Abstract
Purpose
Preoperative preparation with halo gravity traction (HGT) has several advantages but is still controversial. A multicenter, observational, retrospective study was conducted to determine whether HGT provides better frontal correction in surgery for adolescent idiopathic scoliosis (AIS).
Methods
Between 2010 and 2020, all patients who underwent posterior spinal fusion (PSF) AIS with a Cobb angle greater than 80° were included. The included patients who underwent HGT were compared (complications rate and radiographic parameters) to patients who did not undergo traction (noHGT). For patients who underwent HGT, a spinal front X-ray at the end of the traction procedure was performed.
Results
Sixty-four in noHGT and forty-seven in HGT group were analyzed with a 31-month mean follow-up. The mean ratio of Cobb angle correction was 58.8% in noHGT and 63.6% in HGT group (p = 0.023). In HGT, this ratio reached 9% if the traction lasted longer than 30 days (p = 0.009). The complication rate was 11.7% with a rate of 6.2% in noHGT and 19.1% in HGT group (p = 0.07). In patient whose preoperative Cobb angle was greater than 90°, the mean ratio of Cobb angle correction increases to 6.7% (p = 0.035) and the complications rate increased to 14% in the no HGT group and decreased to 13% in the HGT group (p = 0.9).
Conclusion
HGT preparation in the management of correction of AIS with a Cobb angle greater than 90° is a technique providing a greater frontal correction gain with similar complication rate than PSF correction alone. We recommend a minimum halo duration of 4 weeks.
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Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
SOFOP group author: SOFOP: French Society Orthopaedic Pediatric, Marseille, France. Franck Accadbled: Department of Pediatric Orthopedic Surgery, Purpan Children’s Hospital, Toulouse University, 330 Avenue de la Grande Bretagne, 31000, Purpan, Toulouse, France. Emilie André: Department of Pediatric Orthopedic surgery, CHU Nantes, Nantes, France. Damien Fron: Department of Pediatric Orthopedic surgery, CHU Lille, Lille, France. Antoine Hamel: Department of Pediatric Orthopedic surgery, CHU Nantes, Nantes, France. Adèle Happiette: Department of Pediatric Orthopedic surgery, CHU Robert Debré, APHP, Paris, France. Thierry Haumont: Department of Pediatric Orthopedic Surgery, Children’s Hospital, Lyon, France. Brice Ilharreborde: Department of Pediatric Orthopedic surgery, CHU Robert Debré, APHP, Paris, France. Pierre Journeau: Department of Pediatric Orthopedic surgery, CHU Nancy, Nancy, France. Yan Lefèvre: Department of Pediatric Orthopedic surgery, CHU Bordeaux, Bordeaux, France. Gregory Lucas: Department of Pediatric Surgery, Hôpital Sud, Rennes University, Rennes, France. Christian Morin: Department of Pediatric Orthopedic surgery, Institut Calot, Berck-sur-Mer, France. Thierry Odent: Department of Pediatric Orthopedic surgery, CHU Tours, Tours, France. Sébastien Pesenti: Department of Pediatric Orthopedic surgery, CHU La Timone, Marseille, France. Jérôme Sales de Gauzy: Department of Pediatric Orthopedic Surgery, Purpan Children’s Hospital, Toulouse University, 330 Avenue de la Grande Bretagne, 31000, Purpan, Toulouse, France. Catalin Ursu: Department of Pediatric Orthopedic surgery, Institut Calot, Berck-sur-Mer, France. Raphaël Vialle: Department of Pediatric Orthopedic surgery, CHU A. Trousseau, APHP, Paris, France.
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Langlais, T., Josse, A., Violas, P. et al. Frontal correction assessment in severe adolescent idiopathic scoliosis surgery using halo gravity traction before to posterior vertebral arthrodesis: a multicenter retrospective observational study. Eur Spine J 33, 713–722 (2024). https://doi.org/10.1007/s00586-023-08062-z
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DOI: https://doi.org/10.1007/s00586-023-08062-z