Guest guest Posted October 29, 2010 Report Share Posted October 29, 2010 So, they are doing Risser in Boston? Its def not Early Treatment w/ EDF (applied under age 2, when its most effective).. I agree that its promising and hopeful for future children w/ slowly progressing curves perhaps, but clearly they are not applying ET. Im actually saddened by this article as well. HRH > > I know there are some patients of Dr E's in the group. Perhaps their > kiddos were included in this study. > Not a lot of new information...(more success when treated young and with > smaller curves) as we already know. Still, it's always nice to see > published research supporting casting.~ > > Risser Casting for Infantile Idiopathic Scoliosis: Efficacy > andComplicationsSunday, October 3, 2010: 8:28 AM Union Square > (Intercontinental Hotel) M. Baulesh, BA, Judkins, MD and Mark > A. kson, MD,Orthopaedics, The Children's Hospital, Aurora, COPurpose: > To evaluate the complication rate associated with Rissercasting when > managing progressive infantile idiopathic scoliosis (IIS),and to determine > if Risser casting can effectively correct or diminishthe progression of > these scoliotic curves in the 30 day-old to 3year-old infant > population.Methods: For this retrospective study, charts and radiographs > of 22patients who underwent serial Risser casting for the management > ofprogressive IIS from January 2005 – December 2009 were reviewed.Patients > were excluded if they did not have IIS, did not start castingmanagement > before the age of 4 years-old, or did not finish theirtreatment at our > facility.Pre-casting and post-casting Cobb angles and rib vertebral > angledifferences (RVAD) were measured from pre-existing radiographs taken > aspart of routine clinical care. Charts were reviewed for age, > diagnosis,outcomes, complications, number of casts, and length of > casting.Results: The average age at time of first casting was 24 months [3 > –47 months]. The average number of casts used per patient was 7.4 [2– 20 > casts] over an average timeframe of 13 months [2 – 48months].The mean Cobb > angle pre-casting was 46.64 degrees [26 – 70, SD11.99] compared to 28.27 > degrees [5 – 65; SD 15.97] post-casting,revealing an average improvement > of 18.37 degrees [p<0.0001]. The meanRVAD pre-casting was 25.90 degrees [8 > – 50; SD 11.37] compared to21.55 degrees [2 – 45; SD 13.83] post-casting, > showing an averageimprovement of 4.35 degrees [p=0.087].Two patients' > curves (9.1%) progressed despite casting and wereconverted to surgical > intervention. The remaining 20 patients (90.9%)were successfully managed > with Risser casting until conversion toremovable braces.Overall, two minor > but noteworthy complications were seen; pulmonaryconstriction and > pneumonia that improved after the removal of the cast,and the need for > immediate repeat casting due to curve decomposition.Both patients > recovered completely and went onto continue management viaRisser > casting.Conclusion: Risser body casting is a safe and effective > alternative formanaging progressive IIS, successfully staving off surgery > in over 90%of patients and therefore allowing for more normal spinal > growth. Astatistically significant improvement in Cobb angle of over 18 > degreeswas observed. However, patients with Cobb angles greater than 55 > degreesand large RVAD measurements are at risk for cast management > failure.Risser cast management is not without risks and early surgery > maybebeneficial for select patients > > ~ > Noah 5 years old > 9 months of casting in SLC; 2 1/2 years of bracing; Currently > treatment-free at 8* > And Mariella 1 yr old - resolved Infantile Scoliosis > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2010 Report Share Posted October 29, 2010 I believe this study was conduted by Dr. E out of Children's Hospital in Aurora, Colorado; not Dr. E at Children Hospital of Boston. > > So, they are doing Risser in Boston? Its def not Early Treatment w/ EDF > (applied under age 2, when its most effective).. > I agree that its promising and hopeful for future children w/ slowly > progressing curves perhaps, but clearly they are not applying ET. Im > actually saddened by this article as well. > HRH > > > > > > I know there are some patients of Dr E's in the group. Perhaps their > > kiddos were included in this study. > > Not a lot of new information...(more success when treated young and with > > smaller curves) as we already know. Still, it's always nice to see > > published research supporting casting.