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.

Side view of jacket

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.