title: Brace treatment of thoracolumbar kyphosis in spondylometaphyseal dysplasia with restoration of vertebral morphology and sagittal profile: a case report.
abstract: BACKGROUND
  The Kozlowski type of spondylometaphyseal dysplasia (SMD-K) is characterized by vertebral and metaphyseal abnormalities. The longitudinal evolution of thoracolumbar kyphosis associated with vertebral anomalies in SMD-K is unclear.
  
  
  OBJECTIVE
  To document the longitudinal changes in sagittal alignment and vertebral morphology in a patient with SMD-K treated nonoperatively with a Milwaukee brace.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Patient with SMD-K having multiple vertebral anomalies and a thoracolumbar kyphosis.
  
  
  METHODS
  A girl with SMD-K seen initially at 21 months old was followed for 14 years. She presented with thoracolumbar kyphosis associated with multiple vertebral anomalies consisting primarily of hypoplasia at L1, beaking at L2, and ovoid shape of adjacent vertebrae. The patient was treated with a Milwaukee brace and followed until she was 16 years old.
  
  
  RESULTS
  After initiation of brace treatment, the thoracolumbar kyphosis gradually resolved and she had a normal sagittal alignment at last follow-up. Normal vertebral morphology was also completely restored in the sagittal plane. The patient developed a main thoracic scoliosis that did not require additional treatment.
  
  
  CONCLUSIONS
  Nonoperative treatment with bracing can be attempted in patients with SMD-K affected by thoracolumbar kyphosis and multiple vertebral anomalies, because full restoration of normal sagittal alignment and vertebral morphology is possible.
authors.affiliation: Department of Surgery, CHU Sainte-Justine, Côte-Sainte-Catherine Montréal, Montreal, Quebec, Canada H3T 1C5.
authors.forename: Sameh
authors.initials: S
authors.lastname: Ibrahim
authors.affiliation: Department of Surgery, CHU Sainte-Justine, Côte-Sainte-Catherine Montréal, Montreal, Quebec, Canada H3T 1C5; Department of Surgery, University of Montreal, 2900 Boulevard Édouard-Montpetit, Montreal, Quebec, Canada H3T 1J4.
authors.forename: Hubert
authors.initials: H
authors.lastname: Labelle
authors.affiliation: Department of Surgery, CHU Sainte-Justine, Côte-Sainte-Catherine Montréal, Montreal, Quebec, Canada H3T 1C5; Department of Surgery, University of Montreal, 2900 Boulevard Édouard-Montpetit, Montreal, Quebec, Canada H3T 1J4; Department of Surgery, Hopital du Sacre-Coeur de Montreal, 5400 Boulevard Gouin Ouest, Montreal, Quebec, Canada H4J 1C5. Electronic address: macthiong@gmail.com.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Mac-Thiong
mesh_terms: D000293:Adolescent; D001915:Braces; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D011859:Radiography; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging*; D016896:Treatment Outcome
keywords: Bracing; Kyphosis; Skeletal dysplasia; Spine; Spondylometaphyseal dysplasia