Zheng Bin, Zhao Deng, Yu Panfeng, Zhu Zhenqi, Liu Haiying, Liang Yan
Spine surgery, Peking University People's Hospital, Beijing, China.
Department of Orthopedics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
J Orthop Surg Res. 2025 Aug 22;20(1):791. doi: 10.1186/s13018-025-06211-2.
Severe spinal deformities require surgical intervention, with preoperative traction commonly used to improve spinal flexibility and surgical safety. However, the impact of traction on bone mineral density (BMD) and its relationship with correction outcomes remains poorly understood.
This retrospective study analyzed patients with severe spinal deformities who underwent halo-pelvic traction before surgical correction. Key parameters including Cobb angle, thoracic kyphosis (TK), height, and BMD were measured before and after traction. Paired t-tests and Pearson correlation analysis were performed to assess treatment effects and relationships between variables.
Twenty-six patients (10 males, 16 females; mean age 25.31 ± 7.52 years) underwent traction for an average of 3.88 ± 1.31 months. Traction significantly improved spinal parameters: Cobb angle decreased by 37.56 ± 7.45° (P < 0.001), thoracic kyphosis reduced by 35.72 ± 13.32° (P < 0.001), and height increased by 10.2 ± 3.36 cm (P < 0.001). However, BMD decreased significantly by 17.90 ± 15.58 (P < 0.001). Correlation analysis revealed strong positive correlations between BMD loss and Cobb angle correction(r = 0.730) and Thoracic kyphosis correction(r = 0.683), indicating greater correction was associated with more pronounced BMD reduction.
While preoperative traction effectively corrects severe spinal deformities and improves flexibility, it significantly decreases BMD. The strong correlation between correction effectiveness and bone loss highlights the need for careful monitoring of bone quality during traction, especially in high-risk patients. Further research is needed to optimize traction protocols and prevent bone loss.
严重脊柱畸形需要手术干预，术前牵引常用于提高脊柱柔韧性和手术安全性。然而，牵引对骨密度（BMD）的影响及其与矫正效果的关系仍知之甚少。
这项回顾性研究分析了在手术矫正前接受头盆环牵引的严重脊柱畸形患者。在牵引前后测量关键参数，包括Cobb角、胸椎后凸（TK）、身高和骨密度。进行配对t检验和Pearson相关分析以评估治疗效果和变量之间的关系。
26例患者（10例男性，16例女性；平均年龄25.31±7.52岁）接受了平均3.88±1.31个月的牵引。牵引显著改善了脊柱参数：Cobb角减小了37.56±7.45°（P<0.001），胸椎后凸减小了35.72±l3.32°（P<0.001），身高增加了10.2±3.36cm（P<0.001）。然而，骨密度显著降低了17.90±15.58（P<0.001）。相关分析显示骨密度降低与Cobb角矫正（r=0.730）和胸椎后凸矫正（r=0.683）之间存在强正相关，表明矫正程度越大，骨密度降低越明显。
虽然术前牵引有效地矫正了严重脊柱畸形并提高了柔韧性，但它显著降低了骨密度。矫正效果与骨质流失之间的强相关性凸显了在牵引期间仔细监测骨质质量的必要性，尤其是在高危患者中。需要进一步研究以优化牵引方案并预防骨质流失。
