The mean physiological curve in the thoracic spine measures 33° (±2 standard deviations = 20-50°)1 in adolescents and is influenced by age, gender, height, weight and genetic factors.
The thoracic kyphosis increases in size and stiffness as we age. This is in part due to changes in muscle tone, effects of occupational or habitual postures, changes in vertebral body shape, and bone mineral density.
It is, therefore, important to manage cases of hyperkyphosis in adolescent patients so as to minimize the effect of the natural deterioration that occurs with age. Furthermore, deleterious changes in the sagittal balance can result in pain, poor function, low self-image and decreased quality of life.
There is evidence to suggest that bracing is an effective treatment for patients with hyper-kyphosis. The best results from bracing are observed when treatment is initiated in skeletally immature patients who have curvatures of between 55-80°.
This case is unique in the sense that the patient had already transitioned through the period of peak growth velocity and was Risser 5 at the initiation of treatment. Despite this, a significant correction was still achieved, which resulted in the patient’s kyphosis being shifted from a pathological curvature to normal range kyphosis angle for the patient’s age.