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Frontal correction assessment in severe adolescent idiopathic scoliosis surgery using halo gravity traction before to posterior vertebral arthrodesis: a multicenter retrospective observational study

Purpose Preoperative preparation with halo gravity traction (HGT) has several advantages but is still controversial. A multicenter, observational, retrospective study was conducted to determine whether HGT provides better frontal correction in surgery for adolescent idiopathic scoliosis (AIS). Metho...

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Published in:European spine journal 2024-02, Vol.33 (2), p.713-722
Main Authors: Langlais, Tristan, Josse, Antoine, Violas, Philippe
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description Purpose Preoperative preparation with halo gravity traction (HGT) has several advantages but is still controversial. A multicenter, observational, retrospective study was conducted to determine whether HGT provides better frontal correction in surgery for adolescent idiopathic scoliosis (AIS). Methods Between 2010 and 2020, all patients who underwent posterior spinal fusion (PSF) AIS with a Cobb angle greater than 80° were included. The included patients who underwent HGT were compared (complications rate and radiographic parameters) to patients who did not undergo traction (noHGT). For patients who underwent HGT, a spinal front X-ray at the end of the traction procedure was performed. Results Sixty-four in noHGT and forty-seven in HGT group were analyzed with a 31-month mean follow-up. The mean ratio of Cobb angle correction was 58.8% in noHGT and 63.6% in HGT group ( p  = 0.023). In HGT, this ratio reached 9% if the traction lasted longer than 30 days ( p  = 0.009). The complication rate was 11.7% with a rate of 6.2% in noHGT and 19.1% in HGT group ( p  = 0.07). In patient whose preoperative Cobb angle was greater than 90°, the mean ratio of Cobb angle correction increases to 6.7% ( p  = 0.035) and the complications rate increased to 14% in the no HGT group and decreased to 13% in the HGT group ( p  = 0.9). Conclusion HGT preparation in the management of correction of AIS with a Cobb angle greater than 90° is a technique providing a greater frontal correction gain with similar complication rate than PSF correction alone. We recommend a minimum halo duration of 4 weeks.
doi_str_mv 10.1007/s00586-023-08062-z
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A multicenter, observational, retrospective study was conducted to determine whether HGT provides better frontal correction in surgery for adolescent idiopathic scoliosis (AIS). Methods Between 2010 and 2020, all patients who underwent posterior spinal fusion (PSF) AIS with a Cobb angle greater than 80° were included. The included patients who underwent HGT were compared (complications rate and radiographic parameters) to patients who did not undergo traction (noHGT). For patients who underwent HGT, a spinal front X-ray at the end of the traction procedure was performed. Results Sixty-four in noHGT and forty-seven in HGT group were analyzed with a 31-month mean follow-up. The mean ratio of Cobb angle correction was 58.8% in noHGT and 63.6% in HGT group ( p  = 0.023). In HGT, this ratio reached 9% if the traction lasted longer than 30 days ( p  = 0.009). The complication rate was 11.7% with a rate of 6.2% in noHGT and 19.1% in HGT group ( p  = 0.07). In patient whose preoperative Cobb angle was greater than 90°, the mean ratio of Cobb angle correction increases to 6.7% ( p  = 0.035) and the complications rate increased to 14% in the no HGT group and decreased to 13% in the HGT group ( p  = 0.9). Conclusion HGT preparation in the management of correction of AIS with a Cobb angle greater than 90° is a technique providing a greater frontal correction gain with similar complication rate than PSF correction alone. We recommend a minimum halo duration of 4 weeks.</description><identifier>ISSN: 0940-6719</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-023-08062-z</identifier><identifier>PMID: 38135731</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Arthrodesis ; Humans ; Life Sciences ; Medicine ; Medicine &amp; Public Health ; Neurosurgery ; Original Article ; Retrospective Studies ; Scoliosis ; Scoliosis - diagnostic imaging ; Scoliosis - surgery ; Spinal Fusion ; Spine ; Surgery ; Surgical Orthopedics ; Traction ; Vertebrae</subject><ispartof>European spine journal, 2024-02, Vol.33 (2), p.713-722</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. 