Shriners Hospitals for Children —Tampa is offering a new service called Mehta casting that will help support young spines as they grow.
Florida and south Georgia children who are born with or who develop scoliosis early in life now have an option that allows families to postpone or in some cases, avoid surgery.
Developed by Orthopaedic Surgeon Min H. Mehta, M.D., F.R.C.S., the procedure involves applying a cast that looks like a plaster jacket. The cast goes around the body and can train a young, curvy spine to grow straighter. In cases where scoliosis develops in an otherwise healthy young child, for unknown reasons, “it can actually make the curve disappear,” said Cheryl Lawing, M.D., an orthopaedic surgeon at the Tampa Shriners Hospital, and one of two surgeons at the hospital who can apply the casting.
“Every year that surgery is delayed can lower the risk of complications and is worth trying if possible,” said Joseph Khoury, M.D., who also applies the Mehta casting at Shriners Hospitals for Children — Tampa.
While the casting won’t cure the types of scoliosis that children are born with or that result from cerebral palsy, casting can often delay the need for surgery. The cast is applied while a child is under general anesthesia and lying on a special table that gives physicians 360-degree access to the child’s body. “We typically do a series of casts, increasing corrections with each cast,” Dr. Lawing said. “Depending on how old the child is, the cast is changed every two to three months depending on how the curve improves.”
The cast cannot be removed and must be kept dry. It covers the entire chest and belly and may include the upper arm on one side for higher curves. Children sometimes need a few days to get used to the cast, but within several days, they are able to resume normal activities. Potential complications mainly involve skin irritation and discomfort in hot weather.
“Despite the discomfort, this casting provides a much safer means of straightening your child’s spine compared to early surgery,” Dr. Lawing said. The other option is surgically placed rods that span the curve and allow for regular lengthening to keep up with normal growth. Sometimes surgeons can use special rods that have a magnet inside them that can be lengthened without surgery. However, surgeons are not always able to use the magnetic rods. In those cases, a surgery is needed every six to nine months to lengthen the rods. With both types of growing rods, there can be a high rate of complications. For these reasons, Dr. Lawing and Dr. Khoury say, it is best to avoid surgery for as long as possible.
Pictured: Cheryl Lawing, M.D., gives a checkup to Jonathan, whose surgery is able to be delayed thanks to a series of Mehta casts. The new method is offered at the Tampa Shriners Hospital and will allow children with scoliosis as babies to avoid or delay spine surgery.