Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8#, Chaoyang District, Beijing, 100020, China.
BMC Surg. 2024 Oct 4;24(1):286. doi: 10.1186/s12893-024-02584-z.
To assess the efficacy of preoperative halo-gravity traction (HGT) in treating severe spinal deformities, evaluating radiological outcomes, pulmonary function, and nutritional status.
This study retrospectively included 33 patients with severe spinal deformity who were admitted to our department from April 2018 to January 2022. All the patients underwent HGT prior to the posterior spinal fusion corrective surgery, with no patients having undergone anterior or posterior release procedures. The correction of deformity, pulmonary function tests (PFTs), and nutritional status data were collected and analyzed before and after HGT.
A total of 33 patients (9 males, 24 females) were finally included in this study with an average age of 17.79 ± 7.96 (range 12-29) years. Among them, 20 patients were aged ≤ 16 years. The traction weight started from 1.5 kg and raised to 45.2 ± 13.2% of body weight on average progressively, with the average traction duration of 129 ± 63 days. After traction, the main curve was corrected from an average of 120.66 ± 3.89° to 94.88 ± 3.35°, and to 52.33 ± 22.36° (53%) after surgery(P < 0.05). PFTs also showed a significant increase in FVC%, FEV1%, and MEF% after traction [43.46 ± 14.76% vs. 47.33 ± 16.04%, 41.87 ± 13.68% vs. 45.19 ± 15.57%, and 40.44 ± 15.87% vs. 45.24 ± 17.91%, p < 0.05]. Total protein, albumin, and BMI were used as indicators of nutritional status. TP and albumin were significantly improved after traction, from 67.24 ± 5.43 g/L to 70.68 ± 6.98 g/L and 42.40 ± 3.44 g/L 45.72 ± 5.23 g/L, respectively(P < 0.05). No significant difference was found in deformity correction and lung function improvement between patients with traction for more or less than three months (p > 0.05). Two patients developed transient brachial plexus palsy during traction.
Halo-gravity traction can partially correct spinal deformity, enhance pulmonary function. And HGT has been shown to facilitate an improved nutritional status in these patients. It could be used as a preoperative adjuvant treatment for severe spinal deformity. However, according to the study, a traction period longer than three months may not be necessary.
评估术前 halo-gravity 牵引（HGT）治疗严重脊柱畸形的疗效，评估影像学结果、肺功能和营养状况。
本研究回顾性纳入 2018 年 4 月至 2022 年 1 月期间我院收治的 33 例严重脊柱畸形患者。所有患者均在后路脊柱融合矫正手术前接受 HGT，无患者行前路或后路松解术。收集并分析 HGT 前后的畸形矫正、肺功能检查（PFTs）和营养状况数据。
共纳入 33 例患者（9 例男性，24 例女性），平均年龄为 17.79±7.96（12-29）岁。其中 20 例患者年龄≤16 岁。牵引重量从 1.5kg 逐渐增加至平均体重的 45.2±13.2%，平均牵引时间为 129±63 天。牵引后主弯从平均 120.66±3.89°矫正至 94.88±3.35°，术后矫正至 52.33±22.36°（53%）（P<0.05）。PFTs 也显示 FVC%、FEV1%和 MEF%在牵引后显著增加[43.46±14.76%比 47.33±16.04%，41.87±13.68%比 45.19±15.57%，40.44±15.87%比 45.24±17.91%，p<0.05]。总蛋白、白蛋白和 BMI 用作营养状况的指标。TP 和白蛋白在牵引后显著改善，分别从 67.24±5.43g/L 增加至 70.68±6.98g/L 和 42.40±3.44g/L 增加至 45.72±5.23g/L（p<0.05）。牵引时间超过或少于三个月的患者在畸形矫正和肺功能改善方面无显著差异（p>0.05）。2 例患者在牵引过程中出现短暂性臂丛神经麻痹。
halo-gravity 牵引可部分矫正脊柱畸形，增强肺功能。HGT 还表明，它可以改善这些患者的营养状况。它可作为严重脊柱畸形的术前辅助治疗。然而，根据研究，牵引时间超过三个月可能没有必要。
