Milwaukee brace
Encyclopedia
The Milwaukee brace, also known as a cervico-thoraco-lumbo-sacral orthosis or CTLSO, is a back brace used in the treatment of spinal curvatures (such as scoliosis
or kyphosis
) in children. It is a full-torso brace that extends from the pelvis to the base of the skull. It was originally designed by Blount and Schmidt in 1946 for postoperative care when surgery required long periods of immobilization.
Milwaukee braces are often custom-made over a mold of the patient's torso, but in some cases, it can be made from prefabricated parts. Three bars—two posterior and one anterior—are attached to a pelvic girdle made of leather or plastic, as well as a neck ring. The ring has an anterior throat mold and two posterior occipital pads, which fit behind the patient's head. Lateral pads are strapped to the bars; adjustment of these straps holds the spine in alignment.
This brace is normally used with growing adolescents to hold a 25° to 40° advancing curve. The brace is intended to minimize the progression to an acceptable level, not to correct the curvature. For corrective measures, special exercises or physical activities are used. If the curvature continues despite the brace, surgery may be required.
The Milwaukee brace is often prescribed to be worn 23 hours a day for several years, or in some cases, permanently.
A related brace is the Boston brace (underarm brace, also known as a thoraco-lumbo-sacral orthosis, or TLSO), which is more commonly used for scoliosis. That brace does not have a neck ring and is more easily concealed under clothing, thus more acceptable to patients. However, it is not suitable for high thoracic or cervical spinal curvatures.
Scoliosis
Scoliosis is a medical condition in which a person's spine is curved from side to side. Although it is a complex three-dimensional deformity, on an X-ray, viewed from the rear, the spine of an individual with scoliosis may look more like an "S" or a "C" than a straight line...
or kyphosis
Kyphosis
Kyphosis , also called roundback or Kelso's hunchback, is a condition of over-curvature of the thoracic vertebrae...
) in children. It is a full-torso brace that extends from the pelvis to the base of the skull. It was originally designed by Blount and Schmidt in 1946 for postoperative care when surgery required long periods of immobilization.
Milwaukee braces are often custom-made over a mold of the patient's torso, but in some cases, it can be made from prefabricated parts. Three bars—two posterior and one anterior—are attached to a pelvic girdle made of leather or plastic, as well as a neck ring. The ring has an anterior throat mold and two posterior occipital pads, which fit behind the patient's head. Lateral pads are strapped to the bars; adjustment of these straps holds the spine in alignment.
This brace is normally used with growing adolescents to hold a 25° to 40° advancing curve. The brace is intended to minimize the progression to an acceptable level, not to correct the curvature. For corrective measures, special exercises or physical activities are used. If the curvature continues despite the brace, surgery may be required.
The Milwaukee brace is often prescribed to be worn 23 hours a day for several years, or in some cases, permanently.
A related brace is the Boston brace (underarm brace, also known as a thoraco-lumbo-sacral orthosis, or TLSO), which is more commonly used for scoliosis. That brace does not have a neck ring and is more easily concealed under clothing, thus more acceptable to patients. However, it is not suitable for high thoracic or cervical spinal curvatures.