The short term clinical efficacy of halo-pelvic traction combined with staged posterior spinal fusion for severe rigid spinal deformity
Objective:To explore the short-term clinical efficacy of halo-pelvic traction(HPT)combined with posterior spinal fusion(PSF)versus PSF alone in the treatment of severe rigid scoliosis.Methods:This retrospective study included patients with severe rigid scoliosis treated with either HPT combined with PSF(HPT+PSF group,19 cases)or PSF alone(PSF group,19 cases)from 2017 to 2020.The spinal correction parameters and deformity improvement rate,changes in pulmonary function before and after traction(including forced vital capacity[FVC],FVC%,forced expiratory volume in one second[FEV1],and FEV1%),perioperative indicators,height changes,and complications were compared between the two groups.Results:The follow-up time ranged from 12 to 20 months,with an average of(16.4±3.5)months.Before traction,there were no significant difference between the two groups in the Cobb angle in coronal position,Cobb angle in sagittal position,C7PL-CSVL and SVA(all P>0.05).One year after surgery,the coronal and sagittal Cobb angle decreased in the group,the differences were statistically significant(all P<0.05).After traction,the FEV1,FEV1%,FVC,and FVC%in the HPT+PSF group were significantly greater than those before traction(all P<0.05).The HPT+PSF group had significantly lower average surgical blood loss and operation time compared to the PSF group(all P<0.05).A significant difference was noted in the osteotomy grading between groups(P<0.05).The height increase in the HPT+PSF group was significantly lower than that in the PSF group,and the overall height increase in the HPT+PSF group was significantly higher than that in the PSF group(both P<0.05).There were 6 cases of traction-related complications and 2 cases of surgery-related complications in the HPT+PSF group,compared to7 complications in the PSF group.Conclusions:HPT combined with PSF is safe and effective in the treatment of severe rigid scoliosis.HPT enhances preoperative pulmonary function and facilitates improvement in deformity while reducing surgical complexity.However,attention should be given to the high incidence of traction-related complications.
Severe Rigid ScoliosisHalo-pelvic TractionPosterior Correction SurgeryPulmonary Function
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