Effectiveness of Bracing for Thoracolumbar Kyphosis in Achondroplasia

Summary: Brace treatment was found to be effective for thoracolumbar kyphosis in achondroplast children.

Purpose: Thoracolumbar kyphosis is common in children with achondroplasia. The purpose of this study was to assess the effectiveness of brace treatment for such spinal deformity.

Methods: A consecutive series of 26 achondroplast children with spinal deformities were treated with a specially designed orthosis. Serial radiographs (both standing and sitting films) were reviewed both in and out of brace. Student's t-test was used to assess the relationship between curve measurements and bracing effect.

Results: There were 17 male and 9 female patients for whom bracing was instituted at an average of 1.6yrs (range 0.8-3.1yrs). Brace-wear averaged approx. 4.6 yrs (range 1.0-15 yrs) and clinical follow-up averaged 9.5 yrs (range 2.5-18.7 yrs). Average pre-bracing deformity was 60 degrees (range 34-86 degrees) while average post-bracing deformity was 32 degrees (range 8-67 degrees). Student's t-test of out-of brace radiographic measurements indicated a significant bracing effect (p<0 .0001).

Discussion: Thoracolumbar kyphosis can be very problematic in children with achondroplasia. We have shown that early institution of brace treatment for such spinal deformity is effective.