Dr E's new study

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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 old9 months of casting in SLC; 2 1/2 years of bracing; Currently treatment-free at 8*And Mariella 1 yr old - resolved Infantile Scoliosis