In which of the following conditions is a Milwaukee CTLSO contraindicated?

A Milwaukee CTLSO (Cervico-Thoraco-Lumbo-Sacral Orthosis) is primarily used in the management of scoliosis, particularly in cases of idiopathic scoliosis in children and adolescents. However, the device is contraindicated for curves greater than 60 degrees.

When the spinal curvature exceeds this threshold, the Milwaukee CTLSO may not be effective in halting progression or correcting the curve. In such severe cases, bracing may not provide sufficient control or support. Instead, other treatment options, such as surgical intervention, might be more suitable for managing significant spinal deformities.

On the other hand, skeletal immaturity is often a consideration for bracing, as this population has a better prognosis for correction with orthotic management. Idiopathic scoliosis is precisely what the Milwaukee CTLSO is designed for, especially in moderate curves. Thoracolumbar curves may also be addressed effectively with this brace if the curvature is within an acceptable range. Thus, the severity of the curve is a critical factor determining the appropriateness of using the Milwaukee CTLSO.