold/correct severe adol./ adult cases and to alleviate their pain. It

was also used in post op recovery for spinal surgeries/fusions.

EDF (elongation, derotation, flexion) was developed in France decades

later and is simply an improvement to the Risser technique, because it

corrects the scoli 3 dimensionally, not 2 dimensionally like a Risser.

EDF was not originally developed for infants and many American orthos

arent exposed to EDF as it was developed in Euro.....It was developed for

adol./adult scoli patients just like Risser. Thats why what Mehta did by

adding EARLY TREATMENT to the EDF mix is so impressive! (to me anyway...)

Living w/ scoli herself, she actually had an original idea! She thought,

Why are we " waiting & watching " these babies progress and suffer so

greatly? She was the 1st ped. ortho to apply her specialized EDF to

rapidly growing infants and started ET back in the 70's!! She actually

learned EDF from one of the EDF inventors (Morel)when she was completing

her residency. She dedicated her entire orthopaedic surgical career to

specializing Early Treatment w/ EDF for babies. She invented the

specialized windows that prevent chest wall deformities and address

rotation, she developed proven ET principles (as in how long to keep

casting, importance of proper materials, how to derotate a babies spine

with the back of your hand and not a strap, etc....She developed so many

specs to make ET work and to make our children as comfortable as possible

while undergoing the ET process.

For babies, Risser doesnt even compare to ET w/ EDF. Its like comparing

apples to oranges or infantile to congenital.

Hope this helps,

Keep the questions coming!

Sincerely,

HRH

> (and all),

>

> Just starting to get caught up on emails...

>

> Yes, her initial doctor's visit said Risser cast. Is there any resouce

> online that talks about Mehta casting or Risser vs Mehta casting? We'd

> like

> to educate ourselves on the hows and especially the whys of the two

> techniques, and why Mehta is going to be better.

>

> Thanks,

>

> On Sat, Oct 23, 2010 at 7:16 AM, <heather@...> wrote:

>

>>

>> I agree 100%. ISOP is thrilled that the original Mehta trained ET Core

>> Group of surgeons are now training others! It will be challenging for

>> ISOP to keep track of everyone who has received training & frames, so we

>> will continue to provide accurate info on Mehtas Early Treatment Method

>> of

>> EDF, so parents can properly advocate for their babes. Our children only

>> have a window of time to be permanently corrected from ET and we must be

>> sure the docs are applying the correct block of EDF casts to our rapidly

>> growing infants.. If parents request a cast, odds are they will get one

>> Risser cast, w/ inappropriate windows and done on a Risser frame. This

>> has happened over and over again during the last 5 yrs and so I will go

>> on

>> continuing to sound like a broken record. Please parents, educate

>> yourself on the differences between old fashioned Risser casting and

>> Early

>> Treatment w/ Mehtas form of EDF, so your baby can benefit from this

>> gentle, corrective treatment modality. And, dont ever hesitate to

>> contact

>> me with questions.

>> Sincerely,

>> HRH

>>

>> > Ami,

>> > This is awesome news. I love to hear new hospitals being added to

>> > the loop with such awesome results. I recently heard from a friend

>> > that two new doctors at Harvard Medical Center have also started

>> > casting. Keep them coming and keep the centers growing. I was very

>> > excited to also hear Lexington Shriners added to the casting world.

>> > That is in our neck of the world. Hopefully the fall tutorial will

>> > be able to catch the west coast. That seems to be the greatest hole

>> > in the states now.

>> >

>> > Great numbers for Miss Abigail! Way to go Boston Childrens!!!

>> >

>> > Sent from my iPhone

>> >

>> > On Oct 20, 2010, at 9:13 PM, " luckyvtmama "

>> <amibeautinet@...<amibeautinet%40>>

>> wrote:

>> >

>> > First off, the hospital treated Abigail's anxiety issues with the

>> utmost

>> > compassion, she came home with a stuffed dog (who had a pink cast on

>> his

>> > midsection!), kept her busy with coloring, crafts, and projects. The

>> Dr.

