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Published in: BMC Musculoskeletal Disorders 1/2020

Open Access 01-12-2020 | Scoliosis | Research article

Clinical efficacy of short-term pre-operative halo-pelvic traction in the treatment of severe spinal deformities complicated with respiratory dysfunction

Authors: Longtao Qi, Beiyu Xu, Chunde Li, Yu Wang

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

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Abstract

Background

Halo traction has been used as an adjunctive method in the treatment of severe spinal deformities. But there are few reports on the clinical efficacy of halo-pelvic traction (HPT) in the treatment of severe spinal deformities complicated with respiratory dysfunction. This study was to evaluate the clinical efficacy and complications associated with pre-operative HPT in the treatment of severe spinal deformities with respiratory dysfunction.

Methods

Thirty patients with severe spinal deformities complicated with respiratory dysfunction treated with short-term pre-operative HPT were retrospectively reviewed. Inclusion criteria were: (1) patients with severe kyphoscoliosis (coronal Cobb angle or kyphosis angle ≥100°) and respiratory failure, (2) patients undergoing HPT until posterior fusion surgery. All patients underwent general anesthesia for HPT application, which the pelvic ring used in this study was a half-ring, and the rods were all placed on the anterolateral side of the truck.

Results

The major coronal curve scoliosis averaged 116.00 ± 16.70° and was reduced to 63.23 ± 14.00° after HPT, 46.33 ± 10.70° after surgery. The major kyphosis was 102.40 ± 27.67° and was reduced to 52.23 ± 14.16° after HPT, 42.0 ± 11.92° after surgery. A significantly increased FVC was observed after HPT (p < 0.001), with a significantly improved FVC% (p < 0.001). Similarly, a significantly increased FEV1 was also observed (p < 0.001), with a significantly improved FEV1% (p < 0.001).

