Three-Stage Correction of Severe Rigid Kyphoscoliosis using Halo-Femoral or Halo-Gravity Traction after Surgical Release: A Systematic Review and Meta-Analysis
Abstract
Management of severe rigid spinal deformity is quite challenging. The use of traction after spinal release helps in achieving better and safer correction. Most studies in the literature describe the use of traction as an adjunct before the surgical correction. Traction after spinal release (anterior or posterior), before definitive scoliosis correction, is not well-studied.
The systematic review was conducted as per preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines using the search phrase (Halo-femoral OR Halo-pelvic) AND Traction AND release AND (scoliosis OR kyphosis). Articles published between June 2000 and June 2023 were included.
Four articles that met the inclusion criteria were analyzed. A total of 168 patients with a mean age of 17.5 years with rigid spinal deformity were included. The mean follow-up was 41.2 months (12–96). A total of 67 patients underwent a posterior release only, while the remaining 101 patients underwent anterior release. The posterior release consisted of Ponte’s osteotomy at all levels. Halo-femoral traction was applied in 147 patients after release, while 21 patients had halo-gravity traction. The mean traction weight used was 21.9 kg for a mean duration of 17.1 (9–44) days. The mean preoperative Cobb angle for the major curve was 101.5° for scoliosis and 76.7° for kyphosis. The overall correction rate achieved following the final posterior fusion was 59% for scoliosis and 46.5% for kyphosis; 48% of the…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 168 participants or records.
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