Paralysis as a result of traction for the treatment of scoliosis: a forgotten lesson from history

Weiner, Marie-France; Silver, J R

doi:10.1038/sc.2009.19

Cited by 10 publications

(6 citation statements)

References 3 publications

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“…Neurological complication caused by the axial traction for scoliosis has been well described. 17,18 It is believed that the corrective forces can stretch the vascular structures of spinal cord and thereby interfere with blood supply making the spinal motor system vulnerable to ischemic insult. 19 MEP is especially sensitive to spinal cord ischemia.…”

Section: Discussionmentioning

confidence: 99%

Impact of Various Weights in the Intraoperative Skull-Skeletal Traction on Correction of Adolescent Idiopathic Scoliosis

Kato

Lewis

Sharma

et al. 2019

Global Spine Journal

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Study Design: A retrospective study. Objectives: Intraoperative skull-skeletal traction (ISST) facilitates the surgical scoliosis correction, but it is also associated with neurological risk. The objective of the present study was to investigate the impact of various traction weights on neurophysiological change and curve correction in surgery for adolescent idiopathic scoliosis (AIS). Methods: A retrospective review of a consecutive series of posterior spinal fusions for AIS patients undergoing corrections with the use of ISST by 2 surgeons in one institution was performed. Intraoperative prone, post-traction radiographs were performed on all cases. The cases were divided into 2 groups, high and low traction weights, based on whether the weight used was ≥35% or <35% of body weight. The frequency of neurophysiological changes and the curve correction were compared between the 2 groups. Results: The intraoperative correction magnitudes by ISST were significantly larger in the high ISST group than in the low ISST group (35° vs 26°, P < .001). Changes in motor-evoked potential (MEP) were more frequently observed in the high ISST group (47% vs 26%, P = .049). A multivariate analysis showed that high ISST was associated with 3 times higher risk of MEP change (95% confidence interval = 1.1-8.0, P = .03) and higher final postoperative correction rates (68% vs 60%, P = .001). Conclusions: The high ISST for AIS was associated with increased intraoperative and ultimate curve corrections, and potentially facilitated better final correction. However, the high weight group was associated with an increased frequency of intraoperative MEP changes.

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Section: Discussionmentioning

confidence: 99%

Impact of Various Weights in the Intraoperative Skull-Skeletal Traction on Correction of Adolescent Idiopathic Scoliosis

Kato

Lewis

Sharma

et al. 2019

Global Spine Journal

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“…Sadly, the dangers of traction had to be rediscovered in the last 30 years. 30 Bell's contribution to the study of diseases of the nerves was extraordinary. He brought order where there had been disorder.…”

Section: Discussionmentioning

confidence: 99%

The contribution to our understanding of spinal disorders by the great Windmill Street School of Anatomy

Weiner

Silver

2010

Spinal Cord

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Study design: This is a review article. Objectives: The aim of this study is to investigate the contribution of the private school of anatomy, the Great Windmill Street School, in our understanding of the physiology, anatomy and pathology of the spine and spinal cord and its role in the treatment of spinal diseases in the eighteenth century. Much has been written about the Hunter brothers and Sir Charles Bell and their contribution to anatomy and medical teaching but the significant role of the Great Windmill Street School of Anatomy in our understanding of the spinal cord and the treatment of spinal disorders had not been previously explored. Setting: Wendover, UK. Methods: Review of the literature. Results: Not applicable. Conclusion: The Great Windmill Street School of Anatomy was unique and fundamental in our understanding of the spine and the spinal cord and the treatment of spinal diseases. What is remarkable is that this work emanated from a private school and not a hospital or a university and it allowed an outstanding school of surgeons and physicians to carry out their work unfettered.

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“…They reported 27 cases of complication including 6 abducens palsies, 5 hypoglossal palsies, 2 glossopharyngeal palsies, 6 brachial plexus palsies, 4 sciatic palsies, 2 paraplegias, 1 permanent and one recovering [25]. In their study, Wilkins and MacEwen described how patients subjected to halo-femoral traction experienced difficulty in swallowing, speech and breathing but showed an immediate relief of the symptoms when the traction was released [7]. …”

Section: Discussionmentioning

confidence: 99%

“…Antonius Nuck (1650-1692) used suspension equipment called a torque, and Johann Georg Heine (1770-1838) and Francois Guillaume Levacher de la Feutrie (1732-1816) attempted treatment upon the spine by means of mechanical beds. Charles Gabriel Pravaz (1791-1853) designed the ‘balançoire orthopédique,' which allowed patients to adjust the traction themselves by means of weights [7]. Forceful traction of the spine by means of extension beds was introduced in France by Charles-Auguste Maisonabe (1779-1851) in the 1820s.…”

Section: Historymentioning

confidence: 99%

Historical Review: Suspension Therapy for the Treatment of Tabes Dorsalis

Weiner¹,

Silver

2014

Eur Neurol

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Background: Suspension therapy was developed by a Russian doctor, A. Motschutkovsky and at the end of the 19th century it was a popular treatment for tabes dorsalis. It was endorsed by Jean-Martin Charcot in France and Weir Mitchell in the United States; but after 10 years, it was abandoned because it proved to be useless and some patients developed paralysis. Summary: The effect of suspension upon a spinal cord affected by tabes dorsalis and a healthy spinal cord has been analyzed in the light of current knowledge. The benefits of suspension were thought to be due to an improvement in the blood supply to the spinal cord and due to the suggestibility or the placebo effect. Key Message: Analysis of the contemporary literature in the light of current research shows that suspension therapy was a powerful weapon that could cause impairment to the conductivity of the spinal cord and this has important implications for current therapy such as the use of Harrington rods.

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Paralysis as a result of traction for the treatment of scoliosis: a forgotten lesson from history

Cited by 10 publications

References 3 publications

Impact of Various Weights in the Intraoperative Skull-Skeletal Traction on Correction of Adolescent Idiopathic Scoliosis

Impact of Various Weights in the Intraoperative Skull-Skeletal Traction on Correction of Adolescent Idiopathic Scoliosis

The contribution to our understanding of spinal disorders by the great Windmill Street School of Anatomy

Historical Review: Suspension Therapy for the Treatment of Tabes Dorsalis

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