Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
World Neurosurg. 2022 Aug;164:e636-e648. doi: 10.1016/j.wneu.2022.05.026. Epub 2022 May 13.
Halo gravity traction (HGT) is an effective way of managing pediatric spinal deformities in the preoperative period. This study comprehensively reviews the existing literature and evaluates the effect of HGT on various radiographic parameters regarding spinal correction and, secondarily, evaluates the improvement in pulmonary function as well as nutritional status.
In accordance with PRISMA guidelines, a comprehensive search was conducted for articles on HGT in the treatment of spinal deformity. Spinal deformity after traction and surgery, change of pulmonary function, nutritional status, and prevalence of complications were the main outcome measurements. All meta-analyses were conducted using random models according to the between-study heterogeneity, estimated with I.
A total of 694 patients from 24 studies were included in this review. Compared with pretraction values, the average coronal Cobb angle reduction after traction was 27.66° (95% confidence interval [CI], 23.41-31.90; P < 0.001) and 47.43° (95% CI, 39.32-55.54; P < 0.001) after surgery. The sagittal Cobb angle reduction after HGT and surgery was 27.23° (95% CI, 22.83-31.62; P <0.001) and 36.77° (95% CI, 16.90-56.65; P < 0.001), respectively. There was a statistically significant improvement in the overall pulmonary function, as evident by an increase in a forced vital capacity of 8.44% (95% CI, -5.68 to -11.20; P < 0.001), and an increase in nutritional status, with a percentage correction of body mass index by 1.58 kg/m (95% CI, -2.14 to -1.02; P < 0.001) after HGT application.
HGT has been shown to significantly improve coronal deformities, sagittal deformities, nutritional status, and pulmonary function in the preoperative period.
halo 重力牵引（HGT）是一种在术前管理小儿脊柱畸形的有效方法。本研究全面综述了现有的文献，并评估了 HGT 对脊柱矫正的各种影像学参数的影响，其次评估了肺功能和营养状况的改善。
根据 PRISMA 指南，对 HGT 治疗脊柱畸形的文章进行了全面搜索。牵引和手术后的脊柱畸形、肺功能变化、营养状况和并发症发生率是主要的测量结果。所有的荟萃分析都是根据研究之间的异质性，用 I 估计，用随机模型进行的。
本综述共纳入 24 项研究的 694 例患者。与牵引前相比，牵引后冠状 Cobb 角平均减少 27.66°（95%置信区间，23.41-31.90；P<0.001），术后减少 47.43°（95%置信区间，39.32-55.54；P<0.001）。HGT 和手术后矢状 Cobb 角减少分别为 27.23°（95%置信区间，22.83-31.62；P<0.001）和 36.77°（95%置信区间，16.90-56.65；P<0.001）。整体肺功能有明显改善，用力肺活量增加 8.44%（95%置信区间，-5.68 至-11.20；P<0.001），营养状况改善，体重指数校正百分比增加 1.58kg/m（95%置信区间，-2.14 至-1.02；P<0.001）。
HGT 在术前可显著改善冠状畸形、矢状畸形、营养状况和肺功能。
