Awake serial body casting for the management of infantile idiopathic scoliosis: is general anesthesia necessary?
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Awake serial body casting for the management of infantile idiopathic scoliosis: is general anesthesia necessary? Scott M. LaValva1 · Elle M. MacAlpine1 · Noriaki Kawakami2 · Jigar S. Gandhi1 · Kazuaki Morishita2 · Peter F. Sturm3 · Sumeet Garg4 · Michael P. Glotzbecker5 · Jason Brett Anari1 · John M. Flynn1 · Pediatric Spine StudyGroup · Patrick J. Cahill1 Received: 13 January 2020 / Accepted: 13 April 2020 © Scoliosis Research Society 2020
Abstract Study design It is a retrospective cohort study. Objectives To compare the radiographic and clinical outcomes of serial body casting for infantile idiopathic scoliosis (IIS) with versus without the use of general anesthesia (GA). Summary of background data Serial body casting for IIS has traditionally been performed under GA. However, reports of neurotoxic effects of anesthetics in young children have prompted physicians to consider instead performing these procedures while patients are awake and distracted by electronic devices. Methods Patients from a multicenter registry who underwent serial casting for IIS were included. The patients were divided into asleep (GA) and awake (no GA) cohorts. Comparisons were made between pre-casting, first in-cast, and post-casting radiographic measures in each cohort. The rates of successful casting (≥ 10° major CA improvement), curve progression, and incidence of casting abandonment for surgical intervention were also compared. Results One-hundred and twenty-one patients who underwent serial casting for IIS were included. Ninety-two (76%) patients were asleep during casting procedures, while 29 (24%) were awake. Patients in the awake cohort were older (p
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