The Use of Halo Gravity Traction in the Treatment of Severe Early Onset Spinal Deformity

Spine
Sravisht IyerFOCOS Spine Research Group

Abstract

Retrospective Review of Prospective cohort. To describe the feasibility of preoperative halo gravity traction (HGT) with subsequent growing rod/guided growth (GR/GG) placement in early onset spinal deformity (EOSD). In children with severe EOSD, primary implantation of GR/GG constructs is not always possible. We describe a staged protocol with preoperative HGT followed by GR/GG implantation. EOSD patients treated with HGT prior to GR/GG implantation were included. HGT used traction up to 50% body weight for 4 to 29 weeks. Pulmonary function tests (PFTs) were performed before and after HGT. Coronal Cobb (CC) and Sagittal Cobb (SC) angles were measured on the Pre-HGT, Post-HGT and 6 week postop x-rays. Thirty patients were included. Average age at GR/GG implantation was 9 years. Most cases (n = 24, 80%) were idiopathic. Most pts had kyphoscoliosis (n = 16, 53.3%). Pre-HGT CC averaged 112 ± 22° and SC averaged 106 ± 26°. CC and SC improved 29% after HGT. There was a significant improvement in body mass index following HGT. CC improved further to 70 ± 14° (36% vs. pre-HGT) and SC to 63 ± 21° (41%) with GR/GG placement. HGT-related complications occurred in nine patients (30%); eight pin site infections, one cranial abscess. Most HG...Continue Reading

References

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Citations

Jan 7, 2020·Chinese Medical Journal·Yan-Bin Zhang, Jian-Guo Zhang
Mar 7, 2020·The Orthopedic Clinics of North America·Elizabeth B GausdenMathias P Bostrom
Nov 30, 2019·Zeitschrift für Orthopädie und Unfallchirurgie·Christoph Eckhard HeydeNicolas H von der Höh
Jun 15, 2021·JBJS Essential Surgical Techniques·K Aaron ShawJoshua S Murphy
Sep 8, 2021·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Anne-Laure SimonBrice Ilharreborde

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