Progressive correction of severe spinal deformities with halo-gravity traction


Published online: Aug 27 2011

Sami Bouchoucha, Anis Khelifi, Walid Saied, Chokri Ammar, Mohamed Nebil Nessib, Maher Ben Ghachem

From the Children's Hospital, Tunis, Tunisia

Abstract

Treatment of rigid and severe spinal deformities is challenging and risky. Preoperative halo-gravity traction can be used to progressively reduce the deformity before spinal fusion. The aim of this study was to evaluate the effectiveness of halo-gravity traction for the correction of severe spinal deformities. Fifteen patients were reviewed retrospectively. Their mean age at the beginning of traction was 13.5 years. The mean duration of traction was 64 days. The main curve in the coronal plane improved from +/- 95° to +/-67°, a gain of +/-28° (range 0°-50°) or +/-30%. The curve in the sagittal plane improved from +/- 96° to +/- 78°, a gain of +/- 18° (range 0°-45°) or +/-19%. Other authors report gains up to 46% and 43%, respectively in the coronal and in the sagittal plane, but this might be due to different conditions, techniques, and evaluations. One patient with a pre-existing neurological deficit developed paraplegia. According to the literature congenital curves with associated kyphosis are exposed to paraplegia. Halo-gravity traction is effective and is usually tolerated better than other techniques of traction using the halo device.