Conclusion

This study indicated that the modified HPT could be used to help patients with severe spinal deformities complicated with respiratory dysfunction achieve significant correction in both the coronal and sagittal deformities during the pre-operative treatment period along with improved respiratory function and in the absence of severe complications.
Literature
1.
go back to reference Sucato DJ. Management of severe spinal deformity: scoliosis and kyphosis. Spine (Phila Pa 1976). 2010;35(25):2186–92. Sucato DJ. Management of severe spinal deformity: scoliosis and kyphosis. Spine (Phila Pa 1976). 2010;35(25):2186–92.
2.
go back to reference Gollogly S, Smith JT, Campbell RM. Determining lung volume with three-dimensional reconstructions of CT scan data: a pilot study to evaluate the effects of expansion thoracoplasty on children with severe spinal deformities. J Pediatr Orthop. 2004;24(3):323–8.PubMed Gollogly S, Smith JT, Campbell RM. Determining lung volume with three-dimensional reconstructions of CT scan data: a pilot study to evaluate the effects of expansion thoracoplasty on children with severe spinal deformities. J Pediatr Orthop. 2004;24(3):323–8.PubMed
3.
go back to reference Bouchoucha S, Khelifi A, Saied W, Ammar C, Nessib MN, Ben Ghachem M. Progressive correction of severe spinal deformities with halo-gravity traction. Acta Orthop Belg. 2011;77(4):529–34.PubMed Bouchoucha S, Khelifi A, Saied W, Ammar C, Nessib MN, Ben Ghachem M. Progressive correction of severe spinal deformities with halo-gravity traction. Acta Orthop Belg. 2011;77(4):529–34.PubMed
4.
go back to reference Garabekyan T, Hosseinzadeh P, Iwinski HJ, Muchow RD, Talwalkar VR, Walker J, Milbrandt TA. The results of preoperative halo-gravity traction in children with severe spinal deformity. J Pediatr Orthop B. 2014;23(1):1–5.PubMed Garabekyan T, Hosseinzadeh P, Iwinski HJ, Muchow RD, Talwalkar VR, Walker J, Milbrandt TA. The results of preoperative halo-gravity traction in children with severe spinal deformity. J Pediatr Orthop B. 2014;23(1):1–5.PubMed
5.
go back to reference Yang C, Wang H, Zheng Z, Zhang Z, Wang J, Liu H, Kim YJ, Cho S. Halo-gravity traction in the treatment of severe spinal deformity: a systematic review and meta-analysis. Eur Spine J. 2017;26(7):1810–6.PubMed Yang C, Wang H, Zheng Z, Zhang Z, Wang J, Liu H, Kim YJ, Cho S. Halo-gravity traction in the treatment of severe spinal deformity: a systematic review and meta-analysis. Eur Spine J. 2017;26(7):1810–6.PubMed
6.
go back to reference O'Brien JP, Yau AC, Hodgson AR. Halo pelvic traction: a technic for severe spinal deformities. Clin Orthop Relat Res. 1973;93:179–90. O'Brien JP, Yau AC, Hodgson AR. Halo pelvic traction: a technic for severe spinal deformities. Clin Orthop Relat Res. 1973;93:179–90.
7.
go back to reference O'Brien JP, Yau AC, Smith TK, Hodgson AR. Halo pelvic traction. A preliminary report on a method of external skeletal fixation for correcting deformities and maintaining fixation of the spine. J Bone Joint Surg Br. 1971;53(2):217–29.PubMed O'Brien JP, Yau AC, Smith TK, Hodgson AR. Halo pelvic traction. A preliminary report on a method of external skeletal fixation for correcting deformities and maintaining fixation of the spine. J Bone Joint Surg Br. 1971;53(2):217–29.PubMed
8.
go back to reference Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Report working party standardization of lung function tests, European Community for steel and coal. Official statement of the European Respiratory Society. Eur Respir J Suppl. 1993;16:5–40.PubMed Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Report working party standardization of lung function tests, European Community for steel and coal. Official statement of the European Respiratory Society. Eur Respir J Suppl. 1993;16:5–40.PubMed
9.
go back to reference Koller H, Zenner J, Gajic V, Meier O, Ferraris L, Hitzl W. 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. 2012;21(3):514–29.PubMed Koller H, Zenner J, Gajic V, Meier O, Ferraris L, Hitzl W. 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. 2012;21(3):514–29.PubMed
10.
go back to reference Schroeder M, Viezens L, Kunkel P, Ridderbusch K, Hissnauer TN, Jungesblut OD, Hoffmann M, Rueger JM, Stuecker R. Posterior only vertebral column resection for the treatment of severe spinal deformities in pediatric patients: a retrospective case series. World Neurosurg. 2017;101:425–30.PubMed Schroeder M, Viezens L, Kunkel P, Ridderbusch K, Hissnauer TN, Jungesblut OD, Hoffmann M, Rueger JM, Stuecker R. Posterior only vertebral column resection for the treatment of severe spinal deformities in pediatric patients: a retrospective case series. World Neurosurg. 2017;101:425–30.PubMed
11.
go back to reference Bao H, Yan P, Bao M, Qiu Y, Zhu Z, Liu Z, Cheng JC, Ng BK, Zhu F. Halo-gravity traction combined with assisted ventilation: an effective pre-operative management for severe adult scoliosis complicated with respiratory dysfunction. Eur Spine J. 2016;25(8):2416–22.PubMed Bao H, Yan P, Bao M, Qiu Y, Zhu Z, Liu Z, Cheng JC, Ng BK, Zhu F. Halo-gravity traction combined with assisted ventilation: an effective pre-operative management for severe adult scoliosis complicated with respiratory dysfunction. Eur Spine J. 2016;25(8):2416–22.PubMed
12.