>> > checked on her twice and the hospital called the day after she came

>> home

>> > to see how she was doing. We have a visiting nurse coming out on

>> Monday

>> > who will be following Abby to make sure the cast is fitting well.

>> There

>> is

>> > LOTS of padding on this cast! *L* She is so comfortable she can run,

>> bend

>> > down, sit down, climb, go potty (except whiping).

>> >

>> > The doctor got her down to 15 degrees from 46! I attribute some of her

>> > increased flexbility to the Bowen Therapy she has been doing and I am

>> > keeping my fingers crossed that between the two treatments she won't

>> need

>> > surgery!! Boston Children's program is new but I think it will grow to

>> be

>> > an invaluable resource for ET with casting.

>> >

>> > She even said to me " I had FUN at the hospital! " wow.

>> >

>> > ~Ami

>> >

>>

>

March 13, 2012

Because Mehta is still considered experimental, most doctors are doing Mehta casting but calling it Risser for insurance purposes. (My son was definitely in a Mehta cast, but the Doc warned me to call it Risser since the hospital didn't approve of Mehta casts. However, since the casts are tailored to the needs of each child, it is technically up to the doctor's discretion as to how they apply it- thus, applying a Risser cast as a Mehta.)In general, though, Mehta casts will have a belly hole. Depending on the child one or no shoulders may be involved. And Mehta casts are applied using a specific casting table sized for children.Other people here know more of the technical stuff than I do but I hope

that helps.M Ross From: Crystal Redner <ljis2007@...> infantile scoliosis treatment Sent: Tuesday, March 13, 2012 11:40 AM Subject: Risser vs Mehta

Hello all,

I am excited to be part of this group. I have a 3 year old son with

Prader-Willi Syndrome and because of this syndrome he has infantile

scoliosis.He was diagnosed at birth, and has been in a Risser cast for

2 years. THey plan to keep him casted(braces in the summer) until he

is strong enough to go through rod surgery in 13 or so years. He was

in a brace for 6 weeks and we lost all our progress in that short

time. His muscle one is very low which is why he has the scoliosis.

So we put him back in a cast. We then tok it off for 6 months as we

were so tired of him being in a cast but again lost all our progress

and got worse. He has been up to a 50 degree curve at the right top of

his spine. We even went to Childen's in Boston and they said the same

that he needs to be casted. So as I have been researching...can anyone

tell me the difference between Risser and Mehta casting? From what I

read we should be doing Mehta not Risser........Thanks for listening

and any advice you can give...Have a great Tuesday

Crystal Redner, Mother to Trevin (3) PWS Colorado

--

Sending Smiles

Crystal

March 13, 2012

Hi Crystal,

My son, Simon, is also 3 years old with PWS! He was in a Risser

cast for a year (with a huge tummy cut-out) and his curve progressed

- he began with a 42 degree curve and ended with a 57 degree curve.

His doctor told us that his spine was too stiff for correction and

put him in a brace to hold the curve until he was old enough for rod

surgery. We then came across an article on the National PWS website

that mentioned Mehta casting as the preferred treatment: http://pwsausa.org/syndrome/Guidelines%20on%20Scoliosis%20Monitoring%20and%20Treatment%20MA-65.pdf

Despite what our doctor said, we had to try all possible options

before resigning ourselves to future surgeries. We are so grateful

to that she pointed us to a doctor in our area that is

trained in EDF/Mehta casting. In his first EDF/Mehta cast, his spine

measured 31 degrees - proving that his spine was NOT too stiff! He

has been in an EDF/Mehta cast for a year and had gotten down to 21

degrees in cast. Unfortunately, he has had a rare reaction to his

growth hormone therapy and has had to be out of cast now for 5

months - YIKES! - we're losing ground, but hoping to get back in

cast soon. We were also told that kids with syndromes take longer to

respond to the casting, but they DO respond. I don't know what the

future will hold for him, as scoliosis has such a mind of its own,

but we're confident that now we're pursuing the best option he has

for avoiding surgery later.

Blessings to you and your precious son!

