EDF Casting History

Casting has been used since the turn of the century, primarily to address spinal curves in juvenile, adolescent and adult cases prior to surgical intervention or to alleviate pain. The most common casting method in the U.S. for the treatment of adolescent scoliosis was Risser casting. Dating back to the early 1900’s, Risser casting uses the principles of elongation and derotation to treat spinal curvature.

Risser casting, however, was never designed for rapidly growing infants and children and could result in rib and chest wall deformities. In 1964, Dr.’s. Morel and Cotrel simply improved the Risser technique by adding the third consecutive dimension called Flexion. Scoliosis is a 3-dimensional problem and the EDF technique has the ability to correct the scoliosis 3-dimensionally.

Dr. Mehta learned the EDF technique from the French pioneers and began applying it to her progressive infantile scoliosis patients early. Dr. Mehta was not comfortable “waiting and watching” her young patients deteriorate before her eyes, so she decided to try a new approach. Dr. Mehta introduced the Early Treatment EDF (Elongation, Derotation, Flexion) casting technique for the gentle and permanent correction of infantile scoliosis. Her early intervention with specialized EDF casting showed that rapid growth, if guided early by casting, could encourage the initially curved spine to grow straight.

Between 1975 and 2000, United Kingdom physician Min. H. Mehta, F.R.C.S. tracked the results of 136 patients with infantile scoliosis who she treated using a modified version of the EDF technique created by Cotrel and Morel. Her program was devised around a series of plaster cast changes (also called “serial” casting) under anesthesia every 8 to 16 weeks until the curve was nearly resolved (under 10 degree Cobb angle). With the Mehta method, the majority of these patients experienced full correction and it was determined that treatment was more likely to be successful if started before 2 years of age. However, significant correction can be attained and maintained beyond age 2 and studies have shown that serial EDF casting is a valuable delay tactic in buying growth for the thorax prior to surgical intervention for young patients that cannot be cured, permanently.

Dr. Mehtas Growth Guidance Casting Treatment requires a unique EDF casting frame that provides gentle traction to the young patients spine. The frame provides support to hips and torso while allowing ample room for the surgeon to address the correction of spine rotation and control the lumbar lordosis via the Flexion component. Surgeons and institutions are already moving away from bracing and toward Mehta casting as an ideal first line of defense; its effectiveness for treating progressive infantile or early onset scoliosis is now well documented.

Noel Industries was founded to address the need for a durable, high quality, medical-grade casting frame specifically designed to treat infants and children. It is the most flexible and adjustable frame of its kind, conforming to the criteria established by the pediatric orthopedic community. It requires minimal space in the operating room, includes fully lockable castor wheels, an adjustable bed for comfort and safety. The head rest helps to assist in the anesthesia process. It’s manufactured in the USA and is backed by a full warranty.