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Journal of Peking University (Health Sciences) ›› 2020, Vol. 52 ›› Issue (5): 875-880. doi: 10.19723/j.issn.1671-167X.2020.05.013

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Clinical efficacy of short-term halo-pelvic traction combined with surgery in the treatment of severe spinal deformities

Bei-yu XU1,Long-tao QI1,Yu WANG1,∆(),Chun-de LI1,∆(),Hao-lin SUN1,Shi-jun WANG1,Zheng-rong YU1,Yao ZHAO1,Long-long LIU2   

  1. 1. Department of Orthopedics, Peking University First Hospital, Beijing 100034, China
    2. Department of Orthopedics, Linfen Second People’s Hospital, Shanxi 041000, China
  • Received:2018-06-26 Online:2020-10-18 Published:2020-10-15
  • Contact: Yu WANG,Chun-de LI E-mail:wangyuspine@sina.com;Lichunde@vip.sina.com

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Abstract:

Objective: To evaluate the clinical efficacy of short-term halo-pelvic traction (HPT) combined with surgery in the treatment of severe spinal deformities. Methods: In the study, 24 patients diagnosed as severe spinal deformity accepted the treatment of one-stage short-term HPT and two-stage surgery from January 2015 to May 2018 in our orthopedics department. 24 cases (9 males and 15 females) were retrospectively reviewed. The average age of the cohort was (28.8±10.0) years (12-48 years). The height, scoliosis angle, kyphosis angle, the height difference of shoulders, the height difference of crista iliaca, C7PL-CSVL and the perpendicular distance of S1 and the convex point of the patients were assessed at pre-traction, post-traction and post-surgery. The paired t test was used to analyze the difference among pre-traction, post-traction and post-surgery. Results: The average traction time of 24 cases was (2.5±1.1) weeks (1-5 weeks). The height of pre-traction and post-traction were (141.7±11.2) cm (116-167 cm) and (154.1±9.5) cm (136-176 cm) respectively, showing significant difference (P<0.05), and the increased height was (12.4±4.6) cm (4-20 cm). The average scoliosis angle before traction was 104.9°±35.0°(25°-158°), and it was significantly decreased in post-traction[64.8°±21.0°(19°-92°)] and post-surgery[39.3°±17.0° (10°-70°)] (P<0.05). The traction’s coronal correction rate was 37.2%±10.9% (11.9%-51.2%) and the total coronal correction rate was 61.9%±12.6%(26.9%-79.0%). The average kyphosis angle before traction was 106.9°±29.2°(54°-163°), and it was significantly decreased in post-traction [63.1°±17.1°(32°-92°)] and post-surgery [39.0°±16.8°(10°-68°)](P<0.05). The traction’s sagittal correction rate was 40.0%±10.7%(16.7%-55.5%) and the total sagittal correction rate was 64.3%±10.7%(49.0%-87.5%). The average C7PL-CSVL before traction was (3.2±2.8) cm, and it was significantly decreased in post-traction [(2.5±2.5) cm] (P<0.05). The perpendicular distance of S1 and the convex point before traction was (10.5±4.8) cm, and it was significantly decreased in post-traction[(8.4±3.5) cm] (P<0.05). Conclusion: The one-stage short-term HPT combined with two-stage surgery is a safe and effective procedure for severe spinal deformities. The clinical efficacy is satisfactory and the complication is relatively less.

Key words: Short-term, Halo-pelvic traction, Spinal deformities, Severe, Correction surgery, Correction rate

CLC Number: 

  • R682.1+3

Figure 1

The typical case treated with HPT Male, 37 years old, Pott’s disease. The muscle strength of double lower limbs was grade Ⅳ and he had disorder of urination. The muscle strength of double lower limbs and urination function began to recover after 3 days’ traction and recovered totally after 2 weeks’ traction. A, B, C, the aesthetic posterior appearance before traction, after traction(2 weeks) and after surgery. The height was 158 cm, 165 cm and 167 cm respectively. D, E, F, the aesthetic lateral appearance before traction, after traction and after surgery. G, H, I, the anteroposterior view of X-ray before traction, after traction and after surgery, and the scoliosis angle was 153°, 87° and 42° respectively. J, K, L, the lateral view of X-ray before traction, after traction and after surgery, and the kyphosis angle was 125°, 85° and 75° respectively. "

Table 1

The measurement information before traction, post-traction and post-surgery(x-±s)"

Stage Pre-traction Post-traction Post-surgery
Height/cm 141.7±11.2 154.1±9.5* 155.0±9.5*
Scoliosis angle/(°) 104.9±35.0 64.8±21.0* 39.3±17.0*#
Kyphosis angle/(°) 106.9±29.2 63.1±17.1* 39.0±16.8*#
The height difference of shoulders/cm 2.4±1.8 1.3±0.9* 1.5±1.3*
The height difference of crista iliaca/cm 1.7±1.7 0.9±0.9* 1.0±1.0*
C7PL-CSVL/cm 3.2±2.8 2.5±2.5* 2.0±1.9*
The perpendicular distance of S1 and the convex point/cm 10.5±4.8 8.4±3.5* 6.7±3.7*
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