Lv Changlin, Zhang Ziang, Dong Xuanyu, Li Jianyi, Guo Jianwei, Bai Tianyu, Du Xiaofan, Zhang Guodong, Shao Jiale, Li Jiayan, Du Yukun, Dong Jun, Wang Guodong, Xi Yongming
The Affiliated Hospital of Qingdao University, No. 59 Haier Road, Laoshan District, Qingdao, 266100, Shandong Province, China.
Department of Spinal Surgery, Tengzhou Central People's Hospital, Tengzhou, Shandong Province, China.
Spine Deform. 2025 Sep 12. doi: 10.1007/s43390-025-01184-y.
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.
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.
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.
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.
对颅骨重力牵引（HGT）和颅骨骨盆牵引（HPT）治疗严重僵硬性脊柱畸形患者的临床疗效进行比较，旨在阐明HGT和HPT在治疗此类畸形中的临床价值，并为手术治疗方案提供循证建议。
对两家大型三级医院（2019 - 2022年）治疗的20例患者进行回顾性研究。所有患者均接受后路截骨矫正，并分为HGT组（n = 14）和HPT组（n = 6）。分析的关键参数包括影像学测量指标（Cobb角）、肺功能测试（牵引/手术前后）以及术中指标，如失血量、手术时长和截骨分级。使用SRS - 22问卷评估健康相关生活质量。
两组间基线特征具有可比性。与HPT组相比，HGT组在冠状面和矢状面Cobb角的矫正率均显著更低（P < 0.01），手术时间更长，术中失血量更大，截骨分级更高（P < 0.05）。HGT组FVC%和FEV1%的改善明显更小（P < 0.001）。虽然两组术后SRS - 22r评分均有所提高，但组间差异无统计学意义。两组均未发生神经并发症；HPT组有1例髂骨钉断裂，成功处理，未影响手术结果。
HGT和HPT在严重僵硬性脊柱畸形患者的术前管理中均可行且安全。在这个有限的队列中，与HGT相比，HPT具有更大的角度矫正、更好的肺功能改善以及更低的术中复杂性。虽然这些发现令人鼓舞，但仍需要更大规模的前瞻性研究来验证HPT的长期疗效和安全性，并为高危脊柱畸形病例的临床决策提供更好的依据。