~ > > > > Risser Casting for Infantile Idiopathic Scoliosis: Efficacy > > andComplicationsSunday, October 3, 2010: 8:28 AM Union Square > > (Intercontinental Hotel) M. Baulesh, BA, Judkins, MD and Mark > > A. kson, MD,Orthopaedics, The Children's Hospital, Aurora, COPurpose: > > To evaluate the complication rate associated with Rissercasting when > > managing progressive infantile idiopathic scoliosis (IIS),and to determine > > if Risser casting can effectively correct or diminishthe progression of > > these scoliotic curves in the 30 day-old to 3year-old infant > > population.Methods: For this retrospective study, charts and radiographs > > of 22patients who underwent serial Risser casting for the management > > ofprogressive IIS from January 2005 – December 2009 were reviewed.Patients > > were excluded if they did not have IIS, did not start castingmanagement > > before the age of 4 years-old, or did not finish theirtreatment at our > > facility.Pre-casting and post-casting Cobb angles and rib vertebral > > angledifferences (RVAD) were measured from pre-existing radiographs taken > > aspart of routine clinical care. Charts were reviewed for age, > > diagnosis,outcomes, complications, number of casts, and length of > > casting.Results: The average age at time of first casting was 24 months [3 > > –47 months]. The average number of casts used per patient was 7.4 [2– 20 > > casts] over an average timeframe of 13 months [2 – 48months].The mean Cobb > > angle pre-casting was 46.64 degrees [26 – 70, SD11.99] compared to 28.27 > > degrees [5 – 65; SD 15.97] post-casting,revealing an average improvement > > of 18.37 degrees [p<0.0001]. The meanRVAD pre-casting was 25.90 degrees [8 > > – 50; SD 11.37] compared to21.55 degrees [2 – 45; SD 13.83] post-casting, > > showing an averageimprovement of 4.35 degrees [p=0.087].Two patients' > > curves (9.1%) progressed despite casting and wereconverted to surgical > > intervention. The remaining 20 patients (90.9%)were successfully managed > > with Risser casting until conversion toremovable braces.Overall, two minor > > but noteworthy complications were seen; pulmonaryconstriction and > > pneumonia that improved after the removal of the cast,and the need for > > immediate repeat casting due to curve decomposition.Both patients > > recovered completely and went onto continue management viaRisser > > casting.Conclusion: Risser body casting is a safe and effective > > alternative formanaging progressive IIS, successfully staving off surgery > > in over 90%of patients and therefore allowing for more normal spinal > > growth. Astatistically significant improvement in Cobb angle of over 18 > > degreeswas observed. However, patients with Cobb angles greater than 55 > > degreesand large RVAD measurements are at risk for cast management > > failure.Risser cast management is not without risks and early surgery > > maybebeneficial for select patients > > > > ~ > > Noah 5 years old > > 9 months of casting in SLC; 2 1/2 years of bracing; Currently > > treatment-free at 8* > > And Mariella 1 yr old - resolved Infantile Scoliosis > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2010 Report Share Posted October 29, 2010 Thanks for not speed reading the article like I did. Sorry. Well, Im even more confused at what exactly their doing here at the Childrens Hosp here in Denver/Aurora.....ISOP helped them get a proper frame, so Im not sure why this would be titled Risser and Im not sure why they would start the casting process at 3 yrs.....?? Surely, they've glimpsed at original article on ET by Mehta in JBJS 2005...Glad we held the mini ETP in July here in Denver and we know that The New Rocky Mtn Childrens Hospital in Denver is following ET principles because they have been properly trained and have a frame. The new docs name is up on the list. HRH > I believe this study was conduted by Dr. E out of Children's Hospital in > Aurora, Colorado; not Dr. E at Children Hospital of Boston. > > >> >> So, they are doing Risser in Boston? Its def not Early Treatment w/ EDF >> (applied under age 2, when its most effective).. >> I agree that its promising and hopeful for future children w/ slowly >> progressing curves perhaps, but clearly they are not applying ET. Im >> actually saddened by this article as well. >> HRH >> >> >> > >> > I know there are some patients of Dr E's in the group. Perhaps their >> > kiddos were included in this study. >> > Not a lot of new information...(more success when treated young and >> with >> > smaller curves) as we already know. Still, it's always nice to see >> > published research supporting casting.~ >> > >> > Risser Casting for Infantile Idiopathic Scoliosis: Efficacy >> > andComplicationsSunday, October 3, 2010: 8:28 AM Union Square >> > (Intercontinental Hotel) M. Baulesh, BA, Judkins, MD and >> Mark >> > A. kson, MD,Orthopaedics, The Children's Hospital, Aurora, >> COPurpose: >> > To evaluate the complication rate associated with Rissercasting when >> > managing progressive infantile idiopathic scoliosis (IIS),and to >> determine >> > if Risser casting can effectively correct or diminishthe progression >> of >> > these scoliotic curves in the 30 day-old to 3year-old infant >> > population.Methods: For this retrospective study, charts and >> radiographs >> > of 22patients who underwent serial Risser casting for the management >> > ofprogressive IIS from January 2005 – December 2009 were >> reviewed.Patients >> > were excluded if they did not have IIS, did not start >> castingmanagement >> > before the age of 4 years-old, or did not finish theirtreatment at our >> > facility.Pre-casting and post-casting Cobb angles and rib vertebral >> > angledifferences (RVAD) were measured from pre-existing radiographs >> taken >> > aspart of routine clinical care. Charts were reviewed for age, >> > diagnosis,outcomes, complications, number of casts, and length of >> > casting.Results: The average age at time of first casting was 24 >> months [3 >> > –47 months]. The average number of casts used per patient was 7.4 [2– >> 20 >> > casts] over an average timeframe of 13 months [2 – 48months].The mean >> Cobb >> > angle pre-casting was 46.64 degrees [26 – 70, SD11.99] compared to >> 28.27 >> > degrees [5 – 65; SD 15.97] post-casting,revealing an average >> improvement >> > of 18.37 degrees [p<0.0001]. The meanRVAD pre-casting was 25.90 >> degrees [8 >> > – 50; SD 11.37] compared to21.55 degrees [2 – 45; SD 13.83] >> post-casting, >> > showing an averageimprovement of 4.35 degrees [p=0.087].Two patients' >> > curves (9.1%) progressed despite casting and wereconverted to surgical >> > intervention. The remaining 20 patients (90.9%)were successfully >> managed >> > with Risser casting until conversion toremovable braces.Overall, two >> minor >> > but noteworthy complications were seen; pulmonaryconstriction and >> > pneumonia that improved after the removal of the cast,and the need for >> > immediate repeat casting due to curve decomposition.Both patients >> > recovered completely and went onto continue management viaRisser >> > casting.Conclusion: Risser body casting is a safe and effective >> > alternative formanaging progressive IIS, successfully staving off >> surgery >> > in over 90%of patients and therefore allowing for more normal spinal >> > growth. Astatistically significant improvement in Cobb angle of over >> 18 >> > degreeswas observed. However, patients with Cobb angles greater than >> 55 >> > degreesand large RVAD measurements are at risk for cast management >> > failure.Risser cast management is not without risks and early surgery >> > maybebeneficial for select patients >> > >> > ~ >> > Noah 5 years old >> > 9 months of casting in SLC; 2 1/2 years of bracing; Currently >> > treatment-free at 8* >> > And Mariella 1 yr old - resolved Infantile Scoliosis >> > >> > >> > >> > >> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2010 Report Share Posted October 30, 2010 Yep, it's Dr kson in CO. I know there are (or were) some patients on the group that were casting with him.The study was on children 3 days old to 3 years old. Children were excluded if they were 4 or older. The avg age of the study group was 24 months old.I believe (similar to Greenville) this may be just a case of a doc using the Risser term, but applying the Mehta style of casts. I don't know that for a fact of course since the study summary doesn't include pics or mention rotation. I'll post the full study when/if it's available. Or perhaps if there's anyone still on the group that see's Dr E they could chime in.~Noah 5 years old9 months of casting in SLC; 2 1/2 years of bracing; Currently treatment-free at 8*And Mariella 1 yr old - resolved Infantile Scoliosisinfantile scoliosis treatment From: heather@...Date: Fri, 29 Oct 2010 15:32:05 -0400Subject: Re: Re: Dr E's new study Thanks for not speed reading the article like I did. Sorry. Well, Im even more confused at what exactly their doing here at the Childrens Hosp here in Denver/Aurora.....ISOP helped them get a proper frame, so Im not sure why this would be titled Risser and Im not sure why they would start the casting process at 3 yrs.....?? Surely, they've glimpsed at original article on ET by Mehta in JBJS 2005...Glad we held the mini ETP in July here in Denver and we know that The New Rocky Mtn Childrens Hospital in Denver is following ET principles because they have been properly trained and have a frame. The new docs name is up on the list. HRH > I believe this study was conduted by Dr. E out of Children's Hospital in > Aurora, Colorado; not Dr. E at Children Hospital of Boston. > > >> >> So, they are doing Risser in Boston? Its def not Early Treatment w/ EDF >> (applied under age 2, when its most effective).. >> I agree that its promising and hopeful for future children w/ slowly >> progressing curves perhaps, but clearly they are not applying ET. Im >> actually saddened by this article as well. >> HRH >> >> >> > >> > I know there are some patients of Dr E's in the group. Perhaps their >> > kiddos were included in this study. >> > Not a lot of new information...(more success when treated young and >> with >> > smaller curves) as we already know. Still, it's always nice to see >> > published research supporting casting.