Contact

Mehta Casting (Application of Plaster Jacket)

Overview

What is Mehta casting?

Mehta casting is a non-invasive, serial casting technique used to treat young children with early onset scoliosis. The primary goal is to halt or correct progression of a spinal curve by harnessing the child’s natural growth, often delaying or avoiding the need for surgical intervention. The cast shapes the spine gently toward a straighter position over a series of weeks to months.​

Who is it for?

If your child is younger than approximately 5 years, has progressive early onset scoliosis (typically diagnosed before age 10), and the spinal curve is not responding to observation or bracing, Mehta casting may be considered.

Children most often recommended for Mehta casting are:

  • Infants and toddlers with progressive or worsening scoliosis
  • Children too young or too small for definitive surgical intervention
  • Patients with flexible curves, where growth can be used for gradual correction
  • Those with idiopathic or some neuromuscular/congenital forms of scoliosis

What the Procedure Involves

Here’s an outline of what happens during Mehta casting:

  • The procedure is performed in the operating room under general anaesthesia for comfort and safety
  • The child is carefully positioned on a special casting table, with gentle traction applied to the head and pelvis to elongate and straighten the spine​
  • A soft, protective stockinette is placed against the child’s skin
  • Layers of plaster or fibreglass are applied and carefully molded to the child’s spine and torso, with specific shaping to correct the curve while still allowing for breathing and growth
  • Openings are made in the cast over the stomach (for expansion) and sometimes the back (to avoid pressure sores)
  • The cast usually covers from the armpits to just above the hips
  • Each cast remains in place for 2–3 months, after which a new cast is applied with further gentle correction; this process is repeated until the curve stabilises, resolves, or until the child is old enough for another treatment (bracing, surgery)​
  • X-rays are taken after casting to monitor curve correction

Risks and Complications

While Mehta casting is generally safe, families should be aware of possible risks:
Potential complications include:

  • Skin irritation, pressure sores, or minor wounds from cast edges or pressure points
  • Difficulties with hygiene and skin care under the cast
  • Respiratory issues if the cast is too tight
  • Discomfort, itching, or heat inside the cast
  • Anesthetic-related risks from repeated procedures​
    Serious complications are rare with careful monitoring and proper technique.

Recovery Expectations and Duration

Recovery and adaptation to Mehta casting tends to be straightforward:

  • The child may be discharged home the day of or after the procedure
  • The cast may feel tight or warm for several days while it dries
  • Most children adjust quickly and can remain active, but certain activities (like swimming or sand play) are restricted​
  • Regular cast changes every 2–3 months are needed, usually as a day procedure
  • The entire course of serial casting may last months to a few years, depending on the child’s growth and curve response
  • Many children experience significant curve improvement; some stabilise and can transition to a brace, while others keep casting until surgery is appropriate​
  • Parents are educated on cast care, signs of skin problems, and when to contact the medical team

FAQs

Will my child need surgery after Mehta casting?
Some children are cured or stabilised with casting alone, while others may eventually need bracing or surgical intervention if the curve is very severe or recurs.

How do we care for the cast at home?
Daily sponge baths, watching for red or sore spots, and keeping the cast dry are all key. Never place objects or powders inside the cast. Your treating team will provide detailed cast care instructions.