Application value of halo‑pelvic traction in the treatment of severe rigid spinal deformity.

PURPOSE

Comparison of the clinical outcomes of halo-gravity traction (HGT) and halo-pelvic traction (HPT) was performed in the treatment of patients with severe rigid spinal deformity, with the aim of elucidating the clinical value of HGT and HPT in managing such deformities and providing evidence-based recommendations for surgical treatment planning.

METHODS

A retrospective study was conducted of 20 patients treated at two large tertiary hospitals (2019-2022). All underwent posterior osteotomy correction and were categorized into HGT (n = 14) and HPT (n = 6) groups. Key parameters analyzed included radiographic measures (Cobb angles), pulmonary function tests (before and after traction/surgery), and intraoperative metrics such as blood loss, surgery duration, and osteotomy grade. Health-related quality of life was evaluated using the SRS-22 questionnaire.

RESULTS

Baseline characteristics were comparable between groups. Compared to the HPT group, the HGT group showed significantly lower correction rates in both coronal and sagittal Cobb angles (P < 0.01), longer surgical duration, greater intraoperative blood loss, and higher osteotomy grade (P < 0.05). Improvements in FVC% and FEV1% were significantly smaller in the HGT group (P < 0.001). While both groups showed postoperative gains in SRS-22r scores, the differences between them were not statistically significant. No neurological complications occurred in either group; one case of iliac pin breakage in the HPT group was managed successfully without impacting the surgical outcome.

CONCLUSION

Both HGT and HPT were feasible and safe in the preoperative management of patients with severe rigid spinal deformity. In this limited cohort, HPT was associated with greater angular correction, improved pulmonary function, and reduced intraoperative complexity compared to HGT. While these findings are encouraging, larger prospective studies are warranted to validate the long-term efficacy and safety of HPT and to better inform clinical decision-making in high-risk spinal deformity cases.