Riddle Eric C, Bowen J Richard, Shah Suken A, Moran Edward F, Lawall Harry
Department of Orthopaedics, Alfred I. duPont Hospital for Children, Wilmington, DE 19899, USA.
J South Orthop Assoc. 2003 Fall;12(3):135-40.
The purpose of this study was to evaluate the effectiveness of a newly designed brace in the treatment of adolescent Scheuermann thoracic kyphosis. Twenty-two children who met the roentgenographic criteria of Scheuermann kyphosis and were compliant with treatment were followed until skeletal maturity. Sixteen patients (73%) showed nonprogression of their kyphosis (nine patients demonstrated an improvement, seven patients remained unchanged), and had a mean improvement of 9 degrees (64 degrees to 55 degrees). Six patients (27%) demonstrated progression of the kyphosis and had a mean increase in their kyphosis of 9 degrees (59 degrees to 68 degrees). One patient underwent posterior spinal fusion for progressive thoracic kyphosis despite bracing. It was recommended that this brace be worn until skeletal maturity; in this study this time period was determined to be at least 16 months to induce improvement or halt progression of this disease. Flexible curves are a positive predictor of a successful outcome of bracing with the kyphosis brace. These results are comparable to previous reports in the literature describing the effectiveness of the modified Milwaukee brace in the treatment of Scheuermann thoracic kyphosis prior to skeletal maturity, and the kyphosis brace has the advantage of concealability under normal attire.
本研究的目的是评估一种新设计的支具治疗青少年Scheuermann胸椎后凸畸形的有效性。22名符合Scheuermann后凸畸形影像学标准且依从治疗的儿童被随访至骨骼成熟。16例患者（73%）后凸畸形未进展（9例患者改善，7例患者不变），平均改善9度（从64度降至55度）。6例患者（27%）后凸畸形进展，后凸畸形平均增加9度（从59度增至68度）。1例患者尽管佩戴支具，仍因进行性胸椎后凸畸形接受了后路脊柱融合术。建议佩戴这种支具直至骨骼成熟；在本研究中，该时间段确定为至少16个月，以促进病情改善或阻止疾病进展。柔韧性曲线是使用后凸支具成功治疗的一个积极预测指标。这些结果与文献中先前描述改良密尔沃基支具在骨骼成熟前治疗Scheuermann胸椎后凸畸形有效性的报告相当，并且后凸支具具有在正常着装下可隐蔽的优点。
