OKM serial casting treatment for infantile scoliosis

What is OKM casting and why is it necessary?

OKM casting is a treatment that is done over a period of time. The time span will vary depending on how quickly your child grows. A jacket is made of a mouldable plastic with a thin layer of fabric on both sides, and it is moulded to fit your child’s spine. This is to improve the curvature of the child’s spine by changing the position each time it is done. OKM has replaced plaster casts, they are lighter in weight and are stronger and they may be removed for a short period of time each day. After the cast is applied it will be checked and trimmed to give your child room to move and to help prevent skin problems.

Why does my child need a general anaesthetic or sedation for each cast change?

A general anaesthetic or sedation is sometimes necessary to keep your child very still and relaxed and to allow a better fitting jacket to be applied.

Can I bath my child?

Yes, you can bath your child. The OKM jacket has a zip down either side and across each shoulder so that it can be removed for half an hour each day so that you may bath your child. Please use only soap and water on a face cloth to wash your child. Dry the skin well. You may apply creams to your child’s skin if necessary.

How do I care for my child in the jacket?

You may need to use extra rolled up blankets or towels to support the child’s spine when they are laid on their side or back. Their position when laid in their cot or bed should be changed regularly to relieve any pressure from the jacket against their spine. Try to treat your child as normally as possible. You are likely to be more frustrated by the jacket than your baby. Encourage your child to carry out normal activities. It is possible that your child may regress in their development by up to 3 months but will soon catch up again.

How do I care for the jacket?

Try to keep it as clean and dry as possible and do not put anything inside it. It may have a fleecy material applied around any rough areas to make the edges softer and more comfortable. At the bottom of the jacket near the nappy area, the jacket is sometimes protected with a waterproof tape to help prevent any seepage of urine or faeces damaging it. This padding and protection cannot be applied until the jacket is dry. The ward staff will show you how to put it on before you go home so that you can do it the next day. Once you are home and if you have any problems with the jacket, contact numbers are on the back of this leaflet.

How long will the treatment last?

Usually until your child is big enough to be put into a brace which is managed in the Outpatient clinic, usually around age 5.