Zhang Hongqi, Yang Guanteng, Guo Chaofeng, Liu Jinyang, Tang Mingxing
Department of Spine Surgery and Orthopedics, Xiangya Hospital, Central South University, Changsha, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha, 410008, Hunan, China.
J Orthop Surg Res. 2020 Nov 30;15(1):567. doi: 10.1186/s13018-020-02093-8.
Strong halo-femoral traction has been widely used in the field of severe rigid scoliosis correction. The objective of this study was to analyze the corrective contribution of strong halo-femoral traction in the treatment of severe rigid nonidiopathic scoliosis and discuss its meaning.
A retrospective review was performed for patients with severe rigid nonidiopathic scoliosis who were treated with halo-femoral traction in our center from December 2008 to December 2015. All cases underwent halo-femoral traction for 2 to 4 weeks before a one-stage posterior operation, and the absolute and relative contribution rates of each orthopedic factor (bending, fulcrum, traction, surgery) were analyzed.
A total of 38 patients were included (15 males and 23 females), with a mean age of 16.4 ± 3.73 years (10-22 years) and follow-up of 55.05 ± 6.63 months (range 40-68 months). The etiology was congenital in 17 patients, neuromuscular in 14 patients, neurofibromatosis-1 in 3 patients, and Marfan syndrome in 2 patients. Congenital high scapular disease with scoliosis was found in 2 patients. The mean coronal Cobb angle of the major curve was 97.99° ± 11.47° (range 78°-124°), with a mean flexibility of 15.68% ± 6.65%. The absolute contribution rate (ACR) of bending was 27.26% ± 10.16%, the ACR of the fulcrum was 10.91% ± 2.50%, the ACR of traction was 32.32% ± 11.41%, and the ACR of surgery was 29.50% ± 9.70%. A significant difference in correction was noted between the ACRs of traction and the fulcrum (P < 0.05).
Strong halo-femoral traction plays a relatively significant role in the treatment of severe rigid nonidiopathic scoliosis while decreasing the risk of operation, and it is a safe and effective method for the treatment of severe rigid nonidiopathic scoliosis.
强大的头-股牵引已广泛应用于重度僵硬性脊柱侧弯矫正领域。本研究的目的是分析强大的头-股牵引在治疗重度僵硬性非特发性脊柱侧弯中的矫正作用并探讨其意义。
对2008年12月至2015年12月在本中心接受头-股牵引治疗的重度僵硬性非特发性脊柱侧弯患者进行回顾性研究。所有病例在一期后路手术前均接受2至4周的头-股牵引,并分析每个矫形因素(弯曲、支点、牵引、手术)的绝对和相对贡献率。
共纳入38例患者(男性15例,女性23例),平均年龄16.4±3.73岁(10至22岁),随访55.05±6.63个月(范围40至68个月)。病因包括先天性脊柱侧弯17例,神经肌肉性脊柱侧弯14例,神经纤维瘤病1型3例,马凡综合征2例。2例患者合并先天性高肩胛症伴脊柱侧弯。主弯的平均冠状面Cobb角为97.99°±11.47°(范围78°至124°),平均柔韧性为15.68%±6.65%。弯曲的绝对贡献率(ACR)为27.26%±10.16%,支点的ACR为10.91%±2.50%,牵引的ACR为32.32%±11.41%,手术的ACR为29.50%±9.70%。牵引和支点的ACR在矫正方面存在显著差异(P<0.05)。
强大的头-股牵引在治疗重度僵硬性非特发性脊柱侧弯中发挥着相对显著的作用,同时降低了手术风险,是治疗重度僵硬性非特发性脊柱侧弯的一种安全有效的方法。