Paranjape Chinmay S, Upasani Vidyadhar V, Newton Peter O, Masuda Keisuke, Bomar James D, Johnson Alexandra, Catanzano Anthony A
Portland Shriners Hospitals for Children, Portland, OR, USA.
Rady Childrens Hospital, San Diego, CA, USA.
J Pediatr Soc North Am. 2025 Jun 3;12:100212. doi: 10.1016/j.jposna.2025.100212. eCollection 2025 Aug.
Early-onset scoliosis (EOS) presents significant challenges due to its potential to progress and cause pulmonary complications, necessitating early and effective intervention. Historically, casting techniques have evolved to address these deformities, with elongation-derotation-flexion (EDF) casting being the predominant method. However, EDF casting requires specialized equipment and can be time-consuming. This paper introduces an alternative method for addressing sweeping thoracolumbar curves in EOS: the three-point lateral suspension bending cast. This technique offers several advantages over EDF casting, including ease of application without specialized equipment, reduced procedural time, and the use of waterproof materials. The method involves positioning the patient with the convex apex side of the curve down, using a muslin bias wrap to create a bending fulcrum, and applying a cast that maintains a three-point bending force. This technique is particularly advantageous in settings where access to specialized equipment is limited or in patients with airway considerations. While effective in treating single sweeping curves, challenges remain in applying this method to double curves or thoracic apices above T9. Despite its longstanding use in a high-volume pediatric spine center, this method has not been extensively documented in the literature. The described technique provides a viable, cost-effective alternative for EOS management, with potential implications for broader application in diverse healthcare settings.
(1)Lateral suspension bending casting is an alternative method to elongation-derotation-flexion casting for achieving correction in early-onset scoliosis(2)Bending casts may be applied with minimal specialized equipment and without traction to the neck and head, making it an attractive option for patients with tenuous airways or in environments without a Cotrel table.(3)Bending casts may be applied with waterproof material, for improved patient hygiene and caregiver satisfaction.(4)This method of casting is ideal in long, sweeping thoracolumbar curves with an apex below T8.
早发性脊柱侧弯（EOS）因其有进展并导致肺部并发症的可能性而带来重大挑战，因此需要早期有效干预。从历史上看，支具技术不断发展以应对这些畸形，其中伸长-旋转-屈曲（EDF）支具是主要方法。然而，EDF支具需要专门设备且可能耗时。本文介绍了一种用于处理EOS中胸腰段大弯的替代方法：三点外侧悬吊弯曲支具。与EDF支具相比，该技术具有多个优点，包括无需专门设备即可轻松应用、减少操作时间以及使用防水材料。该方法包括将患者置于曲线凸侧顶点向下的位置，使用斜纹棉布包裹形成弯曲支点，并应用维持三点弯曲力的支具。在获得专门设备受限的环境中或有气道相关考虑的患者中，该技术特别有利。虽然该方法在治疗单一胸腰段大弯时有效，但在将其应用于双弯或T9以上的胸椎顶点时仍存在挑战。尽管该方法在一个大量收治儿童脊柱疾病的中心长期使用，但尚未在文献中得到广泛记录。所描述的技术为EOS的管理提供了一种可行、经济有效的替代方法，可能对在不同医疗环境中的更广泛应用具有启示意义。
（1）外侧悬吊弯曲支具是在早发性脊柱侧弯中实现矫正的EDF支具的替代方法。（2）弯曲支具的应用可能只需最少的专门设备，且无需对颈部和头部进行牵引，这使其成为气道脆弱的患者或没有Cotrel手术台的环境中的一个有吸引力的选择。（3）弯曲支具可以使用防水材料，以改善患者卫生状况并提高护理人员满意度。（4）这种支具方法对于顶点在T8以下的长胸腰段大弯是理想的。
