Abstract
For the past 35 years, we have used halo gravity traction (HGT) to treat patients with a wide variety of underlying spinal deformities. This clinical concepts review will cover the indications, contraindications, HGT technique details, and our preferred method of dynamic HGT. Emphasis will be placed on our protocol, and recommendations that help to avoid complications. HGT is best applied by a standardized team approach intending to medically and nutritionally optimize the patient in preparation for an operative or medical/interventional treatment that will maintain and improve on the deformity correction achieved while avoiding peri- and postoperative complications.
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Nickel VL, Perry J, Garrett A, Heppenstall M. The halo. A spinal skeletal traction fixation device. J Bone Joint Surg Am 1968;50:1400–9.
Stagnara P. Cranial traction using the “Halo” of Rancho Los Amigos. Rev Chir Orthop Reparatrice Appar Mot 1971;57:287–300.
LaMont LE, Johnston CE, Tran DP, et al Radiographic, pulmonary and clinical outcomes with halo gravity traction. Paper presented at: EPOS/POSNA Combined Annual Meeting Barcelona, Spain.
Sink EI, Karol LE, Sanders J, et al. Efficacy of perioperative halogravity traction in the treatment of severe scoliosis in children. J Pediatr Orthop 2001;21:519–24.
Bogunovic L, Lenke LG, Bridwell KH, Luhmann SH. Preoperative halo-gravity traction for severe pediatric spinal deformity: complications, radiographic correction and changes in pulmonary function. Spine Deform 2013;1:33–9.
Rinella A, Lenke L, Whitaker C, et al. Perioperative halo-gravity traction in the treatment of severe scoliosis and kyphosis. Spine 2005;30:475–82.
Sponseller P, Takenaga R, Newton P, et al. The use of traction in the treatment of severe spinal deformity. Spine 2008;33:2305–9.
Nemani VM, Kim HJ, Bjerke-Kroll BT, et al. Preoperative halogravity traction for severe spinal deformities at an SRS-GOP Site in West Africa: protocols, complications, and results. Spine 2015;40:153–61.
Johnston CE. Halo-gravity traction. In: Akbarnia BA, Yazici M, Thompson GH, editors. The growing spine, 2. Berlin: Springer; 2016. p. 537–51.
Johnston CE, Tran DP, McClung A. Functional and radiographic outcomes following growth sparing management of early-onset scoliosis. J Bone Joint Surg Am 2017;99:1036–42.
Glotzbecker M, Johnston CE, Miller P. Is there a relationship betwen thoracic dimensions and pulmonary function in early-onset scoliosis? Spine 2014;39:1590–5.
Harms LR, Andras LM, Sponseller PD, et al. Comparison of percentile weight gain of growth-friendly constructs in early-onset scoliosis. Spine Deform 2018;6:43–7.
D’Astous JL, Sanders JO. Casting and traction treatment methods for scoliosis. Orthop Clin North Am 2007;38:477–84.
Richards BS, Johnston CE. Scoliosis. Philadelphia, PA: Elsevier Sanders; 2014. p. 206–307.
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Author disclosures: ALM (other from Globus, outside the submitted work), BSR (none), and CEJ (other from Medtronic, outside the submitted work; in addition, CEJ has a patent TSRH spinal instrumentation with royalties paid).
IRB approval: No IRB approval is necessary for a clinical concepts review.
Funding: No funding was utilized.
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McIntosh, A.L., Ramo, B.S. & Johnston, C.E. Halo Gravity Traction for Severe Pediatric Spinal Deformity: A Clinical Concepts Review. Spine Deform 7, 395–403 (2019). https://doi.org/10.1016/j.jspd.2018.09.068
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DOI: https://doi.org/10.1016/j.jspd.2018.09.068