The results of preoperative halo-gravity traction in children with severe spinal deformity

Abstract

Halo-gravity traction has been used preoperatively for patients with severe spinal deformity but there are limited data in the literature on the results and complications. We studied the outcomes of perioperative halo-gravity traction in children with severe spinal deformity. A retrospective study was carried out on patients who were treated at our center. Twenty-one patients were included in the study. Radiographic and pulmonary function parameters showed significant improvement during the course of traction and at the final follow-up. The overall complication rate was 19%, including two patients with pin loosening and two patients with superficial pin-site infections treated with oral antibiotics.

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

“…Compared with other skeletal tractions, such as halo-femoral, halo-tibial, or halo-pelvic, HGT provides a slow and gradual correction while the patients are awake, making the continuous monitoring of patients' neurological status possible [3, 25]. With the help of preoperative HGT, partial correction of the deformity can be achieved [7, 8]. In the current study, after the completion of HGT, the average correction rates were 35.98% in the coronal plane and 33.27% in the sagittal plane, which were consistent with the results of previous reported study by Sink et al [5].…”

“…Watanabe et al [4] using HGT for severe scoliosis (≥100°) reported a 28% correction rate after that. Recently, Garabekyan et al [8] observed a 38% reduction in the main coronal curve and a 25% correction in the sagittal plane with HGT applied to a pediatric population. To be noted, no patient had previous spine surgery or anterior release in this study.…”

“…Preoperative HGT has been proved to be a safe method of applying gradual and sustained traction to maximize surgical correction of kyphoscoliosis. Previous studies demonstrated that 15% to 38% correction in scoliosis and 17% to 35% correction in kyphosis could be achieved by preoperative HGT [4–8]. Sponseller et al [9] reported that the total complication rate was lower in patients treated with HGT before definitive fusion than those treated without preoperative HGT (27% versus 52%), showing the capability of preoperative HGT in reducing the risk of complications during scoliosis surgery.…”

“…Although HGT can effectively lower the incidence of surgical complications, it is noteworthy that HGT-related complications, such as cranial nerve palsy, pin site infection, and pin loosening, have been reported in the literatures [4–8, 10–12]. Besides, patients undergoing HGT are consistently immobilized, thereby making their daily physical motion quite restricted.…”

Innovative Method of Gradual Temporary Distraction Using Magnetic Growing Rods (MCGR) for Surgical Treatment of Severe Kyphoscoliosis: Mini-case Series

“…Halo-related complications, such as pin-site infection and loosening, and neurological damage, have been encountered. A recent review of the literature has reported a rate of 53%, with 10% requiring surgery and 31% suffering from transient halo-related neurologic compromise [16,17]. In other series, a 31% incidence of complications can be found, including cranial nerve injuries, Horner syndrome, extremity weakness and bradycardia [3].…”