Halo-pelvic traction for extreme lumbar kyphosis: 3 rare cases with a completely folded lumbar spine

Wang, Yu; Li, Chunde; Liu, Long; Qi, Litong

doi:10.1080/17453674.2020.1824170

Cited by 6 publications

(6 citation statements)

References 14 publications

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“…A major disadvantage of the HEFF is that it is clearly very burdensome for patients to wear, although the modified, half-ring halo-pelvic apparatus described by Wang and colleagues may partially relieve patient discomfort. 14,16 This technique also typically involves prolonged hospitalisation and constant vigilance for pinsite infection.…”

Section: Discussionmentioning

confidence: 99%

“…14,15 Traction techniques described in the literature include halo-pelvic, halo-gravity, and halo traction, accompanied by anterior release procedures as indicated. [7][8][9][10][11][12][14][15][16][17] Halo-pelvic traction was first developed by O'Brien et al in 1958 and has been shown to be very effective as part of the treatment for severe kyphosis. 7,8,14,[16][17][18] For example, previous studies have reported significantly reduced blood loss and surgery time when comparing patients who received preoperative halo-pelvic traction to those who received surgical correction only.…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9][10][11][12][14][15][16][17] Halo-pelvic traction was first developed by O'Brien et al in 1958 and has been shown to be very effective as part of the treatment for severe kyphosis. 7,8,14,[16][17][18] For example, previous studies have reported significantly reduced blood loss and surgery time when comparing patients who received preoperative halo-pelvic traction to those who received surgical correction only. 8,17 In one study, preoperative halo-pelvic traction also significantly improved deformity correction and patient height compared to surgery alone, whereas another study found reduced complications with preoperative halo-pelvic traction but a similar postoperative deformity correction.…”

Section: Introductionmentioning

confidence: 99%

“…9,10,12,19 However, the latter technique remains an effective and affordable option and may even have advantages when it comes to very young children. 8,16 While halo-gravity traction has the advantage of leaving the legs and pelvis unrestrained, it does nevertheless limit independent mobility by requiring a wheelchair or suspensive walking frame, effectively tethering the patient to their gravity suspension device. Conversely, halo-pelvic traction allows for independent, bipedal mobility -an important consideration during the rapid growth and development of early life.…”

Section: Introductionmentioning

confidence: 99%

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Halo-external fixator frame-assisted correction to treat severe kyphotic deformity in children younger than 4 years old

et al. 2022

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BACKGROUND: Severe kyphotic deformity in young children may have devastating outcomes when neglected. Halo-pelvic traction has been shown to be very effective as part of the treatment for severe kyphosis, but little is known about application of this technique in very young individuals. The aim of this case series was to provide novel insights into the surgical technique associated with halo-external fixator frame (HEFF) treatment for severe spinal deformity in patients younger than 4 years old, along with the associated radiologic outcomes and complications METHODS: Clinical and demographic characteristics including the duration in the HEFF, HEFF-associated change in kyphosis angle (KA) and final KA following definitive surgery were extracted from medical records RESULTS: Five female patients with a mean age of 36 months (range 30-44) were included. Three patients had thoracic spinal tuberculosis (mean KA 82°), one had lumbar spinal tuberculosis (KA 42°) and one had iatrogenic post-laminectomy cervical kyphosis (type 1 neurofibromatosis)(KA 112°). The HEFF was applied for a mean of six weeks and resulted in a mean thoracic deformity correction of 29° (38%), a lumbar correction of 23° (55%) and cervical correction of 47° (42%). Definitive surgery resulted in a further mean overall deformity correction of 28, and patients had a satisfactory KA angle (23° lordosis to 31° kyphosis) at the last follow-up. HEFF-associated complications included pin-site infection, pneumonia and frame dislodgement CONCLUSION: HEFF appears to be an effective method for correcting severe kyphotic spinal deformity in very young patients where other options are limited. It allows for independent mobilisation and can provide for spinal stabilisation while awaiting bony healing after definitive surgery. However, healthcare providers should be aware of the potential dangers of HEFF hardware, such as difficulty in establishing an airway due to the fixed position of the neck Level of evidence: Level 4

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Halo-external fixator frame-assisted correction to treat severe kyphotic deformity in children younger than 4 years old

et al. 2022

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“…However, the associated limitations such as long duration of hospitalization, a multistage process, pain, discomfort, infection, unflattering appearance, and various neurological complications diminished its practice. [11] Recently, a few studies have published the outcome of self-designed halo-pelvic ring on patients with severe kyphotic deformities and showed satisfactory results, but few complications still persist. [6,9,11] Keeping in mind, the halo-pelvic distraction an effective and affordable means of treatment which can reduce the kyphotic deformity of the spine to an extent that can be easily managed with surgical intervention, we designed a halo-pelvic apparatus in our center for patients with severe kyphotic deformity.…”

Section: Introductionmentioning

confidence: 99%

Preoperative management through modified halo-pelvic distraction assembly in a case of severe thoracic spine kyphosis

Ilyas¹,

Shah²,

Afridi³

et al. 2021

Surgical Neurology International

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Background: Halo-traction device has been seen with favorable outcome in managing the patients with severe kyphotic deformities preoperatively, however, associated complications are inevitable. Slight modifications can improve the outcome and clinical efficacy. Case Description: A 14-year-old boy was presented with severe kyphotic deformity of 141° from T1 to T10 thoracic vertebrae with diffuse paraspinal calcification in thoracic spine and complete loss of power of both lower limbs. A modified halo-pelvic distraction device was applied before the definitive surgery. The device comprised halo and pelvic assembly, the halo ring was connected to the head with 06 pins, while pelvic assembly had Ilizarov half pins connected to the arches. The assembly construct had four threaded rods, two of them were placed anterolateral and the other two were posterolateral. Distraction at the rate of 3 mm/day was started from 1st postoperative day for 35 days. The neurology improved in both lower limbs and kyphotic angle reduced to 56° from 141°. Surgery at this stage was done and a standalone solid titanium cage was placed from T1 to T10 vertebral body after debridement. No peri- or post-operative complications were observed. Conclusion: The application of halo-pelvic distraction before corrective surgeries can not only reduce the severity of the kyphotic deformity making the definitive surgery easy but neurology can also be improved. The high-risk complications associated with acute correction of deformities can be minimized using our modified halo-pelvic distraction device.

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The contribution of preoperative balanced halo-pelvic traction to severe rigid spinal deformity correction

Zhou,

Liu,

Deng

et al. 2023

Eur Spine J

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Halo-pelvic traction for extreme lumbar kyphosis: 3 rare cases with a completely folded lumbar spine

Cited by 6 publications

References 14 publications

Halo-external fixator frame-assisted correction to treat severe kyphotic deformity in children younger than 4 years old

Halo-external fixator frame-assisted correction to treat severe kyphotic deformity in children younger than 4 years old

Preoperative management through modified halo-pelvic distraction assembly in a case of severe thoracic spine kyphosis

The contribution of preoperative balanced halo-pelvic traction to severe rigid spinal deformity correction

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