Department of Orthopaedics, Southwest Hospital, Third Military Medical University (Army Medical University), No. 29, Gaotanyan Street, Shapingba District, Chongqing, 400038, People's Republic of China.
BMC Surg. 2022 May 28;22(1):208. doi: 10.1186/s12893-022-01662-4.
To evaluate the effect of continuous traction with a combined adjustable Halo-pelvic fixation brace on the cervical spine alignment in patients with severe rigid spinal deformity and analyze its related factors.
We conducted a retrospective cohort study of 21 patients with severe rigid spinal deformity treated in our department between 2015 and 2019. All subjects received combined adjustable Halo-pelvic fixation brace traction before secondary orthopedic surgery. The influence of the Halo-pelvic fixation brace on the cervical spine alignment was evaluated by measuring the parameters of lateral cervical X-ray at three time points: before traction, at the end of traction, and 6 months after orthopedic surgery. The correlation between parameter changes and total traction duration was analyzed to explore factors influencing cervical alignment.
The C2L-C7L angle was 22.40 ± 15.91° before traction, which decreased to 5.91 ± 6.78° at the end of traction but increased to 14.51 ± 10.07° after orthopedic surgery (BT vs ET p < 0.005, ET vs AOS p < 0.005, BT vs AOS p < 0.005). Accordingly, C2L-C7U angle, C2L-C6L angle, C2L-C6U angle, C2L-C5L angle, C7 or T1 slope, C2-C7 SVA, SCA, C2-T1 Ha, C0 slope, and C0-C2 angle also changed similarly to C2L-C7L angle. Furthermore, moderate correlation was observed between C2L-C7L angle and total traction volume (r = 0.563, p = 0.008) and SCA and traction duration (r = 0.525, p = 0.015). However, no significant correlation was found between other cervical alignment parameters and total traction volume and traction duration.
The continuous traction of a combined adjustable Halo-pelvic fixation brace can affect the cervical spine alignment of patients with severe rigid spinal deformity and straighten the physiological curvature of the cervical spine. However, the sagittal alignment gradually recovers after the traction, without any adverse effects on the orthopedic surgery and global balance after the operation; therefore, this apparatus is worthy of wide application.
评估联合可调 Halo-骨盆固定支具持续牵引对重度僵硬性脊柱畸形患者颈椎对线的影响，并分析其相关因素。
回顾性分析 2015 年至 2019 年我科收治的 21 例重度僵硬性脊柱畸形患者的临床资料，所有患者均在二次矫形手术前接受联合可调 Halo-骨盆固定支具牵引。通过测量牵引前、牵引结束时和矫形手术后 6 个月时侧位颈椎 X 线片的参数，评估 Halo-骨盆固定支具对颈椎对线的影响。分析参数变化与总牵引时间的相关性，探讨影响颈椎对线的因素。
牵引前 C2L-C7L 角为 22.40°±15.91°，牵引结束时降至 5.91°±6.78°，但矫形手术后增至 14.51°±10.07°（BT 与 ET 比较，p<0.005；ET 与 AOS 比较，p<0.005；BT 与 AOS 比较，p<0.005）。相应地，C2L-C7U 角、C2L-C6L 角、C2L-C6U 角、C2L-C5L 角、C7 或 T1 斜率、C2-C7 SVA、SCA、C2-T1 Ha、C0 斜率和 C0-C2 角也与 C2L-C7L 角变化相似。此外，C2L-C7L 角与总牵引量之间存在中度相关性（r=0.563，p=0.008），SCA 与牵引时间之间存在中度相关性（r=0.525，p=0.015）。然而，其他颈椎对线参数与总牵引量和牵引时间之间无明显相关性。
联合可调 Halo-骨盆固定支具的持续牵引可影响重度僵硬性脊柱畸形患者的颈椎对线，使颈椎生理曲度变直。然而，牵引后颈椎矢状位逐渐恢复，对术后矫形手术和整体平衡无不良影响；因此，该装置值得广泛应用。
