The radiographic, pulmonary, and clinical outcomes of patients with severe rigid spinal deformities treated via halo-pelvic traction

被引:21
作者
Chen, Jian [1 ]
Sui, Wen-yuan [1 ]
Yang, Jing-fan [1 ]
Deng, Yao-long [1 ]
Xu, Jing [1 ]
Huang, Zi-fang [2 ]
Yang, Jun-lin [1 ]
机构
[1] Shanghai Jiao Tong Univ, Xinhua Hosp, Sch Med, Spine Surg Ctr, 1665 Kongjiang Rd, Shanghai, Peoples R China
[2] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Orthopaed Surg, Guangzhou, Guangdong, Peoples R China
关键词
Severe rigid spinal deformity; Halo-pelvic traction; Halo-gravity traction; Pulmonary function;
D O I
10.1186/s12891-021-03953-y
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
BackgroundThe severe rigid deformity patients with pulmonary dysfunction could not tolerate complicated corrective surgery. Preoperative traction are used to reduce the curve magnitude and improve the pulmonary function before surgery, including halo-gravity traction (HGT) and halo-pelvic traction (HPT). The present study aimed to retrospectively compare the radiographic, pulmonary and clinical outcomes of preoperative HGT and HPT in severe rigid spinal deformity with respiratory dysfunction.Methods81 cases of severe rigid kyphoscoliosis treated with preoperative traction prior to corrective surgery for spinal deformity between 2016 and 2019 were retrospectively reviewed. Two patient groups were compared, HPT group (N=30) and HGT group (N=51). Patient demographics, coronal and sagittal Cobb angles and correction rates, pulmonary function, traction time, osteotomy grade, and postoperative neurological complications were recorded for all cases.ResultsThe coronal Cobb angle was corrected from 140.672.63 to a mean of 120.17 +/- 2.93 degrees in the HGT group, and from 132.32 +/- 4.96 to 87.59 +/- 3.01 degrees in the HPT group (mean corrections 15.33 +/- 1.53 vs. 34.86 +/- 3.11%) (P=0.001). The mean major sagittal curve decreased from 134.28 +/- 3.77 to 113.03 +/- 4.57 degrees in the HGT group and from 129.60 +/- 8.45 to 65.61 +/- 7.86 degrees in the HPT group (P<0.001); the mean percentage corrections were 16.50<plus/minus>2.13 and 44.09 +/- 9.78% (P<0.001). A significant difference in the pulmonary function test results was apparent between the two groups; the mean improvements in the FVC% of the HGT and HPT groups were 6.76<plus/minus>1.85 and 15.6 +/- 3.47% (P=0.024). The HPT group tended to exhibit more FEV% improvement than the HGT group, but the difference was not significant (5.15 +/- 2.27 vs. 11.76 +/- 2.22%, P=0.91).ConclusionsPatients with severe rigid kyphoscoliosis who underwent preoperative HPT exhibited better radiographic correction of the deformity, and pulmonary function, and required fewer osteotomies compared to the HGT group. Thus, HPT may be useful for severe rigid spinal deformity patients with pulmonary dysfunction.
引用
收藏
页数:8
相关论文
共 41 条
[1]   Halo-gravity traction combined with assisted ventilation: an effective pre-operative management for severe adult scoliosis complicated with respiratory dysfunction [J].
Bao, Hongda ;
Yan, Peng ;
Bao, Mike ;
Qiu, Yong ;
Zhu, Zezhang ;
Liu, Zhen ;
Cheng, Jack C. Y. ;
Ng, Bobby K. W. ;
Zhu, Feng .
EUROPEAN SPINE JOURNAL, 2016, 25 (08) :2416-2422
[2]   RESPIRATORY IMPAIRMENT AND AIRWAY CLOSURE IN PATIENTS WITH UNTREATED IDIOPATHIC SCOLIOSIS [J].
BJURE, J ;
GRIMBY, G ;
KASALICKY, J ;
LINDH, M ;
NACHEMSON, A .
THORAX, 1970, 25 (04) :451-+
[3]   Preoperative halo-gravity traction for severe pediatric spinal deformity: Complications, radiographic correction and changes in pulmonary function [J].
Bogunovic L. ;
Lenke L.G. ;
Bridwell K.H. ;
Luhmann S.J. .
Spine Deformity, 2013, 1 (1) :33-39
[4]   A DESCRIPTIVE ANALYSIS OF THE GROWTH AND DECLINE OF THE FVC AND FEV [J].
BURROWS, B ;
CLINE, MG ;
KNUDSON, RJ ;
TAUSSIG, LM ;
LEBOWITZ, MD .
CHEST, 1983, 83 (05) :717-724
[5]   Dynamic magnetic resonance imaging in assessing lung volumes, chest wall, and diaphragm motions in adolescent idiopathic scoliosis Versus normal controls [J].
Chu, Winnie C. W. ;
Li, Albert M. ;
Ng, Bobby K. W. ;
Chan, Dorothy F. Y. ;
Lam, Tsz-ping ;
Lam, Wynnie W. M. ;
Cheng, Jack C. Y. .
SPINE, 2006, 31 (19) :2243-2249
[6]   Preoperative and early postoperative three-dimensional changes of the rib cage after posterior instrumentation in adolescent idiopathic scoliosis [J].
Delorme, S ;
Violas, P ;
Dansereau, J ;
de Guise, J ;
Aubin, CÉ ;
Labelle, H .
EUROPEAN SPINE JOURNAL, 2001, 10 (02) :101-106
[7]   Novel Index to Quantify the Risk of Surgery in the Setting of Adult Spinal Deformity A Study on 10,912 Patients From the Nationwide Inpatient Sample [J].
Diebo, Bassel G. ;
Jalai, Cyrus M. ;
Challier, Vincent ;
Marascalchi, Bryan J. ;
Horn, Samantha R. ;
Poorman, Gregory W. ;
Bono, Olivia J. ;
Cherkalin, Denis ;
Worley, Nancy ;
Oh, Jason ;
Naziri, Qais ;
Spitzer, Allison ;
Radcliff, Kris ;
Patel, Ashish ;
Lafage, Virginie ;
Paulino, Carl B. ;
Passias, Peter G. .
CLINICAL SPINE SURGERY, 2017, 30 (07) :E993-E999
[8]   THE CERVICAL-SPINE AFTER HALO-PELVIC TRACTION - AN ANALYSIS OF THE COMPLICATIONS IN 83 PATIENTS [J].
DOVE, J ;
HSU, LCS ;
YAU, ACMC .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1980, 62 (02) :158-161
[9]   The results of preoperative halo-gravity traction in children with severe spinal deformity [J].
Garabekyan, Tigran ;
Hosseinzadeh, Pooya ;
Iwinski, Henry J. ;
Muchow, Ryan D. ;
Talwalkar, Vishwas R. ;
Walker, Janet ;
Milbrandt, Todd A. .
JOURNAL OF PEDIATRIC ORTHOPAEDICS-PART B, 2014, 23 (01) :1-5
[10]   Pulmonary Function in Adolescent Idiopathic Scoliosis Relative to the Surgical Procedure A 10-Year Follow-up Analysis [J].
Gitelman, Yevgeniy ;
Lenke, Lawrence G. ;
Bridwell, Keith H. ;
Auerbach, Joshua D. ;
Sides, Brenda A. .
SPINE, 2011, 36 (20) :1665-1672