Halo Gravity Traction Is Associated with Reduced Bone Mineral Density of Patients with Severe Kyphoscoliosis

Han, Xiao; Sun, Weixiang; Qiu, Yong; Xu, Leilei; Sha, Shifu; Shi, Benlong; Huang, Yan; Liu, Zhen; Zhu, Zhou

doi:10.1155/2016/8056273

Cited by 16 publications

(12 citation statements)

References 40 publications

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“…Osteoporosis was also noted by several authors in patients treated with halo-pelvic traction due to prolonged immobilization [ 5 ]. Disuse osteoporosis can occur with complete immobilization during halo-femoral traction, and 76% of patients sustained fractures after completing immobilization [ 34 ].…”

Section: Discussionmentioning

confidence: 81%

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Preoperative Halo-Gravity Traction for Severe Thoracic Kyphoscoliosis Patients from Tibet: Radiographic Correction, Pulmonary Function Improvement, Nursing, and Complications

Zeng

et al. 2017

Med Sci Monit

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BackgroundThis study investigated the outcomes of preoperative HGT as an adjunct treatment for severe thoracic kyphoscoliosis, its role in radiographic correction, and pulmonary function improvement, together with nursing strategy and incidence of complications.Material/MethodsEleven patients with a mean age of 18.8 years were retrospectively reviewed. Inclusion criteria were: patients with severe kyphoscoliosis (coronal Cobb angle and kyphosis angle ≥80°); duration of HGT ≥8 weeks; patients undergoing HGT for at least 12 h per day; traction weight no less than 40% of body weight; and patients not receiving physical therapies. All patients underwent respiratory training.ResultsThe major coronal curve scoliosis averaged 114.00±24.43° and was reduced to 80.55±17.98° after HGT. The major kyphosis was 103.91±18.95° and was reduced to 80.55±17.98°. Significantly improved percent-predicted values for FVC was found after HGT (p=0.014), and significantly increased forced expiratory volume in 1 s (FEV1%) was also observed (p<0.001), with significantly improved percent-predicted values for PEF (p=0.003) after HGT.ConclusionsOur data reveal that preoperative HGT can be performed safely, and can help achieve excellent curve correction in both the coronal and sagittal planes, together with improved respiratory function and no severe complications in patients with severe thoracic kyphoscoliosis.

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Section: Discussionmentioning

confidence: 81%

“…Kyphosis was measured between the maximally tilted upper and lower-end vertebrae using the standard Cobb’s method. The correction rates for both coronal and sagittal plane were calculated as follows [ 5 ]:…”

Section: Methodsmentioning

confidence: 99%

Preoperative Halo-Gravity Traction for Severe Thoracic Kyphoscoliosis Patients from Tibet: Radiographic Correction, Pulmonary Function Improvement, Nursing, and Complications

Zeng

et al. 2017

Med Sci Monit

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“…In our study, two patients (6.7%) developed neurologic complications after HPT traction, thought these occurrences returned to normal after reducing the traction. Moreover, due to the lack of immobilization of the patients receiving the modi ed HPT, any occurrence of osteoporosis could be avoided [22,23].…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Short-Term Pre-Operative Halo-Pelvic Traction in the Treatment of Severe Spinal Deformities Complicated With Respiratory Dysfunction

et al. 2020

Preprint

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Background Halo traction has been used as an adjunctive method in the treatment of severe spinal deformities. But there are few reports on the clinical efficacy of halo-pelvic traction (HPT) in the treatment of severe spinal deformities complicated with respiratory dysfunction. This study was to evaluate the clinical efficacy and complications associated with pre-operative HPT in the treatment of severe spinal deformities with respiratory dysfunction.Methods Thirty patients with severe spinal deformities complicated with respiratory dysfunction treated with short-term pre-operative HPT were retrospectively reviewed. Inclusion criteria were: (1) patients with severe kyphoscoliosis (coronal Cobb angle or kyphosis angle ≥100°) and respiratory failure, (2) patients undergoing HPT until posterior fusion surgery. All patients underwent general anesthesia for HPT application, which the pelvic ring used in this study was a half-ring, and the rods were all placed on the anterolateral side of the truck. Results The major coronal curve scoliosis averaged 116.00 ± 16.70° and was reduced to 63.23 ± 14.00° after HPT, 46.33 ± 10.70° after surgery. The major kyphosis was 102.40 ± 27.67° and was reduced to 52.23 ± 14.16° after HPT, 42.0 ± 11.92° after surgery. A signiﬁcantly increased FVC was observed after HPT (p<0.001), with a signiﬁcantly improved FVC% (p<0.001). Similarly, a signiﬁcantly increased FEV1 was also observed (p <0.001), with a signiﬁcantly improved FEV1% (p<0.001).Conclusion This study indicated that the modified HPT could be used to help patients with severe spinal deformities complicated with respiratory dysfunction achieve significant correction in both the coronal and sagittal deformities during the pre-operative treatment period along with improved respiratory function and in the absence of severe complications.

