General Editor: Luiz Vialle

Authors: Emiliano Vialle

Scheuermann Kyphosis Nonoperative treatment

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1 Introduction top

The initial option for most patients is non-operative treatment, which includes physical therapy and the use of orthesis.

2 Physical therapy top

Physical therapy includes back exercises and muscle contractures stretching for adolescents with curves below 60 degrees and adults with mild symptoms.

3 Bracing top


The goal is to obtain partial correction of the deformity.

Bracing is less effective:

  • in skeletally mature patients
  • if kyphosis is greater than 65°
  • with vertebral wedging above 10°

Some loss of correction is expected over time after treatment.

If the apex of the deformity is superior to T8 a Milwaukee brace is indicated.


If the apex of the deformity is inferior to T8 a TLSO can be used. However, the Milwaukee brace will generally give better results than a TLSO brace.

Different protocols recommend usage between 16 and 23 hours until skeletal maturity is achieved.

Gradual removal of the brace with usage during sleep is usually indicated.

v1.0 2016-12-01