Viscoelastic Behaviour of Deformed Spines Under Correction with Halo Pelvic Distraction

Clark, Joseph A.; Hsu, Louis C. S.; Yau, Arthur C. M. C.

doi:10.1097/00003086-197507000-00014

Cited by 16 publications

(15 citation statements)

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“…There is a period of primary creep for about 2-4 h, in which the correction is relatively important. A secondary creep period allows a more gradual reduction of the spinal deformity, such that near maximal curve correction can be obtained after about 10-12 days [17].…”

Section: Discussionmentioning

confidence: 99%

Three-staged correction of severe rigid idiopathic scoliosis using limited halo-gravity traction

Koptan

ElMiligui

2011

Eur Spine J

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Introduction Despite the advantages of modern instrumentation techniques, the treatment of severe rigid idiopathic scoliosis could be very demanding. Traction can provide better, safer correction and minimize complications related to forceful intra-operative maneuvers; however, several side effects are associated with prolonged periods of traction. The aim of this work is to review the clinical and radiographic results of limited perioperative halo-gravity traction in severe rigid curves analyzing its efficacy, advantages and possible complications and comparing it to classic two staged corrections performed without traction. Methods A retrospective case control study including 47 adolescents with severe rigid idiopathic scoliosis divided into two groups; a consecutive series of 21 patients who had a three-staged correction by an anterior release, 2 weeks of halo-gravity traction then posterior instrumentation (TRN group); compared to an earlier series of 26 consecutive patients treated without traction (SAP group). The average age was 18 years ? 1 month and 16 years ? 2 months, respectively. The average preoperative dorsal and lumbar curves for (TRN) group were 106.5°and 87°, respectively, and for (SAP) group were 102°and 81°, respectively. Results Patients were followed up for an average of 6 years (range 3-8 years). A significantly better correction was achieved in (TRN) group (average 59%) compared to (SAP) group (average 47%). At final follow-up, the loss of correction had an average of 8°for (TRN) group and 11°f or (SAP) group. A shorter hospital stay was found in (SAP) group; a shorter operative time was found in (TRN) group and there was no significant difference in blood loss, early or delayed complications. Conclusions Limited halo-gravity traction is an efficient, safe modality in the treatment of severe rigid adolescent scoliosis. The application of gradual traction over a limited period of 2 weeks led to better correction, shorter operative time with no significant complications.

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Section: Discussionmentioning

confidence: 99%

Three-staged correction of severe rigid idiopathic scoliosis using limited halo-gravity traction

Koptan

ElMiligui

2011

Eur Spine J

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“…The existing theories mainly implicate the hematoma caused by the injury, the injury to the soft tissues, or a coexisting fracture. The pattern of injury was also related to autofusion (2,3,9,10). Dove et al (4,5), to explain spontaneous fusion after halopelvic traction, conjectured that distraction of the spine resulted in distraction and consequent stiffness of the cervical spine ligaments and avul- In clinical studies, Nicoll (14) reported spontaneous fusion in 70% of fracture-dislocations of the spine.…”

Section: Discussionmentioning

confidence: 99%

“…Many theories have been formulated since then, most of which implicate hematoma as the main cause of bone formation and subsequent fusion, as well as injuries of the soft tissues or the coexistence of a fracture. Spontaneous traumatic fusion has been associated with the type of injury (4,6,9,10,13,15), immobilization (3,8), and soft-tissue distraction (2,3). The mechanism of injury was also associated with spontaneous fusion (2).…”

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confidence: 99%

Spontaneous Interbody Fusion After Controlled Injuries to the Spine: An Experimental Study in Rabbits

Korres

Babis²,

Paraskevakou³

et al. 2000

Journal of Spinal Disorders

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To evaluate the rationale of spontaneous spine fusion after a spinal injury, the authors conducted an experimental study that consisted of three types of controlled injuries to a rabbit spine model. The first was injury to the intervertebral disk (type I injury). The second was injury of the intervertebral disk along with injury to one of the adjacent vertebral end plates (type II). In type III injury, both the opposing end plates were injured along with the intervertebral disk. In 38 rabbits, a total of 82 injuries of these three types were inflicted. Twenty-six injuries were of type I (n ‫ס‬ 22 rabbits), 26 were type II (n ‫ס‬ 24 rabbits), and 30 were type III (n ‫ס‬ 26 rabbits). Spontaneous fusion occurred only in type III injuries. From the 30 type III injuries, fusion occurred in 20 (66.6%). For an autofusion to occur, both epiphyseal plates may be injured. In the clinical situation, this observation suggests that a radiographically obscure lesion of both neighboring vertebrae may proceed to autofusion of that spinal segment observed later.

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“…This is more likely when several months have elapsed between the last operation and the removal of the apparatus and in patients with paralytic neck muscles. Although one is not actively lengthening the spine it is continually deforming (or "creeping") with the passage of time (6). A typical example of this phenomenon is case 18, a patient with a severe lumbar tuberculous kyphosis, who was corrected by staged procedures and then remained in the apparatus for a further 8 months.…”

Section: Continuing Lengthening Without Actual Distractionmentioning

confidence: 99%

The Halo-Pelvic Apparatus: A Clinical, Bio-Engineering and Anatomical Study

O’Brien

1976

Acta Orthopaedica Scandinavica

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Viscoelastic Behaviour of Deformed Spines Under Correction with Halo Pelvic Distraction

Cited by 16 publications

References 0 publications

Three-staged correction of severe rigid idiopathic scoliosis using limited halo-gravity traction

Three-staged correction of severe rigid idiopathic scoliosis using limited halo-gravity traction

Spontaneous Interbody Fusion After Controlled Injuries to the Spine: An Experimental Study in Rabbits

The Halo-Pelvic Apparatus: A Clinical, Bio-Engineering and Anatomical Study

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