The impact of halo-gravity traction on curve rigidity and pulmonary function in the treatment of severe and rigid scoliosis and kyphoscoliosis: a clinical study and narrative review of the literature

Abstract

The improvement of pulmonary function and the restoration of sagittal and coronal balance are the main goals in the treatment of severe and rigid scoliosis and kyphoscoliosis. A review of the literature showed that HGT is a useful tool for selected patients. Preoperative HGT is indicated in severe curves with moderate to severe pulmonary compromise. HGT should not be expected to significantly improve severe curves without a prior anterior and/or posterior release. The data presented in this study can be used in future studies to compare the surgical and pulmonary outcomes of severe and rigid deformities.

Mechanism of camptocormia in Parkinson's disease analyzed by tilt table-EMG recording

“…Kyphoscoliosis is one of the postural deformities caused by abnormal spinal curvature [21]. Truncal mobility is decreased in kyphoscoliosis, which could result in respiratory impairment [21].…”

The impact of posterior temporary internal distraction on stepwise corrective surgery for extremely severe and rigid scoliosis greater than 130°

“…Severe scoliotic spinal deformities can cause compression of the spinal cord and thoracoabdominal structures [1][2][3], affect the thoracic cage; disturb skeletal, muscular and diaphragmatic function; and reduce respiratory system compliance [24,25]. To date, a series of long-term studies on the natural course of pulmonary impairment and severe scoliosis have shown that there is no spontaneous resolution but rather a slight decline of PFT over time [26], and this is especially the case with curves [100°, in which respiratory system compliance is decreased to levels comparable to those of adult respiratory distress syndrome, which lead to patients suffering long-term sequelae.…”

“…However, the results of other experiments were significantly different and sometimes contradictory. Heiko et al [24] showed that pre-op-HGT did not induce a meaningful release effect for rigid curves, and that the difference in flexibility between HGT radiographs and bending or traction radiographs was not significant. In studies by Seller [54] and Flierl [55], HGT did not improve surgical outcomes for scoliosis.…”

Innovative Method of Gradual Temporary Distraction Using Magnetic Growing Rods (MCGR) for Surgical Treatment of Severe Kyphoscoliosis: Mini-case Series

“…Halo-related complications, such as pin-site infection and loosening, and neurological damage, have been encountered. A recent review of the literature has reported a rate of 53%, with 10% requiring surgery and 31% suffering from transient halo-related neurologic compromise [16,17]. In other series, a 31% incidence of complications can be found, including cranial nerve injuries, Horner syndrome, extremity weakness and bradycardia [3].…”