HALO TRACTION EFFECTIVENESS IN THE MANAGMENT OF CHILDREN WITH SEVERE RIGID SCOLIOSIS
DOI:
https://doi.org/10.71000/n77dfy41Keywords:
severe scoliosis, halo-gravity traction, spinal deformity, pediatric orthopedics, preoperative management, spinal correctionAbstract
Objective: To evaluate efficacy of halo-gravity traction in pediatric patients with severe rigid scoliosis.
Methodology: We enrolled twenty five pediatric patients with severe rigid scoliosis were. All patients underwent halo device application under general anesthesia using six-pin fixation in standard cranial safe zones. Traction was initiated at 2-3 kg and progressively increased to a maximum of 50% body weight with adjustments based on individual tolerance and radiographic response. Radiographic evaluations were documented for spinal alignment changes with particular focus on coronal Cobb angle and kyphosis measurements. All surgical procedures were performed by experienced spinal surgeons.
Results: Mean age was 12.80±2.81 years. Significant radiographic improvements were observed with mean coronal Cobb angles reducing from 102.44±14.78 degrees to 42.88±3.53 degrees post-surgery (p<0.0001). Kyphosis improved from 64.72±17.96 degrees to 31.12±7.81 degrees post-surgery (p<0.0001). One patient had pin tract infection and one patients had CSF leak.
Conclusion: Preoperative halo-gravity traction exhibited an effective and safe approach for managing severe rigid scoliosis in pediatric patients.
References
Verhofste BP, Whitaker AT, Glotzbecker MP, Miller PE, Karlin LI, Hedequist DJ, et al. Efficacy of bracing in skeletally immature patients with moderate–severe idiopathic scoliosis curves between 40 and 60. Spine Deformity. 2020;8(5):911-20.
Manzetti M, Ruffilli A, Barile F, Viroli G, Traversari M, Vita F, et al. Is there a skeletal age index that can predict accurate curve progression in adolescent idiopathic scoliosis? A systematic review. Pediatr Radiol. 2024;54(2):299-315.
Agabegi SS, Kazemi N, Sturm PF, Mehlman CT. Natural history of adolescent idiopathic scoliosis in skeletally mature patients: a critical review. J Am Acad Orthop Surg. 2015;23(12):714-23.
Mostoufi SA, George TK, Mostoufi Y. Spinal Deformities: Kyphosis and Scoliosis. InClinical Guide to Musculoskeletal Medicine: A Multidisciplinary Approach. Springer 2022;91-99
Roberts SB, Tsirikos AI. Paediatric spinal deformity surgery: complications and their management. In Healthcare 2022;10(12);2519
Kim HJ, Yang JH, Chang DG, Suk SI, Suh SW, Song KS, et al. Adult spinal deformity: current concepts and decision-making strategies for management. Asian Spine J. 2020;14(6):886.
Sucato DJ. Management of severe spinal deformity: scoliosis and kyphosis. Spine. 2010;35:2186–2192.
Rinella A, Lenke L, Whitaker C, Kim Y, Park SS, Peelle M, et al. Perioperative halo-gravity traction in the treatment of severe scoliosis and kyphosis. Spine. 2005;30:475-82.
Yang C, Wang H, Zheng Z, Zhang Z, Wang J, Liu H, et al. Halo-gravity traction in the treatment of severe spinal deformity: a systematic review and meta-analysis. Eur Spine J. 2017;26:1810-6.
Sun Y, Zhang Y, Ma H, Tan M, Zhang Z. Halo-pelvic traction in the treatment of severe scoliosis: a meta-analysis. Eur Spine J. 2023;32(3):874-82.
Sponseller PD, Takenaga RK, Newton P, Boachie O, Flynn J, Letko L, et al. The use of traction in the treatment of severe spinal deformity. Spine. 2008;33(21):2305-9.
Watanabe K, Lenke LG, Bridwell KH, Kim YJ, Hensley M, Koester L. Efficacy of perioperative halo-gravity traction for treatment of severe scoliosis. J Orthop Sci. 2010;15:720-30.
Korkmaz M. Effectiveness of halo traction in the treatment of patients with severe rigid scoliosis. J Turk Spinal Surg. 2025;36(1):24-28.
Ilyas MS, Shah A, Zehra U, Ismail M, Elahi H, Aziz A. Effectiveness and safety of preoperative distraction using modified halo-pelvic Ilizarov distraction assembly in patients with severe kyphoscoliosis. Asian Spine J. 2024;18(4):522-531.
Ali SA, Ch AA, Humayun AS, Dar UZ, Awais SM. Experience of halopelvic traction in the treatment of severe spine deformity: A case series. Annals of King Edward Medical University. 2015;21(4):295-300.
Domenech P, Mariscal G, Marquina V, Bas P, Bas T. Efficacy and safety of halo-gravity traction in the treatment of spinal deformities: A systematic review. Rev Esp Cir Ortop Traumatol. 2024;68(2):159-167.
Ma Y, Wang Y, Dou X, et al. Treatment of severe congenital scoliosis with Type II respiratory failure. J Coll Physicians Surg Pak. 2022;32(12):174-177.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Haider Ali, Muhammad Asad, Sikandar Amjad, Shahrukh Khan (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.