~ >> > >> > Risser Casting for Infantile Idiopathic Scoliosis: Efficacy >> > andComplicationsSunday, October 3, 2010: 8:28 AM Union Square >> > (Intercontinental Hotel) M. Baulesh, BA, Judkins, MD and >> Mark >> > A. kson, MD,Orthopaedics, The Children's Hospital, Aurora, >> COPurpose: >> > To evaluate the complication rate associated with Rissercasting when >> > managing progressive infantile idiopathic scoliosis (IIS),and to >> determine >> > if Risser casting can effectively correct or diminishthe progression >> of >> > these scoliotic curves in the 30 day-old to 3year-old infant >> > population.Methods: For this retrospective study, charts and >> radiographs >> > of 22patients who underwent serial Risser casting for the management >> > ofprogressive IIS from January 2005 – December 2009 were >> reviewed.Patients >> > were excluded if they did not have IIS, did not start >> castingmanagement >> > before the age of 4 years-old, or did not finish theirtreatment at our >> > facility.Pre-casting and post-casting Cobb angles and rib vertebral >> > angledifferences (RVAD) were measured from pre-existing radiographs >> taken >> > aspart of routine clinical care. Charts were reviewed for age, >> > diagnosis,outcomes, complications, number of casts, and length of >> > casting.Results: The average age at time of first casting was 24 >> months [3 >> > –47 months]. The average number of casts used per patient was 7.4 [2– >> 20 >> > casts] over an average timeframe of 13 months [2 – 48months].The mean >> Cobb >> > angle pre-casting was 46.64 degrees [26 – 70, SD11.99] compared to >> 28.27 >> > degrees [5 – 65; SD 15.97] post-casting,revealing an average >> improvement >> > of 18.37 degrees [p<0.0001]. The meanRVAD pre-casting was 25.90 >> degrees [8 >> > – 50; SD 11.37] compared to21.55 degrees [2 – 45; SD 13.83] >> post-casting, >> > showing an averageimprovement of 4.35 degrees [p=0.087].Two patients' >> > curves (9.1%) progressed despite casting and wereconverted to surgical >> > intervention. The remaining 20 patients (90.9%)were successfully >> managed >> > with Risser casting until conversion toremovable braces.Overall, two >> minor >> > but noteworthy complications were seen; pulmonaryconstriction and >> > pneumonia that improved after the removal of the cast,and the need for >> > immediate repeat casting due to curve decomposition.Both patients >> > recovered completely and went onto continue management viaRisser >> > casting.Conclusion: Risser body casting is a safe and effective >> > alternative formanaging progressive IIS, successfully staving off >> surgery >> > in over 90%of patients and therefore allowing for more normal spinal >> > growth. Astatistically significant improvement in Cobb angle of over >> 18 >> > degreeswas observed. However, patients with Cobb angles greater than >> 55 >> > degreesand large RVAD measurements are at risk for cast management >> > failure.Risser cast management is not without risks and early surgery >> > maybebeneficial for select patients >> > >> > ~ >> > Noah 5 years old >> > 9 months of casting in SLC; 2 1/2 years of bracing; Currently >> > treatment-free at 8* >> > And Mariella 1 yr old - resolved Infantile Scoliosis >> > >> > >> > >> > >> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2010 Report Share Posted October 30, 2010 and Sorry don't have internet right now so been trying to keep up on my phone. Devyn was part of this study and he was casted starting at 18months to right after he turned 1yr. They do have the proper frame and do look at rotation. They do not do the mushroom tummy cut out or the cut outs in the back for the rotation. You can look at devyn's pic's in the photo section. The full study should have pic's of the kids in the OR after cast removal's and prior to the new ones being put on. The measured and took pictures everytime we went in even this last year for his checkup xray. I had to sign release papers for all of this. Hope this helps with your questions. Rochelle mom to devyn 5yrs old infantile scoliosis(0 degrees) chiari 1 > > >> > > >> So, they are doing Risser in Boston? Its def not Early Treatment w/ EDF > > >> (applied under age 2, when its most effective).. > > >> I agree that its promising and hopeful for future children w/ slowly > > >> progressing curves perhaps, but clearly they are not applying ET. Im > > >> actually saddened by this article as well. > > >> HRH > > >> > > >> > > >> > > > >> > I know there are some patients of Dr E's in the group. Perhaps their > > >> > kiddos were included in this study. > > >> > Not a lot of new information...(more success when treated young and > > >> with > > >> > smaller curves) as we already know. Still, it's always nice to see > > >> > published research supporting casting.