Effect of the type of brace on head to pelvis sagittal alignment of adolescents with Scheuermann's kyphosis.

The aim of this study was to determine the effects of the Milwaukee brace and thoracolumbosacral orthosis (TLSO) on head to pelvis sagittal alignment in adolescents with Scheuermann's kyphosis (SK). A total of 52 adolescents with SK who were under brace treatment were studied. They underwent biplanar radiography of the head to pelvis (EOS Imaging, Paris, France) before and 6 months after the beginning of bracing. We measured T₁ slope, neck tilt (NT), cervical sagittal vertical axis (cSVA), thoracic inlet angle (TIA), C₀-C₂ lordosis, C₂-C₇ lordosis, thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), sagittal vertical axis (SVA) and T₁ spinopelvic inclination (T₁SPi). There were no significant differences in baseline values of TIA, PT, SS, PI, SVA, TK, cSVA, NT and T₁ slope between the two groups (p > 0.05). There were significant differences between the baseline and final measurements of T₁ slope, cSVA, TK, LL, T₁SPi and TIA in both groups (p < 0.05). The results imply that brace treatment can significantly affect head to pelvis sagittal parameters of adolescents with SK. However, there are no significant differences in the values of head to pelvis sagittal parameters when comparing short-term effect of TLSO and the Milwaukee brace.