Preoperative Halo-Gravity Traction for Severe @entity85 at an SRS-GOP Site in XXXX : Protocols, Complications, and Results.

@entity1 @entity16 @entity1513 @entity739 @entity661 @entity85
STUDY DESIGN.: Retrospective analysis of a prospectively collected single-center database. OBJECTIVE.: We describe a modified halo-gravity traction (HGT) protocol for @entity1 with severe @entity85 in @entity739 , and assess the clinical and radiographic outcomes. SUMMARY OF BACKGROUND DATA.: Three-column osteotomies are frequently used in the correction of severe @entity85 ; however, these can be associated with high complication rates and significant risk for @entity16 . Preoperative traction is one modality used to obtain a partial correction prior to definitive fusion. Low numbers and variability of traction protocols, however, have limited previous reports of sustained HGT. METHODS.: All @entity1 who underwent HGT in Ghana from April 2012 to August 2013 were reviewed. HGT was started at 20% body weight and increased by 10% per week until 50% body weight was reached by 4 weeks or thereafter as tolerated. Demographic variables, operative data, radiographic parameters, and health-related quality of life scores were collected. @entity85 reduction index was calculated at each time point by summing the scoliosis and abnormal @entity1513 for each @entity1 and reported as a percentage of the @entity85 . RESULTS.: Twenty-nine @entity1 underwent HGT for an average 107 days prior to definitive posterior spinal fusion (24 @entity1 ) or placement of growing rods (5 @entity1 ). The major curve improved from an average 131   to 90   (31%) after HGT, and to an average 57   (56%) postoperatively. Pure kyphotic curves were rigid (flexibility 22% after traction), with a correction index of 3.88, which is similar to historical controls. @entity85 with HGT plateaued at 63 days. Overall Scoliosis Research Society-22 questionnaire scores improved significantly pretraction versus postoperatively, but there was no change after traction versus before traction. There were 11 pin tract infections, with no @entity16 . CONCLUSION.: HGT is a safe method to partially correct severe @entity85 prior to a definitive procedure, and may reduce the need for higher risk 3-column osteotomies. Importantly, @entity1513 secondary to infection with spontaneous @entity661 is relatively resistant to HGT.Level of Evidence: 4.