~ > > >> > > > >> > Risser Casting for Infantile Idiopathic Scoliosis: Efficacy > > >> > andComplicationsSunday, October 3, 2010: 8:28 AM Union Square > > >> > (Intercontinental Hotel) M. Baulesh, BA, Judkins, MD and > > >> Mark > > >> > A. kson, MD,Orthopaedics, The Children's Hospital, Aurora, > > >> COPurpose: > > >> > To evaluate the complication rate associated with Rissercasting when > > >> > managing progressive infantile idiopathic scoliosis (IIS),and to > > >> determine > > >> > if Risser casting can effectively correct or diminishthe progression > > >> of > > >> > these scoliotic curves in the 30 day-old to 3year-old infant > > >> > population.Methods: For this retrospective study, charts and > > >> radiographs > > >> > of 22patients who underwent serial Risser casting for the management > > >> > ofprogressive IIS from January 2005 – December 2009 were > > >> reviewed.Patients > > >> > were excluded if they did not have IIS, did not start > > >> castingmanagement > > >> > before the age of 4 years-old, or did not finish theirtreatment at our > > >> > facility.Pre-casting and post-casting Cobb angles and rib vertebral > > >> > angledifferences (RVAD) were measured from pre-existing radiographs > > >> taken > > >> > aspart of routine clinical care. Charts were reviewed for age, > > >> > diagnosis,outcomes, complications, number of casts, and length of > > >> > casting.Results: The average age at time of first casting was 24 > > >> months [3 > > >> > –47 months]. The average number of casts used per patient was 7.4 [2– > > >> 20 > > >> > casts] over an average timeframe of 13 months [2 – 48months].The mean > > >> Cobb > > >> > angle pre-casting was 46.64 degrees [26 – 70, SD11.99] compared to > > >> 28.27 > > >> > degrees [5 – 65; SD 15.97] post-casting,revealing an average > > >> improvement > > >> > of 18.37 degrees [p<0.0001]. The meanRVAD pre-casting was 25.90 > > >> degrees [8 > > >> > – 50; SD 11.37] compared to21.55 degrees [2 – 45; SD 13.83] > > >> post-casting, > > >> > showing an averageimprovement of 4.35 degrees [p=0.087].Two patients' > > >> > curves (9.1%) progressed despite casting and wereconverted to surgical > > >> > intervention. The remaining 20 patients (90.9%)were successfully > > >> managed > > >> > with Risser casting until conversion toremovable braces.Overall, two > > >> minor > > >> > but noteworthy complications were seen; pulmonaryconstriction and > > >> > pneumonia that improved after the removal of the cast,and the need for > > >> > immediate repeat casting due to curve decomposition.Both patients > > >> > recovered completely and went onto continue management viaRisser > > >> > casting.Conclusion: Risser body casting is a safe and effective > > >> > alternative formanaging progressive IIS, successfully staving off > > >> surgery > > >> > in over 90%of patients and therefore allowing for more normal spinal > > >> > growth. Astatistically significant improvement in Cobb angle of over > > >> 18 > > >> > degreeswas observed. However, patients with Cobb angles greater than > > >> 55 > > >> > degreesand large RVAD measurements are at risk for cast management > > >> > failure.Risser cast management is not without risks and early surgery > > >> > maybebeneficial for select patients > > >> > > > >> > ~ > > >> > Noah 5 years old > > >> > 9 months of casting in SLC; 2 1/2 years of bracing; Currently > > >> > treatment-free at 8* > > >> > And Mariella 1 yr old - resolved Infantile Scoliosis > > >> > > > >> > > > >> > > > >> > > > >> > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 1, 2010 Report Share Posted November 1, 2010 Thanks . I believe they are applying a 3-d cast w/ out windows. They are def. using the frame...But, have never been trained in Mehta ET principles so Im sure there is a small window in front, no window in back to address rotation...Which are key in Mehtas ET. Its good to see articles published on casting, but frustrating at the same time. I know ET will become more available because the results speak for themselves...But, articles like this are confusing...Not, only to parents but the medical community, as well....I believe that trained centers are seeing the best results and only time/case studies will prove that Mehtas ET principles should be followed so less children fall through the cracks. Great to see that we are slowly moving in that direction. HRH > > Yep, it's Dr kson in CO. I know there are (or were) some patients on > the group that were casting with him. > The study was on children 3 days old to 3 years old. Children were > excluded if they were 4 or older. The avg age of the study group was 24 > months old. > I believe (similar to Greenville) this may be just a case of a doc using > the Risser term, but applying the Mehta style of casts. I don't know that > for a fact of course since the study summary doesn't include pics or > mention rotation. I'll post the full study when/if it's available. Or > perhaps if there's anyone still on the group that see's Dr E they could > chime in. > > ~ > Noah 5 years old > 9 months of casting in SLC; 2 1/2 years of bracing; Currently > treatment-free at 8* > And Mariella 1 yr old - resolved Infantile Scoliosis > > > > > > infantile scoliosis treatment > From: heather@... > Date: Fri, 29 Oct 2010 15:32:05 -0400 > Subject: Re: Re: Dr E's new study > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Thanks for not speed reading the article like I did. Sorry. Well, > Im > > even more confused at what exactly their doing here at the Childrens Hosp > > here in Denver/Aurora.....ISOP helped them get a proper frame, so Im not > > sure why this would be titled Risser and Im not sure why they would start > > the casting process at 3 yrs.....?? Surely, they've glimpsed at original > > article on ET by Mehta in JBJS 