You want my child to wear WHAT?

Mehta cast

It’s a question parents ask me quite often. It might not be in those exact words, but the implication of surprise is there. Their initial reaction is fair — for parents of children younger than four with early-onset scoliosis, I often recommend a full-torso cast, or Mehta cast, to help correct the curvature of their child’s spine.

It’s not an easy recommendation for a parent to hear. And I completely understand why. A full-torso cast is challenging for both parents and children alike to manage on a daily basis.  A child in a Mehta cast must wear it 24-hours-a-day, for a period of a few months or up to three years.  Meanwhile it needs to be kept dry and clean.  And depending upon the child’s age, he may learn to walk while wearing the full-torso cast. Or re-learn to walk. The smallest daily tasks become big hurdles to overcome. So why would I recommend a treatment that presents daily challenges for parents and children? Because the benefits far outweigh the challenges.

The data shows that for children under the age of four with a curve size less than 60 degrees, Mehta casting, or derotational casting, can be an effective way to improve the curve of the spine without surgery. In fact, I was part of a study that found that over 80 percent of children who had idiopathic infantile scoliosis and curves under 60 degrees had resolution of their spinal curves with the Mehta cast treatment.

Parents of children younger than four often ask me why I don’t recommend waiting and performing surgery at a later time.  And my answer is that a significant spinal curve in a child that young can often interfere with his or her lung function and can even lead to a reduced life expectancy.  By utilizing the Mehta technique, the cast opens the chest wall and allows the lungs room to grow, thus improving overall lung function.  The question of bracing also comes up frequently with parents. While a brace is certainly easier for children to wear, there is no evidence that it is actually effective.

Once their child has been wearing the cast for a period of time, parents often remark at how resilient he or she is. And I agree. Kids are amazingly resilient. But what I think parents often miss is their own tenacity.  They find creative ways to help their child bathe. And diaper. And eat.  And go about their daily lives in an adapted way. I am constantly amazed and will continue to be amazed by parents. They will work around anything if it means the improvement of their child’s spine.

Editor’s note: If you’d like to learn more about Mehta casting as a non-invasive treatment for early onset scoliosis, join us on June 5 at 7 p.m. Dr. Peter Sturm and Tania Marcano, a mom whose son was treated with Mehta casting, will host a live online Q&A session. Early onset scoliosis: Get a physician’s and parent’s perspective. For more information and to RSVP, go to our registration page.  

Dr. Peter Sturm

About the Author: Dr. Peter Sturm

Dr. Peter Sturm is the director of the Crawford Spine Center at Cincinnati Children’s and has more than 20 years of experience treating pediatric spinal disorders. He is known nation-wide for the treatment of complex spinal conditions and has a special interest in early-onset scoliosis.

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Comments

  1. Teresa McSheffrey June 03, 23:47
    Hi Dr Sturm, I am so glad to see and hear all the education for parents on casting. You saved Finn at 21 months old and a 90 degree curve from an immediate spinal surgery by giving him a chance and casting him. He just turned 7 on Friday and he is healthy, beautiful, and thriving. He is still in a brace and holding. We are forever thankful to you because you made a difference and changed the course of his life. Teresa (and Finn) McSheffrey
    • Dr. Peter Sturm
      Dr. Peter Sturm Author June 04, 11:42
      Thank you for the kind words. Happy to hear that your son is doing so well!
  2. Ismael Egües A. June 04, 21:41
    Hello Dr Sturm, My name is Ismael Egües from Lima-Peru I'm a the father of Sofía. I want to express all my appreciation for taking the time and dedication to train our doctor (Dr Raúl Macchiavello) at the Cincinnati Children's Hospital. Sofía is doing great and is being treated with Mehta Casting locally in Lima-Peru and now we have one more child getting good results and more children will come soon. Thank You Very Much. Hope one day I could meet you in person so I could give you a warm hand shake. I have a deep admiration for your work and will be forever grateful with you and ISOP for the helping hand you provided us. Best Regards, Ismael Egües
  3. Kayla Mundkowsky June 05, 08:17
    Hi Dr. Sturm, This article is very interesting. My daughter has HGPPS and is on her 3rd body cast. It was very scary at first, but now it's an everyday thing! Thank you for this article, so now I know we're not the only ones!
  4. Nicole June 05, 09:30
    Hi Dr. Sturm Ellie has a straight spine after just 4 casts! :) Thank you! Nicole
  5. Avona Mefford July 01, 00:03
    Dr. Sturm, I want to thank you for what you have done with Jayden. We are adjusting well to his First Mehta Casting and Im still Learning about it. I just have one question, if this does straighten out his Curve, will he still be required to have surgery when he reaches his teenage years?
    • Kate Setter
      Kate Setter July 02, 15:00
      Hi Avona - Please check for a response from the Spine Center in your email. Thank you for asking the question!
    • Ben August 22, 14:40
      Hi Avona, I am in a similar situation and would appreciate if you can share with us if you received an answer. Is surgery completely avoided, or will it be necessary once the growth is complete? Wishing you and your child all the best.
      • Avona Mefford August 31, 23:14
        Hello Ben, I never did get an email answering the Question. He has an appointment on Friday to have his first cast Removed and I will ask them again. Ben, please feel free to email me at avonamefford@gmail.com. It would be nice to speak to other Parents going through this with their child.