Document Type
Article
Publication Date
3-2021
Publisher
SAGE Publications
Source Publication
Global Spine Journal
Source ISSN
2192-5682
Abstract
Study Design:
Retrospective review of consecutive series.
Objective:
The study sought to assess the effect of prolonged pre-operative halo gravity traction (HGT) on the c-spine radiographs
Methods:
Data of 37 pediatric and adult patients who underwent ≥ 12wks pre-op HGT prior to definitive spine surgery from 2013-2015 at a single site in West Africa was reviewed. Radiographic assessment of the c-spine including ADI, SVA and C2-C7 Lordosis were done at pre HGT and at 4 weekly intervals. Paired T-Test was performed to evaluate changes in these parameters during HGT.
Results:
37pts, 18/19 (F/M). Average age 18.2yrs. Diagnoses: 22 idiopathic, 6 congenital, 3 Post TB, 2 NM and 4 NF. Average duration of HGT: 125 days. Baseline coronal Cobb:130 deg, corrected 30% in HGT; baseline sagittal Cobb:146 deg, corrected 32% post HGT. Baseline ADI (3.17 ± 0.63 mm) did not change at 4wks (P > 0.05) but reduced at 8wks (2.80 ± 0.56 mm) and 12wks (2.67 ± 0.51 mm) post HGT (P < 0.05). Baseline HGT SVA (20.7 ± 14.98 mm) significantly improved at 4wks (11.55 ± 10.26 mm), 8wks (7.54 ± 6.78 mm) and 12wks (8.88 ± 4.5 mm) (P < 0.05). Baseline C2-C7 lordosis (43 ± 20.1 deg) reduced at 4wks (26 ± 16.37 deg), 8wks (17.8 ± 14.77 deg) and 12wks (16.7 ± 11.33 deg) post HGT (P < 0.05). There was no incidence of atlanto-axial instability on flexion extension radiographs at any interval.
Conclusion:
Prolonged HGT, while providing partial correction of severe spine deformities, also appeared to have no adverse effect on atlanto-axial stability or cervical alignment. Therefore, HGT can be safely applied for several weeks in the preoperative management of severe spine deformities in pediatric/adult patients.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Yankey, Kawdwo P.; Duah, Henry Ofori; Sacramento-Dominguez, Cristina; Tutu, Henry O.; Owiredu, Mabel Adobea; Mahmud, Rufai; Wulff, Irene; Ofori-Amankwah, Gerhard; Akoto, Harry; Boachie-Adjei, Oheneba; and FOCOS Spine Research Group, "The Effect of Prolonged Pre-Operative Halo Gravity Traction for Severe Spinal Deformities on the Cervical Spine Radiographs" (2021). College of Nursing Faculty Research and Publications. 1188.
https://epublications.marquette.edu/nursing_fac/1188
Comments
Published version. Global Spine Journal, Vol. 13, No. 2 (March 2021): 451-456. DOI. © 2021 The Authors, published by SAGE Publications. Used with permission.
Henry Duah was affiliated with FOCOS Orthopaedic Hospital, Accra, Ghana at the time of publication.
Creative Commons Non Commercial No Derivs CC BY-NC-ND: This article is distributed under the terms of the Creative Commons Attribution-Non Commercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).