{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:49:47Z","timestamp":1787964587495,"version":"build-2784847793"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,11,16]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>This study provides age-stratified outcomes of cast treatment for idiopathic early-onset scoliosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a multicenter, retrospective review of patients with idiopathic early-onset scoliosis treated with Mehta casting at 4 tertiary children\u2019s hospitals between 2001 and 2016. The inclusion criteria were idiopathic early-onset scoliosis and a minimum follow-up of 2 years after casting ended. The exclusion criteria were &lt;2 casts, &gt;3 casts at an outside facility, and a major curve of &lt;20\u00b0 pre-treatment. Subjects were grouped by age at first cast: &lt;18 months, 18 to &lt;24 months, 2 to &lt;3 years, 3 to &lt;4 years, and \u22654 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 134 patients with a mean follow-up of 5.2 years (95% confidence interval [CI], 4.8 to 5.5 years) after casting. Prior to treatment, the major curve was not significantly different between the various age groups and was a mean of 50.4\u00b0 (95% CI, 48.0\u00b0 to 52.8\u00b0 [range, 22\u00b0 to 109\u00b0]). Of the &lt;18-month group (n = 59), at the final follow-up at a mean of 7.4 years (95% CI, 6.8 to 8.1 years) of age, 75% had scoliosis of &lt;15\u00b0, and 6.8% had undergone a surgical procedure or had a major curve of \u226550\u00b0. The results declined in the 18 to &lt;24-month group (n = 30), with a major curve of &lt;15\u00b0 at the final follow-up at 8.5 years (95% CI, 7.3 to 9.7 years) of age in 33% (p &lt; 0.001), and 17% having undergone a surgical procedure or had a major curve of \u226550\u00b0, with results nearly identical in the 2 to &lt;3-year group (n = 21). The results continued to decline with increasing age; 23% of the 3 to &lt;4-year group had a major curve of &lt;15\u00b0 at the final follow-up, and 31% had undergone a surgical procedure or had scoliosis of \u226550\u00b0. Of the \u22654-year group, just 9.1% had scoliosis of &lt;15\u00b0 (p &lt; 0.0001 compared with the &lt;18-month group), and 64% had undergone a surgical procedure or had scoliosis of \u226550\u00b0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Children who underwent casting prior to 18 months of age were more likely to have a major curve of &lt;15\u00b0 at a minimum 2-year follow-up after casting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.22.00344","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T14:05:57Z","timestamp":1663855557000},"page":"1977-1983","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":16,"title":["Age-Stratified Outcomes of Mehta Casting in Idiopathic Early-Onset Scoliosis"],"prefix":"10.2106","volume":"104","author":[{"given":"Graham T.","family":"Fedorak","sequence":"first","affiliation":[{"name":"Kapi\u2019olani Medical Center for Women and Children, Honolulu, Hawaii"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce A.","family":"MacWilliams","sequence":"additional","affiliation":[{"name":"Shriners Hospitals for Children, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Stasikelis","sequence":"additional","affiliation":[{"name":"Shriners Hospitals for Children, Greenville, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Szczodry","sequence":"additional","affiliation":[{"name":"Shriners Hospitals for Children, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Lerman","sequence":"additional","affiliation":[{"name":"Shriners Hospitals for Children, Northern California, Sacramento, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua M.","family":"Pahys","sequence":"additional","affiliation":[{"name":"Shriners Hospitals for Children, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"D\u2019Astous","sequence":"additional","affiliation":[{"name":"Shriners Hospitals for Children, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,9,22]]},"reference":[{"key":"bib1-20250430","first-page":"59","article-title":"[The elongation-derotation-flexion technic in the correction of scoliosis]","volume":"50","author":"Cotrel","year":"1964","journal-title":"Rev Chir Orthop Reparatrice Appar Mot."},{"issue":"17","key":"bib2-20250430","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.2106\/JBJS.18.01268","article-title":"Minimum 5-year follow-up of Mehta casting to treat idiopathic early-onset scoliosis","volume":"101","author":"Fedorak","year":"2019","journal-title":"J Bone Joint Surg Am."},{"issue":"8","key":"bib3-20250430","doi-asserted-by":"crossref","first-page":"e625","DOI":"10.1097\/BPO.0000000000001006","article-title":"Initial cast correction as a predictor of treatment outcome success for infantile idiopathic scoliosis","volume":"37","author":"Gomez","year":"2017","journal-title":"J 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