CHICAGO — Patience pays off. For a young patient with scoliosis, the curve in her spine threatened to throw a major curve in her health and ability to grow. But an old-fashioned technique with a new twist is helping her avoid surgery.
Hailey Gamboa is a typical four year old. “She’s really active and does a lot,” Christi Gamboa, Hailey’s mother, says.
Not much holds Hailey Gamboa back — not even the bulky armor underneath her sparkly, green sweater.
“She is now wearing her eleventh cast, and it’s her last one,” Christi Gamboa says. “She would kind of walk funny. We couldn’t pinpoint what it was. Whenever she was standing still and playing she would lean into one of her hips and stick her hip out. We just googled what that might be and infantile scoliosis came up.”
An x-ray confirmed the diagnosis — Hailey had a 55 degree curve in her spine.
“Our fear was that she would need surgery,” Christi Gamboa says.
But pediatric orthopedic surgeon Dr David Roberts had another idea.
“The cast goes from just underneath her arms to just above her hips, so it’s like a little jacket,” says Dr. David Roberts, of the NorthShore University HealthSystem.
Hailey’s worn one — 24 hours a day — since the age of two. And about every three to four months she’s refitted. The technique is called serial casting.
“It’s not removable, which is probably the reason the casts are more effective than removable braces,” Roberts says.
Each round starts in the operating room and in the air.
Says Roberts, “So we put this suspension on, and it’s how she’ll be held, actually be suspended, which allows us to wrap the whole cast around her body.”
Hailey is under anesthesia so she feels no discomfort during the fittings.
Says Roberts, “As the cast hardens we’ll do some maneuvers to actually correct the cast so it hardens in the right position. We hold this for about two minutes or so. Scoliosis is not just a curve. You see a sort of 3-D twist, kind of like a slinky that twists and curves over a little bit. And so the correction maneuvers are 3-D trying to untwist the curvature, and that’s what makes this different than previous techniques that didn’t work as well.”
But much of the correction comes naturally. As Hailey grows, the cast holds her spine in a straighter position – allowing her to actually outgrow her scoliosis.
“It’s specially designed and molded to her to correct the curve and allow her, as she grows, to guide the curve straight. Her most recent curve was down to just under 10 degrees, so very straight,” Roberts says.
Once the cast is set, Dr. Roberts cuts out a few strategically placed holes that allow Hailey to breathe and eat freely. Then it’s time to decorate.
Says Roberts, “It’s a little bit like arts and crafts. I don’t put on stick-on tattoos too often.”
He adds, “This is one of the few orthopedic conditions that’s life-threatening. If the curve gets worse, it can affect her ability to, her heart and lungs to function and affect her ability to grow.”
“The only limitation is that she can’t get her cast wet, so we can’t go swimming in the summer, and we had to adjust how we do bath time. But other than those two things she can do any activity she wants to do,” Christi Gamboa says.
Hailey will wear a removable back brace once the casting process is complete – and she’ll be followed into adulthood to make sure her curve doesn’t return. But if children are started young enough with serial casting, the success rate is more than 90 percent.
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