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Clinical efficacy of short-term halo-pelvic traction combined with surgery in the treatment of severe spinal deformities
Received date: 2018-06-26
Online published: 2020-10-15
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.
Bei-yu XU , Long-tao QI , Yu WANG , Chun-de LI , Hao-lin SUN , Shi-jun WANG , Zheng-rong YU , Yao ZHAO , Long-long LIU . Clinical efficacy of short-term halo-pelvic traction combined with surgery in the treatment of severe spinal deformities[J]. Journal of Peking University(Health Sciences), 2020 , 52(5) : 875 -880 . DOI: 10.19723/j.issn.1671-167X.2020.05.013
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