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European Spine Journal

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01-08-2016 | Original Article

Halo-gravity traction combined with assisted ventilation: an effective pre-operative management for severe adult scoliosis complicated with respiratory dysfunction

Authors: Hongda Bao, Peng Yan, Mike Bao, Yong Qiu, Zezhang Zhu, Zhen Liu, Jack C. Y. Cheng, Bobby K. W. Ng, Feng Zhu

Published in: European Spine Journal | Issue 8/2016

Abstract

Purpose

To investigate the change of pulmonary function in adult scoliosis patients with respiratory dysfunction undergoing HGT combined with assisted ventilation.

Methods

21 adult patients were retrospectively reviewed with a mean age of 26.2 years. Inclusion criteria were as follows: age over 18 years old; coronal Cobb angle greater than 100°; with respiratory failure; and duration of HGT more than 1 month. All patients underwent respiratory training.

Results

The Cobb angle averaged 131.21° and was reduced to 107.68° after HGT. Significantly increased mean forced vital capacity (FVC) was found after HGT (P = 0.003) with significantly improved percent-predicted values for FVC (P < 0.001). Meanwhile, significantly increased forced expiratory volume in 1 s (FEV1) was also observed (P < 0.001) with significantly improved percent-predicted values for FEV1 (P = 0.003) after HGT.

Conclusion

The results of our study revealed that combined HGT and assisted ventilation would be beneficial to pulmonary function improvement in severe adult scoliosis cases, most of which were young adults.

Sucato DJ (2010) Management of severe spinal deformity: scoliosis and kyphosis. Spine (Phila Pa 1976) 35:2186–2192CrossRef

Watanabe K, Lenke LG, Bridwell KH, Kim YJ, Hensley M et al (2010) Efficacy of perioperative halo-gravity traction for treatment of severe scoliosis (≥100 degrees). J Orthop Sci 15:720–730CrossRefPubMed

Doherty MJ, Millner PA, Latham M, Dickson RA, Elliott MW (2001) Non-invasive ventilation in the treatment of ventilatory failure following corrective spinal surgery. Anaesthesia 56:235–238CrossRefPubMed

Perry J, Nickel VL (1959) Total cervicalspine fusion for neck paralysis. J Bone Joint Surg Am 41-A:37–60PubMed

Stagnara P (1971) Cranial traction using the “Halo” of Rancho Los Amigos. Rev Chir Orthop Reparatrice Appar Mot 57:287–300PubMed

Koller H, Zenner J, Gajic V, Meier O, Ferraris L et al (2012) The impact of halo-gravity traction on curve rigidity and pulmonary function in the treatment of severe and rigid scoliosis and kyphoscoliosis: a clinical study and narrative review of the literature. Eur Spine J 21:514–529CrossRefPubMed

Nepple JJ, Lenke LG (2009) Severe idiopathic scoliosis with respiratory insufficiency treated with preoperative traction and staged anteroposterior spinal fusion with a 2-level apical vertebrectomy. Spine J 9:e9–e13CrossRefPubMed

Rinella A, Lenke L, Whitaker C, Kim Y, Park SS et al (2005) Perioperative halo-gravity traction in the treatment of severe scoliosis and kyphosis. Spine (Phila Pa 1976) 30:475–482CrossRef

Sink EL, Karol LA, Sanders J, Birch JG, Johnston CE et al (2001) Efficacy of perioperative halo-gravity traction in the treatment of severe scoliosis in children. J Pediatr Orthop 21:519–524PubMed

10.

Gupta P, Kuperstock JE, Hashmi S, Arnolde V, Gossett JM et al (2013) Efficacy and predictors of success of noninvasive ventilation for prevention of extubation failure in critically ill children with heart disease. Pediatr Cardiol 34:964–977CrossRefPubMed

11.

Weinstein SL, Zavala DC, Ponseti IV (1981) Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients. J Bone Joint Surg Am 63:702–712PubMed

12.