2005...Glad we held the mini ETP in July > > here in Denver and we know that The New Rocky Mtn Childrens Hospital in > > Denver is following ET principles because they have been properly trained > > and have a frame. The new docs name is up on the list. > > HRH > > > >> I believe this study was conduted by Dr. E out of Children's Hospital in > >> Aurora, Colorado; not Dr. E at Children Hospital of Boston. > >> > >> > >>> > >>> So, they are doing Risser in Boston? Its def not Early Treatment w/ >>> EDF > >>> (applied under age 2, when its most effective).. > >>> I agree that its promising and hopeful for future children w/ slowly > >>> progressing curves perhaps, but clearly they are not applying ET. Im > >>> actually saddened by this article as well. > >>> HRH > >>> > >>> > >>> > > >>> > I know there are some patients of Dr E's in the group. Perhaps their > >>> > kiddos were included in this study. > >>> > Not a lot of new information...(more success when treated young and > >>> with > >>> > smaller curves) as we already know. Still, it's always nice to see > >>> > published research supporting casting.~ > >>> > > >>> > Risser Casting for Infantile Idiopathic Scoliosis: Efficacy > >>> > andComplicationsSunday, October 3, 2010: 8:28 AM Union Square > >>> > (Intercontinental Hotel) M. Baulesh, BA, Judkins, MD and > >>> Mark > >>> > A. kson, MD,Orthopaedics, The Children's Hospital, Aurora, > >>> COPurpose: > >>> > To evaluate the complication rate associated with Rissercasting when > >>> > managing progressive infantile idiopathic scoliosis (IIS),and to > >>> determine > >>> > if Risser casting can effectively correct or diminishthe progression > >>> of > >>> > these scoliotic curves in the 30 day-old to 3year-old infant > >>> > population.Methods: For this retrospective study, charts and > >>> radiographs > >>> > of 22patients who underwent serial Risser casting for the management > >>> > ofprogressive IIS from January 2005 – December 2009 were > >>> reviewed.Patients > >>> > were excluded if they did not have IIS, did not start > >>> castingmanagement > >>> > before the age of 4 years-old, or did not finish theirtreatment at >>> our > >>> > facility.Pre-casting and post-casting Cobb angles and rib vertebral > >>> > angledifferences (RVAD) were measured from pre-existing radiographs > >>> taken > >>> > aspart of routine clinical care. Charts were reviewed for age, > >>> > diagnosis,outcomes, complications, number of casts, and length of > >>> > casting.Results: The average age at time of first casting was 24 > >>> months [3 > >>> > –47 months]. The average number of casts used per patient was 7.4 [2– > >>> 20 > >>> > casts] over an average timeframe of 13 months [2 – 48months].The mean > >>> Cobb > >>> > angle pre-casting was 46.64 degrees [26 – 70, SD11.99] compared to > >>> 28.27 > >>> > degrees [5 – 65; SD 15.97] post-casting,revealing an average > >>> improvement > >>> > of 18.37 degrees [p<0.0001]. The meanRVAD pre-casting was 25.90 > >>> degrees [8 > >>> > – 50; SD 11.37] compared to21.55 degrees [2 – 45; SD 13.83] > >>> post-casting, > >>> > showing an averageimprovement of 4.35 degrees [p=0.087].Two patients' > >>> > curves (9.1%) progressed despite casting and wereconverted to >>> surgical > >>> > intervention. The remaining 20 patients (90.9%)were successfully > >>> managed > >>> > with Risser casting until conversion toremovable braces.Overall, two > >>> minor > >>> > but noteworthy complications were seen; pulmonaryconstriction and > >>> > pneumonia that improved after the removal of the cast,and the need >>> for > >>> > immediate repeat casting due to curve decomposition.Both patients > >>> > recovered completely and went onto continue management viaRisser > >>> > casting.Conclusion: Risser body casting is a safe and effective > >>> > alternative formanaging progressive IIS, successfully staving off > >>> surgery > >>> > in over 90%of patients and therefore allowing for more normal spinal > >>> > growth. Astatistically significant improvement in Cobb angle of over > >>> 18 > >>> > degreeswas observed. However, patients with Cobb angles greater than > >>> 55 > >>> > degreesand large RVAD measurements are at risk for cast management > >>> > failure.Risser cast management is not without risks and early surgery > >>> > maybebeneficial for select patients > >>> > > >>> > ~ > >>> > Noah 5 years old > >>> > 9 months of casting in SLC; 2 1/2 years of bracing; Currently > >>> > treatment-free at 8* > >>> > And Mariella 1 yr old - resolved Infantile Scoliosis > >>> > > >>> > > >>> > > >>> > > >>> > >> > >> > >> > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 1, 2010 Report Share Posted November 1, 2010 Thanks for confirming that Rochelle. It does help with all my questions. I call you this week. HRH > and > Sorry don't have internet right now so been trying to keep up on > my phone. Devyn was part of this study and he was casted starting > at 18months to right after he turned 1yr. They do have the proper > frame and do look at rotation. They do not do the mushroom tummy > cut out or