Comparing In-brace Correction, Compliance, and Quality of Life Between Milwaukee and Lyon Braces in Adolescents With Thoracic Hyperkyphosis

A thoracic curve degree of greater than 45° leads to thoracic hyperkyphosis, and its common treatment method is orthotic treatment. The acceptance rate of spinal orthosis depends on in-brace correction, patient`s compliance and quality of life.

In this study, we aimed to compare in-brace correction, compliance and quality of life in patients with thoracic hyperkyphosis wearing Milwaukee and Lyon braces.

In this case study, we retrospectively analyzed data for 23 adolescents with thoracic hyperkyphosis worn Milwaukee brace (n=15) and Lyon brace (n=8). In-brace correction was assessed by comparing Cobb angle before and two months after wearing brace. Compliance was determined by the percentage of actual hours worn in accordance with the prescribed regimen. The Quality of Life Profile for Spinal Deformities questionnaire was used to assess the quality of life and mental/psychological functions. Data normality assumption was assessed by Kolmogorov-Smirnov test. Other tests used for data analysis included paired t-test and independent t-test.

Patients had thoracic kyphosis angle of 55-75 degrees aged 10-17 years. They were divided into two groups of Milwaukee(n=15; mean age= 14 years; mean first Cobb angle= 67.9 degrees) and Lyon (n=8; mean age= 13.75 years ; mean first Cobb angle= 61.7 degrees). No significant difference was found between in-brace correction of two groups (p= 0.073), while the compliance of Lyon group was better. Furthermore, findings reported a significant difference in quality of life between groups (p= 0.018), where Lyon group had improved quality of life.

Lyon brace had less detrimental effect on the quality of life of patients in comparison with the Milwaukee brace, while the compliance after using Lyon brace was better; however, identical in-brace correction was achieved by both braces. Therefore, by considering and integration of significant factors in treatment plan, these braces can be used for in-brace correction.