Abstract
Background
Improvement of Scheuermann's thoracic kyphosis in the growing spine with Milwaukee brace treatment has been reported. However, the role of brace treatment in Mb. Scheuermann is controversial.
We report results of brace treatment by low profile scoliosis module with sternal shield.
Indication
Thoracic kyphosis >55° or back pain and kyphosis >50°.
Material
21 consecutive patients (17 boys, 4 girls) referred to the Orton Orthopaedic Hospital between 2000-2007. One boy interrupted treatment and the follow-up of two boys was carried out at another hospital. The data of 18 patients are reported.
Results
The mean age of patients at the beginning of treatment was 14 years (11-17) and the average thoracic kyphosis was 71° (50-94). On extension radiographs, the kyphosis decreased to 43°(16-66) with a mean correction of 38%.
The average time of brace treatment was 2,5 (1-7) years. The final follow- up visit was at the age of 19 (15-21) years. At the final follow-up, the mean thoracic kyphosis was 59° (30-78).
Permanent correction of thoracic kyphosis was achieved in 15 patients (83%) with a mean correction of 15 degrees. In two patients no correction was achieved and in one patient the kyphosis increased 9°. No patient required operative treatment.
Discussion and conclusion
The efficiency of brace treatment is difficult to prove because natural history of Scheuermann's kyphosis is not fully known.
Our material is too small for any final conclusions. However, treatment of the growing spine with modified low profile brace seem to decrease progression of kyphosis in most cases and operative treatment may be avoided.
Ethics approval: none
Conflict of interest: none