Payo J, Perez-Grueso FS, Fernandez-Baillo N, Garcia A (2009) Severe restrictive lung disease and vertebral surgery in a pediatric population. Eur Spine J 18:1905–1910CrossRefPubMedPubMedCentral

13.

Swank S, Lonstein JE, Moe JH, Winter RB, Bradford DS (1981) Surgical treatment of adult scoliosis. A review of two hundred and twenty-two cases. J Bone Joint Surg Am 63:268–287PubMed

14.

Laserna E, Barrot E, Beiztegui A, Quintana E, Hernandez A et al (2003) Non-invasive ventilation in kyphoscoliosis. A comparison of a volumetric ventilator and a BIPAP support pressure device. Arch Bronconeumol 39:13–18CrossRefPubMed

15.

Ergun P, Aydin G, Turay UY, Erdogan Y, Caglar A et al (2002) Short-term effect of nasal intermittent positive-pressure ventilation in patients with restrictive thoracic disease. Respiration 69:303–308CrossRefPubMed

16.

Carrey Z, Gottfried SB, Levy RD (1990) Ventilatory muscle support in respiratory failure with nasal positive pressure ventilation. Chest 97:150–158CrossRefPubMed

17.

Strumpf DA, Millman RP, Carlisle CC, Grattan LM, Ryan SM et al (1991) Nocturnal positive-pressure ventilation via nasal mask in patients with severe chronic obstructive pulmonary disease. Am Rev Respir Dis 144:1234–1239CrossRefPubMed

18.

Renston JP, DiMarco AF, Supinski GS (1994) Respiratory muscle rest using nasal BiPAP ventilation in patients with stable severe COPD. Chest 105:1053–1060CrossRefPubMed

19.

Rochester DF, Braun NM, Laine S (1977) Diaphragmatic energy expenditure in chronic respiratory failure. The effect of assisted ventilation with body respirators. Am J Med 63:223–232CrossRefPubMed

20.

Bumpass DB, Lenke LG, Bridwell KH, Stallbaumer JJ, Kim YJ et al (2014) Pulmonary function improvement after vertebral column resection for severe spinal deformity. Spine (Phila Pa 1976) 39:587–595CrossRef

21.

Koptan W, ElMiligui Y (2012) Three-staged correction of severe rigid idiopathic scoliosis using limited halo-gravity traction. Eur Spine J 21:1091–1098CrossRefPubMed

22.

Caubet JF, Emans JB (2011) Halo-gravity traction versus surgical release before implantation of expandable spinal devices: a comparison of results and complications in early-onset spinal deformity. J Spinal Disord Tech 24:99–104CrossRefPubMed

23.

Seller K, Haas S, Raab P, Krauspe R, Wild A (2005) Preoperative halo-traction in severe paralytic scoliosis. Z Orthop Ihre Grenzgeb 143:539–543CrossRefPubMed

24.

Flierl S, Carstens C (1997) The effect of halo-gravity traction in the preoperative treatment of neuromuscular scoliosis. Z Orthop Ihre Grenzgeb 135:162–170CrossRefPubMed

25.

Nemani VM, Kim HJ, Bjerke-Kroll BT et al (2015) Preoperative halo-gravity traction for severe spinal deformities at an SRS-GOP site in West Africa: protocols, complications, and results. Spine 40(3):153–161CrossRefPubMed

Title: Halo-gravity traction combined with assisted ventilation: an effective pre-operative management for severe adult scoliosis complicated with respiratory dysfunction
Authors: Hongda Bao
Peng Yan
Mike Bao
Yong Qiu
Zezhang Zhu
Zhen Liu
Jack C. Y. Cheng
Bobby K. W. Ng
Feng Zhu
Publication date: 01-08-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 8/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-016-4607-0

At a glance: The STEP trials

Springer Medicine

Halo-gravity traction combined with assisted ventilation: an effective pre-operative management for severe adult scoliosis complicated with respiratory dysfunction

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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