Long-term outcome after brace treatment of Scheuermann's kyphosis: an observational controlled cohort study.
Angelo G Aulisa, Martina Marsiolo, Valeria Calogero and 2 others
PMID 37746785WHAT IT FOUND
For 158 patients with thoracic Scheuermann's kyphosis treated with an antigravity brace, mean thoracic curve was 57.6° at baseline and 44.49° at ten-year follow-up.
Apex vertebral wedging angle was 14.43° at baseline and 8.654° at follow-up.
Key findings
01In 158 patients, mean thoracic Cobb angle was 57.6° at baseline, 43.3° at the end of treatment and 44.49° at ten-year follow-up.
02Mean ALFA angle was 14.43° at baseline, 8.571° at the end of treatment and 8.654° at ten-year follow-up, and end of treatment did not differ significantly from follow-up.
03Correction was related to treatment duration, and mean treatment duration was 28.42 months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The authors state that compliance was confirmed only by oral patient report. The authors state that the low BMI of the sample could overestimate brace effectiveness. The authors state that patients were young at follow-up. Patients were selected for thoracic kyphosis greater than 45° but not greater than 75°, Risser score 0 to 2, apex T7 or lower, and BMI not greater than 25, so the results may not apply to more severe curves, higher BMI, or different skeletal maturity. No exercises were performed, so the paper does not show what an exercise programme would add. The supplied text describes brace-treated patients and does not report a control group comparison in detail.
The easy way to misread this
Do not read the lower kyphosis and ALFA angles at follow-up as proof that the brace caused the improvement. The supplied text reports patients treated with the brace, and the authors state that compliance was confirmed only by oral report. It also states that no exercises were performed. The supplied text does not report a control group comparison in detail.