Posterior-Only Surgical Correction with Heavy Halo-Femoral Traction for the Treatment of Severe and Rigid Congenital Scoliosis Associated with Tethered Spinal Cord and Type II Split Cord Malformation

Zhang, Hongqi; Deng, Ang; Liu, Shaohua; Wang, Yuxiang; Alonge, Emmanuel

doi:10.1016/j.wneu.2020.03.145

“…Nonidiopathic scoliosis includes congenital scoliosis, neuromuscular scoliosis, neurofibromatosis-1, and Marfan syndrome, which usually presents as a known pathogeny with an early onset and rapid progression, leading to complex spinal deformities. Severe rigid nonidiopathic scoliosis is often associated with neural axis malformations, pulmonary dysfunction, and malnutrition, thus increasing the potential risk of a correction [1][2][3][4]. To decrease the risk of a correction, preoperational traction is applied in the treatment of nonidiopathic scoliosis.…”

Section: Introductionmentioning

confidence: 99%

“…The simultaneous traction weight gradually enlarges the intervertebral space, resulting in alleviation of the angle of the main and secondary curve, thus improving the compliance of the spine and pulmonary function, which in return downsizes the deformity and helps avoid severe complications such as spinal cord injury. Additionally, preoperative improvement of the curve is proven to be beneficial for corrective surgery outcomes [4,[6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Analysis of the corrective contribution of strong halo-femoral traction in the treatment of severe rigid nonidiopathic scoliosis

Zhang

¹

,

Yang

²

,

Guo

³

et al. 2020

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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 males and 23 females), with a mean age of 16.4 ± 3.73 years (10–22 years) and follow-up of 55.05 ± 6.63 months (range 40–68 months). 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.

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“…Severe rigid nonidiopathic scoliosis is often associated with neural axis malformations, pulmonary dysfunction and malnutrition, thus increasing the potential risk of correction. [1][2][3][4]. To decrease the risk of correction, preoperation traction is applied in the treatment of nonidiopathic scoliosis.…”

Section: Introductionmentioning

confidence: 99%

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

Zhang

¹

,

Yang

²

,

Guo

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

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.

show abstract

“…Severe rigid nonidiopathic scoliosis is often associated with neural axis malformations, pulmonary dysfunction and malnutrition, thus increasing the potential risk of a correction. [1][2][3][4]. To decrease the risk of a correction, preoperational traction is applied in the treatment of nonidiopathic scoliosis.…”

Section: Introductionmentioning

confidence: 99%

“…The simultaneous traction weight gradually enlarges the intervertebral space, resulting in alleviation of the angle of the main and secondary curve, thus improving the compliance of the spine and pulmonary function, which in return downsizes the deformity and helps avoid severe complications such as spinal cord injury. Additionally, preoperative improvement of the curve is proven to be bene cial for corrective surgery outcomes [4,[6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Analysis of the corrective contribution of strong halo-femoral traction in the treatment of severe rigid nonidiopathic scoliosis

Zhang

¹

,

Yang

²

,

Guo

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

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.

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Posterior-Only Surgical Correction with Heavy Halo-Femoral Traction for the Treatment of Severe and Rigid Congenital Scoliosis Associated with Tethered Spinal Cord and Type II Split Cord Malformation

Cited by 10 publications

References 26 publications

Analysis of the corrective contribution of strong halo-femoral traction in the treatment of severe rigid nonidiopathic scoliosis

Analysis of the corrective contribution of strong halo-femoral traction in the treatment of severe rigid nonidiopathic scoliosis

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

Analysis of the corrective contribution of strong halo-femoral traction in the treatment of severe rigid nonidiopathic scoliosis

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