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Serial casting treatment for infantile scoliosis

What is serial casting and why is it necessary?

Serial 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 plaster of paris with a thin layer of padding underneath and it is moulded to fit your baby’s spine. This is to improve the curvature of baby’s spine by changing the position each time it is done. After the cast is applied it will be checked and trimmed to give baby room to move and to help prevent skin problems.

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

A general anaesthetic or sedation is necessary to keep baby very still and relaxed and to allow a better fitting jacket to be applied. The doctor will decide which is most appropriate for your baby.

baby in a cast

Side view of jacket

baby in a cast

Front view of jacket

 

Can I bath my baby?

No, the cast is made of plaster and must not become wet. You will be able to wash baby though. Plaster of Paris is not waterproof and if it becomes very wet it will become soft and crumble and will no longer provide support for baby’s spine. Please use only soap and water on a face cloth or baby wipes to wash around baby’s neck and underneath both arms. Dry the skin well. Do not use creams or talcum powder in these areas as this makes the skin soggy and could cause sores to develop. When you come to hospital for a change of cast it will be removed on the ward when you arrive. You will then be able to bath and cuddle your baby until it is time for the new cast to be fitted.

How do I care for my baby in the cast?

You may need to use extra rolled up blankets or towels to support baby’s spine when they are laid on their side or back. Their position when laid in their cot should be changed regularly to relieve any pressure from the jacket against their spine. Try to treat your baby as normally as possible. A barrier cream should be used to exposed skin in the nappy area only. You are likely to be more upset by the cast 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 cast?

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 the jacket. 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. If it becomes too tight or the plaster cracks or it begins to smell or you have any problems with baby’s skin then please contact the hospital. Contact numbers are provided below

How long will the treatment last?

Usually until your child is big enough to wear a polythene brace, which is usually around age 2.

Contact us

If you have any questions or problems however trivial they may be – please ask.

Use the contact details below or write your questions down prior to your consultation.

Spinal Nursing Team
0114 226 7984

Orthotic Department
0114 271 7271

Mr Breakwell, Mr Cole, Mr Athanassacopoulos, Mr Bayley, Miss Srinivas
Secretary 0114 2267981

Formetric scan advice
0114 226 0602

Switchboard 0114 2717000

Scoliosis Association (SAUK)
Helpline: 020 8964 1166
E-mail: sauk@sauk.org.uk
Website: www.sauk.org.uk

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Disclaimer

Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

Resource number: SPN4

Resource Type: Article

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NHS

Western Bank
Sheffield
S10 2TH

United Kingdom

Switchboard: 0114 271 7000

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