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Halo-gravity traction in the treatment of severe spinal deformity: a systematic review and meta-analysis

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Abstract

Purpose

Halo-gravity traction has been reported to successfully assist in managing severe spinal deformity. This is a systematic review of all studies on halo-gravity traction in the treatment of spinal deformity to provide information for clinical practice.

Methods

A comprehensive search was conducted for articles on halo-gravity traction in the treatment of spinal deformity according to the PRISMA guidelines. Appropriate studies would be included and analyzed. Preoperative correction rate of spinal deformity, change of pulmonary function and prevalence of complications were the main measurements.

Results

Sixteen studies, a total of 351 patients, were included in this review. Generally, the initial Cobb angle was 101.1° in the coronal plane and 80.5° in the sagittal plane, and it was corrected to 49.4° and 56.0° after final spinal fusion. The preoperative correction due to traction alone was 24.1 and 19.3%, respectively. With traction, the flexibility improved 6.1% but postoperatively the patients did not have better correction. Less aggressive procedures and improved pulmonary function were observed in patients with traction. The prevalence of traction-related complications was 22% and three cases of neurologic complication related to traction were noted. The prevalence of total complications related to surgery was 32% and that of neurologic complications was 1%.

Conclusion

Partial correction could be achieved preoperatively with halo-gravity traction, and it may help decrease aggressive procedures, improve preoperative pulmonary function, and reduce neurologic complications. However, traction could not increase preoperative flexibility or final correction. Traction-related complications, although usually not severe, were not rare.

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Author notes

    Authors and Affiliations

    1. Department of Orthopedic Surgery, Guangdong Orthopedic Hospital (The Third Affiliated Hospital of Southern Medical University), Guangzhou, 510000, China

      Changsheng Yang & Zhongmin Zhang

    2. Department of Spine Surgery, Fuzhou Second Hospital, Xiamen University, Fuzhou, 350007, China

      Huafeng Wang

    3. Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Road, Guangzhou, 510080, China

      Zhaomin Zheng, Jianru Wang & Hui Liu

    4. Department of Orthopaedic Surgery, College of Physicians and Surgeons, Columbia University, 622 West 168th Street PH-11, New York, NY, 10032, USA

      Yongjung Jay Kim

    5. Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, 5 East 98th Street, Box 1188, New York, NY, 10029, USA

      Samuel Cho

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    1. Changsheng Yang
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    2. Huafeng Wang
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    3. Zhaomin Zheng
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    Correspondence to Zhaomin Zheng or Jianru Wang.

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    H. Wang and C. Yang were of equal contribution to this study.

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    Yang, C., Wang, H., Zheng, Z. et al. Halo-gravity traction in the treatment of severe spinal deformity: a systematic review and meta-analysis. Eur Spine J 26, 1810–1816 (2017). https://doi.org/10.1007/s00586-016-4848-y

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    • DOI: https://doi.org/10.1007/s00586-016-4848-y

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