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The contribution of preoperative balanced halo-pelvic traction to severe rigid spinal deformity correction

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Abstract

Purpose

The aim of this study was to assess the clinical efficacy of balanced halo-pelvic traction (HPT) and evaluate its contribution to the correction surgery in treating adult severe rigid spinal deformity.

Methods

One hundred and eight adult patients with severe rigid spinal deformity who underwent preoperative HPT and correction surgery were reviewed. The main coronal curve, segmental kyphotic angle, coronal balance (CB), sagittal balance (SVA), and the length of spine were measured before HPT, after HPT, post-operatively, and at final follow-up. The HPT contribution rates to deformity correction were calculated.

Results

The pre-HPT main coronal curve was 103.4 ± 10.6°, improved to 61.0 ± 13.4° after traction and further improved to 44.2 ± 10.2° after surgical correction, and maintained at 50.3 ± 9.9° at final follow-up. CB started at 4.2 ± 4.8 cm, improved to 2.1 ± 2.5 cm after HPT, 0.8 ± 1.2 cm after operation, and 0.7 ± 0.9 cm at final follow-up. The pre-HPT sagittal segmental kyphotic angle was 67.3 ± 17.7°, was then improved to 42.2 ± 27.5° after traction and further improved to 34.9 ± 10.2° after surgery, and maintained at 35.4 ± 10.4° at final follow-up. The length of spine improved from 35.9 ± 5.9 to 42.6 ± 6.0 cm via HPT, reached up to 45.0 ± 6.0 cm after operation, and maintained at 44.3 ± 5.2 cm at final follow-up.

Conclusion

HPT is effective for the treatment of severe rigid spinal deformity. Balanced HPT can dramatically improve coronal and sagittal deformity as well as spinal length before corrective surgery.

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Availability of data and materials

The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Acknowledgements

None.

Funding

This study was supported by National Natural Science Foundation of China (Nos. 81860473 and 81460405), Key Project of Natural Science Foundation of Jiangxi Province (No. 20202ACB206004), Major Discipline Academic and Technical Leaders Training Program of Jiangxi Province (No. 20204BCJ22026), the Program of Health Commission of Jiangxi Province (No. 20191029), Double-thousand Plan Program of Jiangxi Province (No. JXSQ2023201023), 5511 Innovation-driven Program of Department of Science and Technology, Jiangxi Province (No. 2165BCB18017), and Clinical Cultivation Project of The First Affiliated Hospital of Nanchang University (No. YFYLCYJPY202202).

Author information

Author notes

  1. Zhenhai Zhou, Zhiming Liu, and Wenqiang Deng have contributed equally to this study.

Authors and Affiliations

  1. The Orthopedic Hospital, The First Affiliated Hospital of Nanchang University, #1519 Dongyue Avenue, Nanchang, 330209, Jiangxi, China

    Zhenhai Zhou, Zhiming Liu, Wenqiang Deng, Shengbiao Ma & Kai Cao

  2. Department of Orthopedics, General Hospital of Ningxia Medical University, Ningxia, China

    Zhaohui Ge

  3. Department of Orthopedics, The Second Affiliated Hospital of Kunming Medical University, Kunming, China

    Yingsong Wang

  4. Department of Orthopedics, The Second Affiliated Hospital of Nanchang University, Nanchang, China

    Wenbing Wan

  5. Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Cao Yang

Authors
  1. Zhenhai Zhou
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Contributions

KC and ZZ helped in conceptualization. KC and ZL helped in methodology. ZZ and ZL worked in formal analysis and investigation. SM and WD contributed to writing—original draft preparation. ZZ and WD contributed to writing—review and editing. ZG, YW, KC, WW, and CY worked in resources. ZZ, KC, and SM worked in supervision.

Corresponding author

Correspondence to Kai Cao.

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Conflict of interest

There are no conflicts of interest for this manuscript.

Consent for publication

All authors got the consent for publication.

Ethics approval and consent to participate

The data do not compromise anonymity or confidentiality or breach local data protection laws, and it is approved for publication by The First Affiliated Hospital of Nanchang University, General Hospital of Ningxia Medical University, The Second Affiliated Hospital of Kunming Medical University, The Second Affiliated Hospital of Nanchang University, and Union Hospital of Huazhong University of Science and Technology. All patients provided written informed consent for use of the data.

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Cite this article

Zhou, Z., Liu, Z., Deng, W. et al. The contribution of preoperative balanced halo-pelvic traction to severe rigid spinal deformity correction. Eur Spine J 32, 4054–4062 (2023). https://doi.org/10.1007/s00586-023-07916-w

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  • DOI: https://doi.org/10.1007/s00586-023-07916-w

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