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World J Orthop. Dec 18, 2015; 6(11): 935-943
Published online Dec 18, 2015. doi: 10.5312/wjo.v6.i11.935
Serial elongation-derotation-flexion casting for children with early-onset scoliosis
Federico Canavese, Antoine Samba, Alain Dimeglio, Mounira Mansour, Marie Rousset
Federico Canavese, Antoine Samba, Alain Dimeglio, Mounira Mansour, Marie Rousset, Pediatric Surgery Department, “Estaing” University Hospital, 63003 Clermont-Ferrand, France
Alain Dimeglio, Faculté de Médecine, Université de Montpellier, 34000 Montpellier, France
Author contributions: Canavese F, Samba A and Dimeglio A contributed equally to this work, designed the aim of the editorial content, generated the figures and wrote the manuscript; Mansour M and Rousset M revised the manuscript and granted final approval for the version to be published.
Conflict-of-interest statement: The authors have no competing interests to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Federico Canavese, MD, PhD, Professor of Pediatric Surgery, Pediatric Surgery Department, “Estaing” University Hospital, 1 Place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand, France. canavese_federico@yahoo.fr
Telephone: +33-4-73750293 Fax: +33-4-73750291
Received: April 1, 2015
Peer-review started: April 2, 2015
First decision: July 10, 2015
Revised: September 2, 2015
Accepted: October 1, 2015
Article in press: October 8, 2015
Published online: December 18, 2015
Processing time: 260 Days and 1.6 Hours
Abstract

Various early-onset spinal deformities, particularly infantile and juvenile scoliosis (JS), still pose challenges to pediatric orthopedic surgeons. The ideal treatment of these deformities has yet to emerge, as both clinicians and surgeons still face multiple challenges including preservation of thoracic motion, spine and cage, and protection of cardiac and lung growth and function. Elongation-derotation-flexion (EDF) casting is a technique that uses a custom-made thoracolumbar cast based on a three-dimensional correction concept. EDF can control progression of the deformity and - in some cases-coax the initially-curved spine to grow straighter by acting simultaneously in the frontal, sagittal and coronal planes. Here we provide a comprehensive review of how infantile and JS can affect normal spine and thorax and how serial EDF casting can be used to manage these spinal deformities. A fresh review of the literature helps fully understand the principles of the serial EDF casting technique and the effectiveness of conservative treatment in patients with early-onset spinal deformities, particularly infantile and juvenile scolisois.

Keywords: Early-onset scoliosis; Infantile scoliosis; Juvenile scoliosis; Elongation-derotation-flexion casting; Conservative

Core tip: Infantile and juvenile scoliosis still pose challenges to pediatric orthopedic surgeons. Elongation-derotation-flexion (EDF) casting is a technique that uses a custom-made thoracolumbar cast based on a three-dimensional correction concept. EDF can control progression of the deformity and-in some cases-coax the initially-curved spine to grow straighter by acting simultaneously in the frontal, sagittal and coronal planes. A critical literature review is needed in order to understand the principles of the technique and the effectiveness of conservative treatment using the specific EDF casting technique in young and very young patients.