Rüstem CELİLOV, Ataberk BEYDEMİR, Mehmet KAYMAKOĞLU, Mehmet AYVAZ, Halil Gökhan DEMİRKIRAN, Muharrem YAZICI
Journal of Turkish Spinal Surgery - 2026;37(3):91-96
Objective: Serial derotational casting (SDC) is widely used in the management of early onset scoliosis (EOS) to control deformity and preserve thoracic growth; however, factors associated with curve progression remain incompletely defined. This study aimed to evaluate the clinical and radiographic outcomes of SDC and to explore factors associated with progression. Materials and Methods: Thirty patients with EOS (20 girls, 10 boys) treated with SDC (>=2 casts) were retrospectively reviewed. Etiologies were congenital (n=18), syndromic (n=6), and idiopathic (n=6). Radiographs were evaluated at pre-cast, post-first-cast, and final follow-up. Progression was defined as a >=5 derece increase in the main Cobb angle. Repeated-measures non-parametric tests assessed temporal changes, and univariate analyses explored associations with progression. Results: At final follow-up, 23/30 patients (76.6%) were classified as stable/regressive, and 7/30 patients (23.4%) were classified as progressive. Mean age at first cast was 49.8+/-26.7 months, with a mean follow-up of 25.9+/-13.0 months. Heights at T1-T12 increased in both groups. In the stable/regressive group, the main Cobb angle improved after the first cast (from 59.4 derece to 48.6 derece) and remained relatively stable (58.5 derece at final follow-up), whereas, in the progressive group, it increased to 73.0 derece. Thoracic curve location was significantly associated with progression in univariate analysis (p=0.026), while other variables were not significant. Conclusion: SDC effectively controlled deformity and preserved thoracic growth in most EOS patients. As the cohort was predominantly non-idiopathic (congenital), findings reflect surgical delay and growth preservation rather than curve regression. Thoracic curve location may be associated with a higher risk of progression; however, this finding should be interpreted cautiously due to the limited sample size. SDC appears to function primarily as a temporizing strategy, and close follow-up is essential. Further prospective studies are needed to clarify predictors of treatment response.