go back to reference Muheremu A, Ma Y, Ma Y, Ma J, Cheng J, Xie J. Halo-pelvic traction for severe kyphotic deformity secondary to spinal tuberculosis. Medicine (Baltimore). 2017;96(28):e7491. Muheremu A, Ma Y, Ma Y, Ma J, Cheng J, Xie J. Halo-pelvic traction for severe kyphotic deformity secondary to spinal tuberculosis. Medicine (Baltimore). 2017;96(28):e7491.
13.
go back to reference Janus GJ, Finidori G, Engelbert RH, Pouliquen M, Pruijs JE. Operative treatment of severe scoliosis in osteogenesis imperfecta: results of 20 patients after halo traction and posterior spondylodesis with instrumentation. Eur Spine J. 2000;9(6):486–91.PubMedPubMedCentral Janus GJ, Finidori G, Engelbert RH, Pouliquen M, Pruijs JE. Operative treatment of severe scoliosis in osteogenesis imperfecta: results of 20 patients after halo traction and posterior spondylodesis with instrumentation. Eur Spine J. 2000;9(6):486–91.PubMedPubMedCentral
14.
go back to reference Park DK, Braaksma B, Hammerberg KW, Sturm P. The efficacy of preoperative halo-gravity traction in pediatric spinal deformity the effect of traction duration. J Spinal Disord Tech. 2013;26(3):146–54.PubMed Park DK, Braaksma B, Hammerberg KW, Sturm P. The efficacy of preoperative halo-gravity traction in pediatric spinal deformity the effect of traction duration. J Spinal Disord Tech. 2013;26(3):146–54.PubMed
15.
go back to reference Xia L, Li P, Wang D, Bao D, Xu J. Spinal osteotomy techniques in management of severe pediatric spinal deformity and analysis of postoperative complications. Spine (Phila Pa 1976). 2015;40(5):E286–92. Xia L, Li P, Wang D, Bao D, Xu J. Spinal osteotomy techniques in management of severe pediatric spinal deformity and analysis of postoperative complications. Spine (Phila Pa 1976). 2015;40(5):E286–92.
16.
go back to reference Gonzalez C, Ferris G, Diaz J, Fontana I, Nuñez J, Marín J. Kyphoscoliotic ventilatory insufficiency: effects of long-term intermittent positive-pressure ventilation. Chest. 2003;124(3):857–62.PubMed Gonzalez C, Ferris G, Diaz J, Fontana I, Nuñez J, Marín J. Kyphoscoliotic ventilatory insufficiency: effects of long-term intermittent positive-pressure ventilation. Chest. 2003;124(3):857–62.PubMed
17.
go back to reference Smiljanić I, Kovac V, Cimić M. Changes in pulmonary functional parameters after surgical treatment of idiopathic scoliosis. Coll Antropol. 2009;33(Suppl 2):145–52.PubMed Smiljanić I, Kovac V, Cimić M. Changes in pulmonary functional parameters after surgical treatment of idiopathic scoliosis. Coll Antropol. 2009;33(Suppl 2):145–52.PubMed
18.
go back to reference LaMont LE, Jo C, Molinari S, Tran D, Caine H, Brown K, Wittenbrook W, Schochet P, Johnston CE, Ramo B. Radiographic, pulmonary, and clinical outcomes with halo gravity traction. Spine Deform. 2019;7(1):40–6.PubMed LaMont LE, Jo C, Molinari S, Tran D, Caine H, Brown K, Wittenbrook W, Schochet P, Johnston CE, Ramo B. Radiographic, pulmonary, and clinical outcomes with halo gravity traction. Spine Deform. 2019;7(1):40–6.PubMed
19.
go back to reference Bogunovic L, Lenke LG, Bridwell KH, Luhmann SJ. Preoperative halo-gravity traction for severe pediatric spinal deformity: complications, radiographic correction and changes in pulmonary function. Spine Deform. 2013;1(1):33–9.PubMed Bogunovic L, Lenke LG, Bridwell KH, Luhmann SJ. Preoperative halo-gravity traction for severe pediatric spinal deformity: complications, radiographic correction and changes in pulmonary function. Spine Deform. 2013;1(1):33–9.PubMed
20.
go back to reference Moodie L, Reeve J, Elkins M. Inspiratory muscle training increases inspiratory muscle strength in patients weaning from mechanical ventilation: a systematic review. J Physiother. 2011;57(4):213–21.PubMed Moodie L, Reeve J, Elkins M. Inspiratory muscle training increases inspiratory muscle strength in patients weaning from mechanical ventilation: a systematic review. J Physiother. 2011;57(4):213–21.PubMed
21.
go back to reference Tredwell SJ, O'Brien JP. Apophyseal joint degeneration in the cervical spine following halo-pelvic distraction. Spine (Phila Pa 1976). 1980;5(6):497–501. Tredwell SJ, O'Brien JP. Apophyseal joint degeneration in the cervical spine following halo-pelvic distraction. Spine (Phila Pa 1976). 1980;5(6):497–501.
22.
go back to reference Abu Salim F, Zielke K. Osteoporosis and halo traction in scoliosis patients. Z Orthop Ihre Grenzgeb. 1982;120(3):330–2.PubMed Abu Salim F, Zielke K. Osteoporosis and halo traction in scoliosis patients. Z Orthop Ihre Grenzgeb. 1982;120(3):330–2.PubMed
23.
go back to reference Han X, Sun W, Qiu Y, Xu L, Sha S, Shi B, Yan H, Liu Z, Zhu Z. Halo gravity traction is associated with reduced bone mineral density of patients with severe Kyphoscoliosis. Biomed Res Int. 2016;2016:8056273.PubMedPubMedCentral Han X, Sun W, Qiu Y, Xu L, Sha S, Shi B, Yan H, Liu Z, Zhu Z. Halo gravity traction is associated with reduced bone mineral density of patients with severe Kyphoscoliosis. Biomed Res Int. 2016;2016:8056273.PubMedPubMedCentral
Metadata
Title
Clinical efficacy of short-term pre-operative halo-pelvic traction in the treatment of severe spinal deformities complicated with respiratory dysfunction
Authors
Longtao Qi
Beiyu Xu
Chunde Li
Yu Wang
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Scoliosis
Published in
BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-020-03700-9

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