Department of spinal surgery, Peking University People's Hospital, Beijing, China.
Department of Orthopaedics, The Second Affiliated Hospital of Chengdu, Chengdu Third People's Hospital, Chongqing Medical University, Chengdu, China.
J Orthop Surg Res. 2024 Oct 15;19(1):652. doi: 10.1186/s13018-024-04985-5.
Halo-pelvic traction (HPT) is acknowledged for enhancing pulmonary function and reducing neurological complications in severe and rigid scoliosis and kyphoscoliosis. While its role in improving coronal balance is established, its impact on sagittal kyphosis remains under-researched. This study aims to assess HPT's effects on sagittal alignment in these conditions.
A retrospective review of 37 patients with severe and rigid scoliosis or kyphoscoliosis was conducted to evaluate HPT's efficacy. The analysis focused on the impact of HPT on coronal and sagittal parameters, pulmonary function tests (PFTs) and complications. Radiographic assessments included main cobb angle in coronal, sagittal major kyphosis.
HPT was applied for an average of 2.9 months, significantly reducing the primary coronal curve from 127.7°±30.3° to 74.9°±28.3° (P < 0.05), achieving a 41.3% correction rate. Sagittal kyphosis correction was more pronounced, with angles decreasing from 80.4°±26.4° to 41.3°±24.4° (P < 0.05), resulting in a 48.6% correction rate. Pulmonary function tests showed improvements in forced vital capacity (FVC) (from 1.32 ± 0.91 to 1.55 ± 0.83) and forced expiratory volume in 1 s (FEV1) (from 1.03 ± 0.76 to 1.28 ± 0.72), with percentage predicted values also increasing (FVC%: 40.4%±24.3-51.4%±23.1%; FEV1%: 37.8%±25.2-48.1%±22.7%; all P < 0.05).
HPT effectively reduces spinal deformity severity and improves pulmonary function in patients with severe and rigid scoliosis and kyphoscoliosis. Sagittal kyphosis correction was notably greater than coronal scoliosis correction. The correlation between PFT improvements and coronal curve adjustments suggests that correcting the coronal Cobb angle is pivotal for pulmonary function enhancement.
halo-pelvic 牵引（HPT）被认为可改善严重僵硬型脊柱侧凸和后凸的肺功能并减少神经并发症。虽然其在改善冠状面平衡方面的作用已得到证实，但在矢状面后凸方面的研究仍不足。本研究旨在评估 HPT 在这些情况下对矢状面排列的影响。
对 37 例严重僵硬型脊柱侧凸或后凸患者进行回顾性研究，以评估 HPT 的疗效。分析重点为 HPT 对冠状面和矢状面参数、肺功能测试（PFT）和并发症的影响。影像学评估包括冠状面主弯 Cobb 角、矢状面主后凸角。
HPT 平均应用 2.9 个月，使原发冠状面主弯从 127.7°±30.3°减小至 74.9°±28.3°（P < 0.05），矫正率为 41.3%。矢状面后凸矫正更为明显，角度从 80.4°±26.4°减小至 41.3°±24.4°（P < 0.05），矫正率为 48.6%。肺功能测试显示用力肺活量（FVC）（从 1.32 ± 0.91 增加至 1.55 ± 0.83）和 1 秒用力呼气量（FEV1）（从 1.03 ± 0.76 增加至 1.28 ± 0.72）均有改善，预计值百分比也有所增加（FVC%：40.4%±24.3-51.4%±23.1%；FEV1%：37.8%±25.2-48.1%±22.7%；均 P < 0.05）。
HPT 可有效降低严重僵硬型脊柱侧凸和后凸患者的脊柱畸形严重程度并改善肺功能。矢状面后凸矫正明显大于冠状面侧凸矫正。PFT 改善与冠状面弯矫正之间的相关性表明，矫正冠状面 Cobb 角对于改善肺功能至关重要。
