Abstract | STUDY DESIGN: Retrospective case-control study. OBJECTIVES: To compare patients treated with and without intraoperative halo-femoral traction to assess neuromuscular spinal deformity correction as well as the safety of the technique. SUMMARY OF BACKGROUND DATA: Optimal sitting balance can be achieved in nonambulatory neuromuscular patients with pelvic obliquity by maneuvering a Galveston-type rod or inserting screws into the iliac wings; however, this is often clinically challenging because of the small, soft bone-stock in the pelvis of these patients. METHODS: RESULTS: Preoperative lumbar scoliosis averaged 87 degrees (range 30 degrees-141 degrees) in the halo-femoral traction group and 67 degrees (range 28 degrees-108 degrees) in the control group (P = 0.012). Postoperative lumbar Cobb decreased to 35 degrees (range 15 degrees-60 degrees) in the halo-femoral traction group and 32 degrees (range 4 degrees-66 degrees) in the control group (P = 0.181). Preoperative pelvic obliquity averaged 26 degrees (range 8 degrees-47 degrees) in the halo-femoral traction group and 17 degrees (range 8 degrees-44 degrees) in the control group (P = 0.017); postoperative averaged 6 degrees (range 1 degrees-23 degrees) in the halo-femoral traction group and 7 degrees (range 0 degrees-27 degrees) in the control group. Average pelvic obliquity correction was 78% in the halo-femoral traction group and 52% in the control group (P = 0.001). There were no intraoperative or postoperative halo-femoral traction apparatus-related complications noted (pin cut-out, femoral fractures, pin-sight infections, etc.). CONCLUSIONS: Intraoperative use of halo-femoral traction during the surgical treatment of patients with nonambulatory neuromuscular scoliosis provided significantly improved lumbar curve and pelvic obliquity correction. Intraoperative halo-femoral traction had no associated perioperative complications.
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Authors | Katsushi Takeshita, Lawrence G Lenke, Keith H Bridwell, Yongjung J Kim, Brenda Sides, Marsha Hensley |
Journal | Spine
(Spine (Phila Pa 1976))
Vol. 31
Issue 20
Pg. 2381-5
(Sep 15 2006)
ISSN: 1528-1159 [Electronic] United States |
PMID | 16985468
(Publication Type: Clinical Trial, Comparative Study, Journal Article)
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Topics |
- Adolescent
- Adult
- Bone Nails
- Cerebral Palsy
(complications, pathology, surgery)
- Child
- Female
- Femur
(surgery)
- Humans
- Internal Fixators
- Intraoperative Period
- Male
- Muscular Dystrophies
(complications, pathology, surgery)
- Neuromuscular Diseases
(complications, pathology, surgery)
- Pelvis
(diagnostic imaging, pathology, surgery)
- Radiography
- Sacrum
(diagnostic imaging, pathology, surgery)
- Scoliosis
(etiology, pathology, surgery)
- Spinal Fusion
(instrumentation)
- Thoracic Vertebrae
(diagnostic imaging, pathology, surgery)
- Traction
(instrumentation, methods)
- Treatment Outcome
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