the cut outs in the back for the rotation. You can > look at devyn's pic's in the photo section. The full study should > have pic's of the kids in the OR after cast removal's and prior > to the new ones being put on. The measured and took pictures > everytime we went in even this last year for his checkup xray. I > had to sign release papers for all of this. Hope this helps with > your questions. > > Rochelle mom to devyn 5yrs old infantile scoliosis(0 degrees) chiari 1 > > >> >> >> >> >> >> So, they are doing Risser in Boston? Its def not Early Treatment w/ >> EDF >> >> >> (applied under age 2, when its most effective).. >> >> >> I agree that its promising and hopeful for future children w/ slowly >> >> >> progressing curves perhaps, but clearly they are not applying ET. Im >> >> >> actually saddened by this article as well. >> >> >> HRH >> >> >> >> >> >> >> >> >> > >> >> >> > I know there are some patients of Dr E's in the group. Perhaps >> their >> >> >> > kiddos were included in this study. >> >> >> > Not a lot of new information...(more success when treated young and >> >> >> with >> >> >> > smaller curves) as we already know. Still, it's always nice to see >> >> >> > published research supporting casting.~ >> >> >> > >> >> >> > Risser Casting for Infantile Idiopathic Scoliosis: Efficacy >> >> >> > andComplicationsSunday, October 3, 2010: 8:28 AM Union Square >> >> >> > (Intercontinental Hotel) M. Baulesh, BA, Judkins, MD >> and >> >> >> Mark >> >> >> > A. kson, MD,Orthopaedics, The Children's Hospital, Aurora, >> >> >> COPurpose: >> >> >> > To evaluate the complication rate associated with Rissercasting >> when >> >> >> > managing progressive infantile idiopathic scoliosis (IIS),and to >> >> >> determine >> >> >> > if Risser casting can effectively correct or diminishthe >> progression >> >> >> of >> >> >> > these scoliotic curves in the 30 day-old to 3year-old infant >> >> >> > population.Methods: For this retrospective study, charts and >> >> >> radiographs >> >> >> > of 22patients who underwent serial Risser casting for the >> management >> >> >> > ofprogressive IIS from January 2005 – December 2009 were >> >> >> reviewed.Patients >> >> >> > were excluded if they did not have IIS, did not start >> >> >> castingmanagement >> >> >> > before the age of 4 years-old, or did not finish theirtreatment at >> our >> >> >> > facility.Pre-casting and post-casting Cobb angles and rib vertebral >> >> >> > angledifferences (RVAD) were measured from pre-existing radiographs >> >> >> taken >> >> >> > aspart of routine clinical care. Charts were reviewed for age, >> >> >> > diagnosis,outcomes, complications, number of casts, and length of >> >> >> > casting.Results: The average age at time of first casting was 24 >> >> >> months [3 >> >> >> > –47 months]. The average number of casts used per patient was 7.4 >> [2– >> >> >> 20 >> >> >> > casts] over an average timeframe of 13 months [2 – 48months].The >> mean >> >> >> Cobb >> >> >> > angle pre-casting was 46.64 degrees [26 – 70, SD11.99] compared to >> >> >> 28.27 >> >> >> > degrees [5 – 65; SD 15.97] post-casting,revealing an average >> >> >> improvement >> >> >> > of 18.37 degrees [p<0.0001]. The meanRVAD pre-casting was 25.90 >> >> >> degrees [8 >> >> >> > – 50; SD 11.37] compared to21.55 degrees [2 – 45; SD 13.83] >> >> >> post-casting, >> >> >> > showing an averageimprovement of 4.35 degrees [p=0.087].Two >> patients' >> >> >> > curves (9.1%) progressed despite casting and wereconverted to >> surgical >> >> >> > intervention. The remaining 20 patients (90.9%)were successfully >> >> >> managed >> >> >> > with Risser casting until conversion toremovable braces.Overall, >> two >> >> >> minor >> >> >> > but noteworthy complications were seen; pulmonaryconstriction and >> >> >> > pneumonia that improved after the removal of the cast,and the need >> for >> >> >> > immediate repeat casting due to curve decomposition.Both patients >> >> >> > recovered completely and went onto continue management viaRisser >> >> >> > casting.Conclusion: Risser body casting is a safe and effective >> >> >> > alternative formanaging progressive IIS, successfully staving off >> >> >> surgery >> >> >> > in over 90%of patients and therefore allowing for more normal >> spinal >> >> >> > growth. Astatistically significant improvement in Cobb angle of >> over >> >> >> 18 >> >> >> > degreeswas observed. However, patients with Cobb angles greater >> than >> >> >> 55 >> >> >> > degreesand large RVAD measurements are at risk for cast management >> >> >> > failure.Risser cast management is not without risks and early >> surgery >> >> >> > maybebeneficial for select patients >> >> >> > >> >> >> > ~ >> >> >> > Noah 5 years old >> >> >> > 9 months of casting in SLC; 2 1/2 years of bracing; Currently >> >> >> > treatment-free at 8* >> >> >> > And Mariella 1 yr old - resolved Infantile Scoliosis >> >> >> > >> >> >> > >> >> >> > >> >> >> > >> >> >> >> >> > >> >> > >> >> > >> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 1, 2010 Report Share Posted November 1, 2010 No problem . I will look forward to your call. P.S. we are moving to the city. > >> > >> >> > >> > >> >> So, they are doing Risser in Boston? Its def not Early Treatment w/ > >> EDF > >> > >> >> (applied under age 2, when its most effective).. > >> > >> >> I agree that its promising and hopeful for future children w/ slowly > >> > >> >> progressing curves perhaps, but clearly they are not applying ET. Im > >> > >> >> actually saddened by this article as well. > >> > >> >> HRH > >> > >> >> > >> > >> >> > >> > >> >> > > >> > >> >> > I know there are some patients of Dr E's in the group. Perhaps > >> their > >> > >> >> > kiddos were included in this study. > >> > >> >> > Not a lot of new information...