Scheuermann kyphosis. Follow-up of Milwaukee-brace treatment

From 1960 through 1978, a total of 274 patients who had a diagnosis of Scheuermann kyphosis were treated with a Milwaukee brace at the Twin Cities Scoliosis Center. We analyzed the long-term results in 120 patients who had used the Milwaukee brace and had been followed for at least five years after the completion of treatment. The average age of the patients at the initiation of treatment was twelve years and five months, the average age at the completion of treatment was sixteen years and one month, and the average age at the last follow-up examination was twenty-four years. Of the patients who wore the brace consistently, seventy-six showed improvement in the kyphosis between the initial evaluation and the evaluation at final follow-up, while twenty-four showed worsening and ten were unchanged. Seven of the twenty-four patients who were worse had had surgery before the review for this study. The indication for surgery was a kyphosis of more than 60 degrees that was increasing and was not controlled by the brace. Ten patients were inconsistent in their use of the brace. Two of the ten patients had improvement and eight had worsening of the kyphosis; three of the latter eight had a spinal fusion. This study showed that the Milwaukee brace is usually an effective method of treatment for patients who have Scheuermann kyphosis; however, four of fourteen patients who had an initial kyphosis of more than 74 degrees required a spinal fusion.