Cobb angle outcomes in adolescent idiopathic scoliosis curves above the seventh/eighth thoracic vertebrae: A comparison of Milwaukee and Chêneau bracing techniques.

BACKGROUND: Although the Chêneau brace is effective for 3-dimensional scoliosis correction, current expert recommendations generally limit its use, along with other thoracolumbosacral orthoses, to thoracic curves with an apex below T7/T8. The purpose of this study was to compare the effects of Milwaukee and Chêneau braces on Cobb angle and other radiographic parameters in adolescents with idiopathic scoliosis (AIS) presenting with thoracic curve apices above T7/T8.

METHODS: In this prospective comparative study, participants were treated with either a Milwaukee brace or a Chêneau brace for thoracic scoliosis with curve apices above the T7/T8 level. Both interventions incorporated brace-specific exercise programs designed according to the biomechanical principles of each orthosis. Clinical and radiographic assessments included sex, age, primary Cobb angle at brace initiation and best in-brace correction, T1-T12 kyphosis angle, trunk shift, apical vertebral translation, and coronal deformity angular ratio (C-DAR).

RESULTS: Fifty-two adolescents with AIS (12 males and 40 females) were enrolled. Both brace groups demonstrated significant improvements in scoliosis Cobb angle, thoracic kyphosis, trunk shift, and apical vertebral translation compared with pretreatment values (p < .05). However, no significant differences were observed between the Milwaukee and Chêneau groups regarding in-brace radiographic outcomes (p > .05).

CONCLUSIONS: Both Milwaukee and Chêneau braces appear to be effective treatment options for adolescents with idiopathic scoliosis and thoracic curve apices above T7/T8, suggesting that Chêneau bracing may also be applicable in high thoracic curves traditionally managed with Milwaukee braces.