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 topenlarge
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.