Historical Lyonaise brace treatment for adolescent hyperkyphosis. Results of 272 cases reviewed 2 years minimum after removal of the brace

Introduction The conservative orthopaedic treatment of hyperkyphosis is less classical than the scoliosis one, because Hyperkyphosis does not affect the respiratory function, and it is more difficult to define normality. The consequences of hyperkyphosis are mainly pain and aesthetic. In English literature very few homogeneous series of results are published. Lowe [1] in a review of the current literature using evidence-based medicine, concludes that when recognized early in adolescence with progressive kyphosis, bracing treatment will usually result in modest correction of the deformity. Sachs [2] analyzing the results of 274 patients concludes that the Milwaukee brace is usually an effective method of treatment for patients who have Scheuermann kyphosis; however, four of fourteen patients who had an initial kyphosis of more than 74 degrees required a spinal fusion. Weiss [3] analyzes the use of transverse correction forces instead of distraction forces with a 3 points brace in 56 patients. In Lyon, we use since 60 years, an historical protocol consisting of: plaster cast reduction, plexidur 5 points brace and specific exercises. Currently, this treatment is performed in day hospital.