Postoperative shoulder-spine spica cast for young children

Immobilization of the young child after spinal surgery is an important component of the surgical plan. This study reviews the authors' experience with postoperative immobilization in a shoulder-body spica cast and provides a detailed description of the technique. Twenty-two children with an average age of 31 months at the time of surgery were placed in the shoulder-spine spica cast after hemivertebra excision. There was no loss of correction in any of the 22 children during the period of postoperative immobilization. All patients were able to be ambulatory in the shoulder-spine spica cast while immobilized. Patients experienced the minor complications of prolonged cast wear, with one cast becoming loose and three casts causing skin rash. One patient required removal of the cast 6 weeks after surgery for unrelated nausea and vomiting. The shoulder-spine spica cast has been used at the authors' institution with great success and allows children to be ambulatory after hemivertebra resection.