Yang Zhao, Liu Yang, Qi Longtao, Wu Shanshan, Li Jingwen, Wang Yu, Jiang Bin
Peking University First Hospital, Beijing, China.
School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing, China.
Front Med (Lausanne). 2021 Nov 25;8:767238. doi: 10.3389/fmed.2021.767238. eCollection 2021.
Halo-gravity traction is a commonly used clinical intervention to reduce surgical risk in patients with scoliosis before surgical correction. Some previous studies have focused on the application of halo-gravity traction on patients with severe spinal deformity and pulmonary insufficiency, but the overall effect of halo-gravity traction has not been fully understood. The object of the present study was to perform a meta-analysis exploring the efficacy of preoperative halo-gravity traction on radiographic measurement and pulmonary function in severe scoliosis patients with pulmonary insufficiency. We searched the medical works of literature completed before January 17, 2021, in the databases of Pubmed, Embase, and Cochrane Library. Studies that quantitatively analyzed the effects of halo-gravity traction on the deformity and pulmonary functions of patients with severe scoliosis were included. Two researchers independently conducted the literature search, data extraction, and quality assessment. We used the Review Manager Software (version 5.4) for statistical analysis and data analysis. Mean difference (MD) with 95% confidence intervals (CIs) were calculated to evaluate the effects of halo-gravity traction. Seven studies involving 189 patients received halo-gravity traction therapy preoperatively were analyzed in our study. Preoperative halo-gravity traction significantly ameliorated the degree of deformity in severe scoliosis patients with pulmonary insufficiency, especially reduced coronal Cobb angle and sagittal Cobb angle effectively [mean deviation (MD) = 2 7.28 (95%CI 21.16-33.4), < 0.001; MD = 22.02 (95%CI 16.8-27.23), < 0.001]. Preoperative halo-gravity traction also improved the pulmonary functions in patients, especially increasing %FVC and %FEV1 [MD = -0.0662 (95%CI -0.0672--0.0652), < 0.001; MD = -0.0824 (95%CI -0.0832--0.081) < 0.001]. Preoperative halo-gravity traction for severe scoliosis patients shows significant improvement in the degree of deformity and pulmonary functions. Halo-gravity traction is an effective method to improve the tolerance of patients to surgery in the perioperative period.
头环重力牵引是一种常用的临床干预措施，用于在手术矫正前降低脊柱侧弯患者的手术风险。先前的一些研究集中在头环重力牵引在严重脊柱畸形和肺功能不全患者中的应用，但头环重力牵引的总体效果尚未完全了解。本研究的目的是进行一项荟萃分析，探讨术前头环重力牵引对伴有肺功能不全的严重脊柱侧弯患者影像学测量和肺功能的疗效。我们在PubMed、Embase和Cochrane图书馆数据库中检索了2021年1月17日前完成的医学文献。纳入定量分析头环重力牵引对严重脊柱侧弯患者畸形和肺功能影响的研究。两名研究人员独立进行文献检索、数据提取和质量评估。我们使用Review Manager软件（版本5.4）进行统计分析和数据分析。计算95%置信区间（CI）的平均差（MD）以评估头环重力牵引的效果。我们的研究分析了7项涉及189例术前接受头环重力牵引治疗的患者的研究。术前头环重力牵引显著改善了伴有肺功能不全的严重脊柱侧弯患者的畸形程度，尤其是有效降低了冠状面Cobb角和矢状面Cobb角[平均偏差（MD）=27.28（95%CI 21.16 - 33.4），<0.001；MD = 22.02（95%CI 16.8 - 27.23），<0.001]。术前头环重力牵引还改善了患者的肺功能，尤其是增加了%FVC和%FEV1[MD = -0.0662（95%CI -0.0672 - -0.0652），<0.001；MD = -0.0824（95%CI -0.0832 - -0.081）<0.001]。术前对头环重力牵引治疗严重脊柱侧弯患者的畸形程度和肺功能有显著改善。头环重力牵引是提高患者围手术期手术耐受性的有效方法。
