Preoperative Halo Traction for Severe Scoliosis

Abstract

Study Design. Retrospective case control study. Objective. The aim of this study was to analyze the appropriate traction period and preoperative halo traction (HT)-related factors in severe scoliosis Summary of Background Data. HT can reduce risks involved in severe scoliosis treatment, and its safety and efficacy are well known. However, a lack of evidence exists in guiding the appropriate traction period and other factors involved in HT. Methods. We retrospectively reviewed 59 patients who underwent preoperative HT, analyzed correction rate changes over time using HT, and assessed other factors by dividing the patients into two groups according to differences between the post-bending correction angle (PBC) and post-halo traction correction angle (PTC): group A (PBC ≒ PTC) and group B (PBC < PTC). The grouping was determined by whether the difference between PBC and PTC was >8°, the maximum measurement error when measuring the Cobb angle. Results. The mean Cobb angle improved from 96.9° preoperatively to 72.9° post-bending to 63.3° post-traction and 32.5° postoperatively. The coronal correction of the major curve (change in curve from the start to each week/total change in curve after traction) was 28.2% at 1 week (n = 59), 34.0% at 2 weeks (n = 58), 33.8% at 3 weeks (n = 41), and 32.2% at 4 weeks (n = 13); a difference was noted between the first and second weeks (P < 0.001, <0.001, 0.244, and 0.082, respectively). Compared with group A, group B had a lower height (154.9 vs. 144.4 cm, P = 0.029), lower body weight (49.1 vs. 39.4 kg, P = 0.017), higher traction/body weight ratio (0.41 vs. 0.47, P = 0.025), and more halo-femoral traction (0 vs. 6, P = 0.018). Conclusion. Traction for ≥3 weeks was unnecessary for optimal traction. In patients with low height and weight, halo-femoral traction with a heavy traction weight was effective. Level of Evidence: 4

Relationship between BMP2/9 Levels and Spinal Function and Quality of Life in Patients with Severe Scoliosis after PVCR

“…is situation may be caused by the following reasons: (1) the etiology of some patients with scoliosis is closely related to the abnormal secretion of BMP and other bone growthpromoting factors. e long-term abnormal increase of BMP and other factors can induce the aggravation of bone deformities in the case of abnormal bone structure, which can [10,11]. (3) e secretion of BMP2 and BMP9 proteins needs a certain material basis, and their metabolism in the body is rapid after secretion.…”

The Use and Complications of Halo Gravity Traction in Children with Scoliosis

“…The most improvement (82%) occurred in the first 3 weeks and the mean duration of traction was 42 days [ 29 ]. Hwang et al obtained the most correction (28.2%) within 1 week and observed that significant changes in the curvature, a correction of 34%, occurred in up to 2 weeks [ 30 ].…”

Preoperative Halo-Femoral Traction With Posterior Surgical Correction for the Treatment of Extremely Severe Rigid Congenital Scoliosis (Cobb Angle >120°)

“…Compared with HGT, HFT and HPT can provide more correction force. A retrospective study from Hwang et al 17 indicated that HPT had an average correction rate of 34.4%. Similar to a study of Hwang et al, Wang et al 18 found the correction rate from HPT could up to 50%.…”

“…A study showed that it usually takes at least 2 to 3 months of traction to reach a relatively satisfactory correction rate. 17 A longer time in bed may increase the incidence rate of traction-related complications, such as pin infection, weakness of the lower extremities, reduced bone quality, and peripheral neurologic deficits. In contrast, during HGT, patients could get out of bed, walk around, and sit upright, which would improve general satisfaction, maintain more lower extremity strength/bone strength, and result in less pain without femoral traction.…”