Complications of Halo-Pelvic Distraction for Scoliosis

Abstract

A survey has been undertaken of the various complications of halo-pelvic distraction in 118 patients with scoliosis prior to spinal fusion. In the first sixty-two patients the standard solid distraction rods were employed. The neurological complications included ten cases of cranial nerve lesions and two cases of paraplegia, one of them permanent. Springs were then incorporated in the distraction rods so as to allow direct readings ofthe distraction forces, and a total force of 18 kilograms was not exceeded in the last fifty-six patients. No further serious neurological complications occurred, but the amount of correction achieved in the adolescent and juvenile idiopathic types of scoliosis was reduced.

Posterior Only Pedicle Screw Instrumentation With Intraoperative Halo-Femoral Traction in the Surgical Treatment of Severe Scoliosis (>100°)

“…Avascular necrosis of the odontoid process and cervical spondylosis have been previously reported with spinal traction as a result of prolonged periods of distraction of the odontoid and apophyseal joints, respectively. 4,7,9,11,13,21 In our series, overdistraction was monitored by visualization of the cervical spine on intraoperative fluoroscopy. In general, the traction did not exceed 50% of the patient's body weight.…”

Utilização da tração halo-craniana pré-operatória no tratamento de deformidades vertebrais de alto valor angular

“…A controvérsia persiste acerca do protocolo ideal para a tração halo-gravitacional 4,5,[11][12][13][14][15] . O número de pinos cranianos, o peso e o dia inicial, o aumento do peso e o limite máximo de peso utilizado são questões ainda debatidas na literatura.…”

“…Em nossa série, um caso de soltura do halo gravitacional foi observado após a colocação inicial de peso (paciente sete), tendo sido resolvido com nova instalação do halo. Diferente de outros estudos não foram observadas complicações como perda da lordose, degeneração cervical apofisária, alterações neurológicas, infecção intradural e extradural em nosso grupo de pacientes 1,2,12,13,[15][16][17][18][19][20][21][22][23][24] .…”

15 The Use of Traction in Treating Large Scoliotic Curves in Idiopathic Scoliosis

“…An average correction of 55% was achieved; however, the treatment course was long, with 4 to 6 weeks in traction and 3 months of bed rest following fusion, and was fraught with complications including pin-site problems, cranial-nerve palsies, and spinal-cord paraplegia. 8 Despite the powerful correction effected by this method, the prevalence of complications has driven halo-pelvic traction out of favor. Wilkins and MacEwen noted cranial nerve palsy in 6 of 70 patients treated with halo-femoral or halo-pelvic traction.…”