-Patrice

03/13/2012 9:40 AM, Crystal Redner wrote:

Hello all,

I am excited to be part of this group. I have a 3 year old

son with

Prader-Willi Syndrome and because of this syndrome he has

infantile

scoliosis.He was diagnosed at birth, and has been in a

Risser cast for

2 years. THey plan to keep him casted(braces in the

summer) until he

is strong enough to go through rod surgery in 13 or so

years. He was

in a brace for 6 weeks and we lost all our progress in

that short

time. His muscle one is very low which is why he has the

scoliosis.

So we put him back in a cast. We then tok it off for 6

months as we

were so tired of him being in a cast but again lost all

our progress

and got worse. He has been up to a 50 degree curve at the

right top of

his spine. We even went to Childen's in Boston and they

said the same

that he needs to be casted. So as I have been

researching...can anyone

tell me the difference between Risser and Mehta casting?

From what I

read we should be doing Mehta not Risser........Thanks for

listening

and any advice you can give...Have a great Tuesday

Crystal Redner, Mother to Trevin (3) PWS Colorado

--

Sending Smiles

Crystal

March 13, 2012

OK, so do Mehta have holes in the tummy as well?On Tue, Mar 13, 2012 at 10:30 AM, Patrice Scheck <patrice.scheck@...> wrote:

Crystal,

I just saw from your signature that you're in Colorado. If your son

is having his casting done at Children's in Denver, that would be a

Risser cast.

-Patrice

On 03/13/2012 9:40 AM, Crystal Redner wrote:

Hello all,

I am excited to be part of this group. I have a 3 year old

son with

Prader-Willi Syndrome and because of this syndrome he has

infantile

scoliosis.He was diagnosed at birth, and has been in a

Risser cast for

2 years. THey plan to keep him casted(braces in the

summer) until he

is strong enough to go through rod surgery in 13 or so

years. He was

in a brace for 6 weeks and we lost all our progress in

that short

time. His muscle one is very low which is why he has the

scoliosis.

So we put him back in a cast. We then tok it off for 6

months as we

were so tired of him being in a cast but again lost all

our progress

and got worse. He has been up to a 50 degree curve at the

right top of

his spine. We even went to Childen's in Boston and they

said the same

that he needs to be casted. So as I have been

researching...can anyone

tell me the difference between Risser and Mehta casting?

From what I

read we should be doing Mehta not Risser........Thanks for

listening

and any advice you can give...Have a great Tuesday

Crystal Redner, Mother to Trevin (3) PWS Colorado

--

Sending Smiles

Crystal

-- Sending Smiles :)Crystal

March 13, 2012

Hi Patrice! Nice to meet you! My son has PWS too!

Marina

> >

> > Hello all,

> >

> > I am excited to be part of this group. I have a 3 year old son with

> > Prader-Willi Syndrome and because of this syndrome he has infantile

> > scoliosis.He was diagnosed at birth, and has been in a Risser cast for

> > 2 years. THey plan to keep him casted(braces in the summer) until he

> > is strong enough to go through rod surgery in 13 or so years. He was

> > in a brace for 6 weeks and we lost all our progress in that short

> > time. His muscle one is very low which is why he has the scoliosis.

> > So we put him back in a cast. We then tok it off for 6 months as we

> > were so tired of him being in a cast but again lost all our progress

> > and got worse. He has been up to a 50 degree curve at the right top of

> > his spine. We even went to Childen's in Boston and they said the same

> > that he needs to be casted. So as I have been researching...can anyone

> > tell me the difference between Risser and Mehta casting? From what I

> > read we should be doing Mehta not Risser........Thanks for listening

> > and any advice you can give...Have a great Tuesday

> > Crystal Redner, Mother to Trevin (3) PWS Colorado

> >

> > --

> > Sending Smiles

> > Crystal

> >

>

March 13, 2012

I will for sure call you, how do you get into Shriners? On Tue, Mar 13, 2012 at 12:10 PM, jogen30 <jogen30@...> wrote:

Hi Crystal my son is 3 and has PWS too. We had our first cast put on at the end of Feb at Shriners in Philadelphia. The Mehta cast. The ortho there is knowledgable about scoliosis in PWS. Please send me an email and I will elaborate more. You can also call me 478-235-2039.

marina

Mom to