Orthotic results in adolescent kyphosis

Area of Science:

• Orthopedic surgery
• Spinal disorders
• Biomechanical engineering

Background:

• Adolescent kyphosis is a spinal deformity requiring effective bracing.
• Boston lumbar and modified Milwaukee orthoses are common treatment options.
• Orthotic compliance significantly impacts treatment outcomes.

Purpose of the Study:

• To compare the efficacy and compliance of Boston lumbar orthosis versus modified Milwaukee orthosis in treating adolescent kyphosis.
• To evaluate the impact of daily wear time on treatment effectiveness.

Main Methods:

• Retrospective review of 75 adolescent kyphosis patients treated with either Boston or Milwaukee orthosis.
• Analysis of curve improvement, orthosis compliance rates, and daily wear duration.
• Comparison of outcomes based on curve severity and orthosis type.

Main Results:

• The Boston orthosis group demonstrated higher compliance (61%) compared to the Milwaukee group (29%).
• Despite younger patients and smaller curves in the Boston group, both orthoses showed significant curve improvement in compliant patients (27% Boston, 35% Milwaukee).
• Similar treatment results were observed for patients wearing orthoses at least 16 hours daily versus 23 hours.

Conclusions:

• The Boston lumbar orthosis is a viable alternative to the modified Milwaukee brace for adolescent kyphosis, particularly for curves under 70 degrees and when compliance is uncertain.
• Effective treatment can be achieved with 16 hours of daily orthosis wear.
• The Milwaukee orthosis may be effective for severe kyphosis (>75 degrees) in compliant patients.