In the past we had some cases o progressive scoliosis in young girls. We could better without casting more than 90%. We are using the long term traction Detensor-Method.

one has to go into the atiopathogenesis of the same and i agree with fdr leonhrd rearding avoiding casting but applyting traction but ince congenita hypothyroidism is commonly missed one comes across girls with unexplained scoliosis and hence it is important for allyoung girls with stunted groewth to have the thyroid function tests to prevent the simple cretinism and as bone metabolism is so dependent on thyroid hormones nboth osteoblast as well as osteoclast formation that one does try to rule out deficiencies like hypothyroidiam,rarely hypopaathyroidism etc ,or associated polio which most probably has been taken care with proper immunzation.

You are absolutely right with checking thyriod function, gentle long term traction is very helpful. 

@Kienlein: What do you mean under the term "young girls" ? What age ? How long (days, weeks, years) do you apply the traction ? In 90% you achieve improvement of the deformity after long term traction ? How do you preserve this result ?Do you apply any kind of immobilization (cast, brace) after long term traction ? 

well oung irls means at any age they present but to avoid getting to this stage in some countries routine testing for congenital hypothyroidism is done to see to it that early treatment gets started ,one doesnt need to apply any cast but simple traction .

We do use serial (Mehta) casting in EOS and are pleased with it

For the infantile scoliosis and wedged kyphotic vertebrae( up to 8 years) I was trained and used by myself caster plasting in prone position. Done under general anaesthesia (as you should do in young children with congenital hip luxation or severe dysplasia too) . In prone postion with polsters under the thighs and under the shoulders/ sternum you can even give manual redression at the apex, while extending and lordosating the spine during hardening ( as in Murk Jansen's plaster bed or a  little like Calot did in Pott's Kyphosis) .It works out well every time unto complete correction too ( Mehta) . For one reason or another after that age the Risser table was used, but I found the impact on the child never pleasant and you are unable to bring lordosis to the thoracolumbar spine so much. Bivalved braces after moulds in Boehlers position and later the TLI brace replaced the us e of the Risser casting techniques. Traction in bed never looked attractive to us or encouraging a child to be active and ambulant.

@Piet van Loon: Thank you for your post. My opinion is close to yours. In my practice well fitted braces replaced casts some years ago. Children are happier with braces. 

Children with congenital or neurogenic scoliosis do not respond as well with casting method. Idiopathic infantile type of scoliosis respond very well with casting. Casting again come into prominence through the work of Min Mehta. As we know 50% of infantile idiopathic scoliosis are progressive and 50% resolutive.

Younger kids with EOS under 3-4 years do better with Mehta casting. Dr. Vitale in NY, Columbia U can give you more detailed opinion.

Ages 5 and up I have used Rigo-Cheneau bracing and Schroth physiotherapy for example a 52 degree JIS with good result avoiding growing rod surgeries and spinal fusion. ( posted in my list) Now this kid is 12 and going well. Another case was presented at the SOSORT conference by Grant Wood young child treated by Schroth physiotherapy and Rigo-Cheneau bracing from age 2 and it's going well. This scoliosis curve was even more severe, Cobb 70-80 range at the start

@ Cen:  Yes, you are right about the 50-50 ratio in infantile scoliosis. In babies the ratio is even much more favorable for the resolutive cases. Schede's bed is obsolete long time ago. As for IIS, unfortunately, the positive results of  application of casts often councide with the natural history. The main problem is how to make a precise prognosis for an eventual progressiveness ? This is the question.

I have no expiriance with that

In progressiviness of any spinal deformation , like scolisosis, there is an increased thightness of neuromuscular structures , caused by the dyscongruncy of growth between the CNS and the skeleton. In children with "neuromuscular"disorders this phenomena is obvious: the more spastic, the more deformation you can expect. In healthy children their lack of stretch ( by their sedentary lifestyle without compensatory stretching excersises) will give progression, evident in the growth spurt. At that time I found very thight extensor muscles, like hamstrings and gastrocnemius ( SLR test) . 

excersises and extension by bracing can bring quick correction and better locomotor functions. 

I never use it,because is not practical to the patient and his family. I feel that is best early surgery, as growing rod or hemi epiphysiodesis

Obviously, serial casting has a very narrow field of application. In my opinion early surgery in EOS seems to have replaced the classics. 

I use serial casting up until the child is due to start Kindergartin, or schoool (around age 4-5).  Growing rods have diminishing returns, with less length with each lengthening. Most surgeons quote about 6 effectuive lentgthenings. I think we will see the same with MAGEC, that is, a decreqasing increase in lenghtening with time Therefore, it makes sense to put surgery off as long as possibe, but a child should not be sent to school in a body cast. They stink, and other children make fun of them

I have no expirience with scoliosis with high curve and indication for surgery treatment.

We still use casting in cases of progressive EOS before 18 months to 2 years of age. Growing rod surgery is still limited in children of this age, requiring multiple procedures. Therefore we feel it is worth a trial period at least

I use expandable prosthesis  mostly

@Mohammad D Alfawareh:  What do you mean under "expandable prosthesis" ?

https://www.youtube.com/watch?v=eMeYns9e7qg