Mehdikhani Mahboobeh, Behtash Hamid, Ganjavian Mohammad Saleh, Abu Osman Noor Azuan, Khalaj Nafiseh
Department of Biomedical Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia Rehabilitation Research Center, Iran University of Medical Sciences Tehran, Iran
Department of Orthopaedic Surgery, Shafa Yahyaiian Hospital, Iran University of Medical Sciences, Iran.
Prosthet Orthot Int. 2014 Aug;38(4):316-20. doi: 10.1177/0309364613499063. Epub 2013 Aug 15.
The Milwaukee brace is an efficient method for correcting hyperkyphosis before skeletal maturity. However, loss of correction in long-term follow-up is inevitable.
To determine loss of correction and factors affecting the loss of correction.
Retrospective study.
A total of 49 corrected patients by Milwaukee brace participated minimum 2 years after treatment completion. The participants were categorized into two groups based on their roentgenograms: Group 1 (n = 36) had kyphotic curves of 45° or less and Group 2 (n = 13) had kyphotic curves of more than 45°.
The mean loss of corrections for Group 1 and Group 2 were 3.80° (ranges = 0°-13°) and 12.92° (ranges = 8°-22°), respectively. Group 1 showed no significant difference between the average hyperkyphosis of the patients for the part-time and full-time treatment duration (p = 0.02). By contrast, a significant difference was observed between the average hyperkyphosis of patients in Group 2 for the part-time and full-time treatment duration (p < 0.05).
Patients with kyphosis of 60° or less who can save the correction in full-time orthotic treatment in part-time treatment may have the least loss of correction over time.
As the orthotic treatment is a time-consuming method that needs the close collaboration of patient and treatment team, it is possible that clinicians predict the probable result of treatment and efficiency of orthotic treatment. Thus, a clinician can abandon orthotic treatment and refer the patient for an operation.
密尔沃基支具是在骨骼成熟前矫正脊柱后凸的有效方法。然而，长期随访中矫正丢失是不可避免的。
确定矫正丢失情况及影响矫正丢失的因素。
回顾性研究。
49例接受密尔沃基支具矫正治疗的患者在治疗完成后至少随访2年。根据X线片将参与者分为两组：第1组（n = 36）脊柱后凸角度为45°或更小，第2组（n = 13）脊柱后凸角度大于45°。
第1组和第2组的平均矫正丢失分别为3.80°（范围 = 0° - 13°）和12.92°（范围 = 8° - 22°）。第1组患者在兼职和全职治疗期间的平均脊柱后凸度无显著差异（p = 0.02）。相比之下，第2组患者在兼职和全职治疗期间的平均脊柱后凸度存在显著差异（p < 0.05）。
脊柱后凸60°或更小且在兼职治疗中能像全职支具治疗一样维持矫正效果的患者，随着时间推移矫正丢失可能最少。
由于支具治疗是一种耗时的方法，需要患者与治疗团队密切合作，临床医生有可能预测治疗的可能结果及支具治疗的效果。因此，临床医生可以放弃支具治疗并将患者转诊进行手术。
