The part-time Milwaukee brace treatment of juvenile idiopathic scoliosis. Long-term follow-up.

A long-term follow-up in 15 patients who had juvenile idiopathic scoliosis was instituted to determine the efficacy of a part-time Milwaukee brace program. The patients were divided into two groups. In Group I patients, part-time bracing was successful in controlling the scoliosis. The average curvature at the onset of bracing was 32 degrees, and the final curvature was 28 degrees. None of the final curvatures increased more than 7 degrees from the initial curvatures. In Group II patients, following six years of part-time bracing, the patients ultimately were treated by posterior fusion and Harrington instrumentation. All of these patients had curvatures greater than 35 degrees at the onset of part-time bracing. All patients who had curvatures less than 35 degrees at the onset of part-time bracing and whose rib--vertebrate angle difference (RVAD) remained less than 20 degrees were successfully treated without surgery. All patients who had curvatures of greater than 45 degrees at the onset of bracing and whose RVAD exceeded 20 degrees eventually underwent spinal fusion. A consistent finding of vertebral body half-wedging was noted on the side of the concavity. The persistence of this finding appeared to correlate well with the patients clinical response.