(more success when treated young and > >> > >> >> with > >> > >> >> > smaller curves) as we already know. Still, it's always nice to see > >> > >> >> > published research supporting casting.~ > >> > >> >> > > >> > >> >> > Risser Casting for Infantile Idiopathic Scoliosis: Efficacy > >> > >> >> > andComplicationsSunday, October 3, 2010: 8:28 AM Union Square > >> > >> >> > (Intercontinental Hotel) M. Baulesh, BA, Judkins, MD > >> and > >> > >> >> Mark > >> > >> >> > A. kson, MD,Orthopaedics, The Children's Hospital, Aurora, > >> > >> >> COPurpose: > >> > >> >> > To evaluate the complication rate associated with Rissercasting > >> when > >> > >> >> > managing progressive infantile idiopathic scoliosis (IIS),and to > >> > >> >> determine > >> > >> >> > if Risser casting can effectively correct or diminishthe > >> progression > >> > >> >> of > >> > >> >> > these scoliotic curves in the 30 day-old to 3year-old infant > >> > >> >> > population.Methods: For this retrospective study, charts and > >> > >> >> radiographs > >> > >> >> > of 22patients who underwent serial Risser casting for the > >> management > >> > >> >> > ofprogressive IIS from January 2005 – December 2009 were > >> > >> >> reviewed.Patients > >> > >> >> > were excluded if they did not have IIS, did not start > >> > >> >> castingmanagement > >> > >> >> > before the age of 4 years-old, or did not finish theirtreatment at > >> our > >> > >> >> > facility.Pre-casting and post-casting Cobb angles and rib vertebral > >> > >> >> > angledifferences (RVAD) were measured from pre-existing radiographs > >> > >> >> taken > >> > >> >> > aspart of routine clinical care. Charts were reviewed for age, > >> > >> >> > diagnosis,outcomes, complications, number of casts, and length of > >> > >> >> > casting.Results: The average age at time of first casting was 24 > >> > >> >> months [3 > >> > >> >> > –47 months]. The average number of casts used per patient was 7.4 > >> [2– > >> > >> >> 20 > >> > >> >> > casts] over an average timeframe of 13 months [2 – 48months].The > >> mean > >> > >> >> Cobb > >> > >> >> > angle pre-casting was 46.64 degrees [26 – 70, SD11.99] compared to > >> > >> >> 28.27 > >> > >> >> > degrees [5 – 65; SD 15.97] post-casting,revealing an average > >> > >> >> improvement > >> > >> >> > of 18.37 degrees [p<0.0001]. The meanRVAD pre-casting was 25.90 > >> > >> >> degrees [8 > >> > >> >> > – 50; SD 11.37] compared to21.55 degrees [2 – 45; SD 13.83] > >> > >> >> post-casting, > >> > >> >> > showing an averageimprovement of 4.35 degrees [p=0.087].Two > >> patients' > >> > >> >> > curves (9.1%) progressed despite casting and wereconverted to > >> surgical > >> > >> >> > intervention. The remaining 20 patients (90.9%)were successfully > >> > >> >> managed > >> > >> >> > with Risser casting until conversion toremovable braces.Overall, > >> two > >> > >> >> minor > >> > >> >> > but noteworthy complications were seen; pulmonaryconstriction and > >> > >> >> > pneumonia that improved after the removal of the cast,and the need > >> for > >> > >> >> > immediate repeat casting due to curve decomposition.Both patients > >> > >> >> > recovered completely and went onto continue management viaRisser > >> > >> >> > casting.Conclusion: Risser body casting is a safe and effective > >> > >> >> > alternative formanaging progressive IIS, successfully staving off > >> > >> >> surgery > >> > >> >> > in over 90%of patients and therefore allowing for more normal > >> spinal > >> > >> >> > growth. Astatistically significant improvement in Cobb angle of > >> over > >> > >> >> 18 > >> > >> >> > degreeswas observed. However, patients with Cobb angles greater > >> than > >> > >> >> 55 > >> > >> >> > degreesand large RVAD measurements are at risk for cast management > >> > >> >> > failure.Risser cast management is not without risks and early > >> surgery > >> > >> >> > maybebeneficial for select patients > >> > >> >> > > >> > >> >> > ~ > >> > >> >> > Noah 5 years old > >> > >> >> > 9 months of casting in SLC; 2 1/2 years of bracing; Currently > >> > >> >> > treatment-free at 8* > >> > >> >> > And Mariella 1 yr old - resolved Infantile Scoliosis > >> > >> >> > > >> > >> >> > > >> > >> >> > > >> > >> >> > > >> > >> >> > >> > >> > > >> > >> > > >> > >> > > >> > > > > > > > Quote Link to comment Share on other sites More sharing options...
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