Analysis of the Corrective Contribution of Strong Halo-femoral Traction in the Treatment of Severe Rigid Nonidiopathic Scoliosis

Abstract

Introduction: Strong halo-femoral traction has been widely used in the field of severe rigid scoliosis correction. The objective of this study was to analyze the corrective contribution of strong halo-femoral traction in the treatment of severe rigid nonidiopathic scoliosis and discuss its meaning.Material and methods: A retrospective review was performed for patients with severe rigid nonidiopathic scoliosis who were treated with halo-femoral traction in our center from December 2008 to December 2015. All cases underwent halo-femoral traction for 2 to 4 weeks before a one-stage posterior operation, and the absolute and relative contribution rates of each orthopedic factor (bending, fulcrum, traction, surgery) were analyzed.Results: A total of 38 patients were included (15 male and 23 female), with a mean age of 16.4± 3.73 years (10-22 years) and follow-up of 55.05 ± 6.63 mos. (range 40-68 mos.). The etiology was congenital in 17 patients, neuromuscular in 14 patients, neurofibromatosis-1 in 3 patients and Marfan syndrome in 2 patients. Congenital high scapular disease with scoliosis was found in 2 patients. The mean coronal Cobb angle of the major curve was 97.99°±11.47° (range 78°–124°), with a mean flexibility of 15.68% ±6.65%. The absolute contribution rate (ACR) of bending was 27.26% ±10.16%, the ACR of the fulcrum was 10.91% ±2.50%, the ACR of traction was 32.32% ±11.41%, and the ACR of surgery was 29.50% ±9.70%. A significant difference in correction was noted between the ACRs of traction and the fulcrum (P < 0.05).Discussion: Strong halo-femoral traction plays a relatively significant role in the treatment of severe rigid nonidiopathic scoliosis while decreasing the risk of operation, and it is a safe and effective method for the treatment of severe rigid nonidiopathic scoliosis.