The therapeutic characteristics of serial casting on congenital scoliosis: a comparison with non-congenital cases from a single-center experience.

BACKGROUND: The therapeutic efficacy of serial casting on idiopathic scoliosis has been gradually documented. However, literatures on serial casting for congenital scoliosis (CS) remain extremely rare. This paper aimed to compare the treatment outcomes of serial casting between CS and non-CS patients to comprehensively evaluate the therapeutic characteristics of serial casting on CS patients. METHODS: A total of 23 early-onset scoliosis cases were included and divided into congenital scoliosis (CS, n = 8) and non-congenital group (non-CS, n = 15). Therapeutic outcomes including the major curve Cobb angle, thoracic kyphosis angle, lumbar lodosis angle, and thoracic spine growing rate were compared between groups at precast, after the first cast, and at the latest follow-up, respectively. RESULTS: All patients received the first cast at the age of 3.25 ± 1.20 years and 5.70 ± 1.18 times of cast corrections. The average casting time was 17.17 ± 3.38 months, and the mean follow-up time was 23.91 ± 12.28 months. Both CS and non-CS groups had significant decrease in Cobb angle after the first cast and at the latest follow-up (all P < 0.05). Cobb angle was significantly lower in non-CS group than in CS group at both time points (all P < 0.01). The correction rate of Cobb angle was significantly higher in non-CS group than in CS group (around 50 vs. 20%, both P < 0.01). The mean thoracic growth rate was significantly lower in CS group than in non-CS group (0.72 ± 0.20 vs. 1.42 ± 0.22 cm/year, P < 0.001). At the latest follow-up, there are 2 cases receiving growing rod surgery, 8 cases wearing a brace, and 13 cases continuing serial casting. CONCLUSIONS: Although the therapeutic efficacy of casting on CS patients is not as good as that on non-CS patients, casting is still an efficient treatment option for CS patients to delay the need for initial surgery.

[Diagnosis and treatment of bone lymphangioma associated with spinal deformity in children].

OBJECTIVE: To investigate the diagnosis, treatment and outcomes of bone lymphangioma associated with spinal deformity in children. METHODS: Eight cases of children with bone lymphangioma associated with spinal deformity at our hospital from 1983 to 2010 were reviewed and analyzed with the following criteria: clinical manifestations, imaging features, histopathological characteristics and therapeutic options. The outcomes of early intervention treatment were assessed. The key diagnostic points and therapeutic principles were summarized on the basis of our own as well as international and domestic experiences. RESULTS: Paraplegia developed in 2 cases because of delayed treatment. The remaining 6 cases were followed up for 10 months to 2 years with satisfactory effects. By curettage lesions, bone grafts, intralesional injection of bleomycin and pedicle screw-stick system maintaining the spinal stability, bone lymphangioma became smaller or disappeared and spinal deformity was effectively controlled. The mean scoliosis and kyphosis correction rates were 57.0% and 58.4% respectively. CONCLUSIONS: Bone lymphangioma in children is rare. If costa and vertebrae are involved, spinal deformity will progressively develop and lead eventually to paraplegia. With an early diagnosis and the administration of proper drugs, bone lymphangioma can be effectively controlled. Surgery for the stability of spinal deformity will effectively prevent the occurrence of paraplegia.