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“…Furthermore, preoperative HGT can also have an impact on the BMD. Long traction duration may bring more bone mineral loss [21]. In this study, CIH-HT combined PO approach was used for the treatment of cervical kyphosis in patients with NF-1.…”

Section: Discussionmentioning

confidence: 99%

“…HGT could provide a slow and gradual correction while the patients were awake , which typically decreased the amount of corrective force that needed to be applied to the cervical spine. With the help of preoperative HGT, partial correction of the deformity can be achieved to make the surgical procedure easier with less operative risk [21]. In this study, each patient underwent CIH-HT prior to the correction surgery.…”

Section: Discussionmentioning

confidence: 99%

Continuous Incremental Heavy Halo Traction Combined with Posterior-only Approach for Severe Cervical Kyphosis with Neurofibromatosis-1.

Guo

Author)

Zhou

et al. 2019

Preprint

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Background Surgical management of cervical kyphosis in patients with NF-1 is a challenging task. Presently, anterior-only (AO), posterior-only (PO) and combined anterior-posterior (AP) spinal fusion are common surgical strategies. However, the choice of surgical strategy and application of Halo traction remain controversial. Few studies have shown and recommended posterior-only approach for cervical kyphosis correction in patients with NF-1. The aim of this study is to evaluate the safety and the effectiveness of Continuous-Incremental-Heavy Halo Traction (CIH-HT) combined with posterior-only approach for treatment of cervical kyphosis with NF-1. Methods 19 patients with severe cervical kyphosis due to NF-1 were reviewed retrospectively between January 2010 and April 2017. All the cases underwent CIH-HT combined with posterior instrumentation and fusion surgery. Correction result, neurologic status and complications were analyzed. Results In this study, cervical kyphosis Cobb angle decreased from initial 63.0 ± 21.0 degrees to postoperative 10.8 ± 4.0 degrees(P＜0.01),with total correction rate of 92%, which consist of 44% from CIH-HT and 48% from surgical correction. JOA scores were improved from preoperative 13.6±1.6 to postoperative 16.0±1.0(P＜0.01). Neurological status was also improved. There was no correction loss and the neurological status was stable in mean 3.7 years follow-up. The incidence of complications was 36.8% (7/19). Six patients underwent local complications and one patient underwent a second surgery. Conclusion CIH-HT combined PO approach is safe and effective method for cervical kyphosis correction in patients with NF-1. A satisfied correction result, and successful bone fusion can be achieved via this procedure, even improvement of neurological deficits can also be obtained. Our study suggested that CIH-HT combined PO approach is another consideration for cervical kyphosis correction in patients with NF-1. Key words : Neurofibromatosis-1; Cervical kyphosis; Continuous-Incremental-Heavy Halo Traction; posterior-only approach;

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Halo Gravity Traction Is Associated with Reduced Bone Mineral Density of Patients with Severe Kyphoscoliosis

Cited by 16 publications

References 40 publications

Preoperative Halo-Gravity Traction for Severe Thoracic Kyphoscoliosis Patients from Tibet: Radiographic Correction, Pulmonary Function Improvement, Nursing, and Complications

Preoperative Halo-Gravity Traction for Severe Thoracic Kyphoscoliosis Patients from Tibet: Radiographic Correction, Pulmonary Function Improvement, Nursing, and Complications

Clinical Efficacy of Short-Term Pre-Operative Halo-Pelvic Traction in the Treatment of Severe Spinal Deformities Complicated With Respiratory Dysfunction

Continuous Incremental Heavy Halo Traction Combined with Posterior-only Approach for Severe Cervical Kyphosis with Neurofibromatosis-1.

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