TO THE EDITOR:
We read “Use of the Milwaukee Brace for Progressive Idiopathic Scoliosis” (78-A: 557–567, April 1996), by Noonan et al., with considerable interest. We were particularly struck by the difference between their analysis of results and ours5.
As the details in both articles are reviewed, the reason for the difference becomes clear. First, Noonan et al. reviewed the results for 102 patients, although those for only eighty-eight were analyzed statistically since they, unlike us, eliminated patients who had curves of more than 45 degrees. A statistically valid comparison of this small group of eighty-eight patients with the 1020 patients in our study is difficult, especially when the results have to be subdivided according to age, curve, magnitude, and compliance.
Second, the duration of treatment with the brace in their study (one year and eight months) was much shorter than that in ours (three years and eight months).
Third, in the study by Noonan et al., the best correction in the brace for the group for which treatment failed was 8 per cent and that for the group for which treatment was successful was 20 per cent. In our study, the over-all average best correction in the brace was 30 per cent.
Another criticism that we have is the inadequate bibliography concerning the results of bracing for idiopathic scoliosis. Noonan et al. did not cite the superb study of Milwaukee bracing by Salanova9, which is also available as a monograph3, Salanova9 and Durand3 found that, of the curves associated with the highest risk for progression (thoracic curves in premenarchal girls who had a Risser sign of 0 or 1), only 21 per cent worsened, in contrast to the expected 68 per cent rate of worsening for untreated curves. These results were …
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