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The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c409t-8ec928bf15b16aadbbfc233a7033b62da7a41bbaf3fb4fe99d55cb8b36d304113</citedby><cites>FETCH-LOGICAL-c409t-8ec928bf15b16aadbbfc233a7033b62da7a41bbaf3fb4fe99d55cb8b36d304113</cites><orcidid>0000-0003-1427-5518</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38135731$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://univ-lyon1.hal.science/hal-04475020$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Langlais, Tristan</creatorcontrib><creatorcontrib>Josse, Antoine</creatorcontrib><creatorcontrib>Violas, Philippe</creatorcontrib><creatorcontrib>and the French Society of Orthopaedic Paediatric (SOFOP)</creatorcontrib><creatorcontrib>and the French Society of Orthopaedic Paediatric (SOFOP)</creatorcontrib><title>Frontal correction assessment in severe adolescent idiopathic scoliosis surgery using halo gravity traction before to posterior vertebral arthrodesis: a multicenter retrospective observational study</title><title>European spine journal</title><addtitle>Eur Spine J</addtitle><addtitle>Eur Spine J</addtitle><description>Purpose Preoperative preparation with halo gravity traction (HGT) has several advantages but is still controversial. A multicenter, observational, retrospective study was conducted to determine whether HGT provides better frontal correction in surgery for adolescent idiopathic scoliosis (AIS). Methods Between 2010 and 2020, all patients who underwent posterior spinal fusion (PSF) AIS with a Cobb angle greater than 80° were included. The included patients who underwent HGT were compared (complications rate and radiographic parameters) to patients who did not undergo traction (noHGT). For patients who underwent HGT, a spinal front X-ray at the end of the traction procedure was performed. Results Sixty-four in noHGT and forty-seven in HGT group were analyzed with a 31-month mean follow-up. The mean ratio of Cobb angle correction was 58.8% in noHGT and 63.6% in HGT group ( p  = 0.023). In HGT, this ratio reached 9% if the traction lasted longer than 30 days ( p  = 0.009). The complication rate was 11.7% with a rate of 6.2% in noHGT and 19.1% in HGT group ( p  = 0.07). In patient whose preoperative Cobb angle was greater than 90°, the mean ratio of Cobb angle correction increases to 6.7% ( p  = 0.035) and the complications rate increased to 14% in the no HGT group and decreased to 13% in the HGT group ( p  = 0.9). Conclusion HGT preparation in the management of correction of AIS with a Cobb angle greater than 90° is a technique providing a greater frontal correction gain with similar complication rate than PSF correction alone. 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Josse, Antoine ; Violas, Philippe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c409t-8ec928bf15b16aadbbfc233a7033b62da7a41bbaf3fb4fe99d55cb8b36d304113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Arthrodesis</topic><topic>Humans</topic><topic>Life Sciences</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Retrospective Studies</topic><topic>Scoliosis</topic><topic>Scoliosis - diagnostic imaging</topic><topic>Scoliosis - surgery</topic><topic>Spinal Fusion</topic><topic>Spine</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Traction</topic><topic>Vertebrae</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Langlais, Tristan</creatorcontrib><creatorcontrib>Josse, Antoine</creatorcontrib><creatorcontrib>Violas, Philippe</creatorcontrib><creatorcontrib>and the French Society of Orthopaedic Paediatric (SOFOP)</creatorcontrib><creatorcontrib>and the French Society of Orthopaedic Paediatric (SOFOP)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>European spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Langlais, Tristan</au><au>Josse, Antoine</au><au>Violas, Philippe</au><aucorp>and the French Society of Orthopaedic Paediatric (SOFOP)</aucorp><aucorp>and the French Society of Orthopaedic Paediatric (SOFOP)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Frontal correction assessment in severe adolescent idiopathic scoliosis surgery using halo gravity traction before to posterior vertebral arthrodesis: a multicenter retrospective observational study</atitle><jtitle>European spine journal</jtitle><stitle>Eur Spine J</stitle><addtitle>Eur Spine J</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>33</volume><issue>2</issue><spage>713</spage><epage>722</epage><pages>713-722</pages><issn>0940-6719</issn><eissn>1432-0932</eissn><abstract>Purpose Preoperative preparation with halo gravity traction (HGT) has several advantages but is still controversial. A multicenter, observational, retrospective study was conducted to determine whether HGT provides better frontal correction in surgery for adolescent idiopathic scoliosis (AIS). Methods Between 2010 and 2020, all patients who underwent posterior spinal fusion (PSF) AIS with a Cobb angle greater than 80° were included. The included patients who underwent HGT were compared (complications rate and radiographic parameters) to patients who did not undergo traction (noHGT). For patients who underwent HGT, a spinal front X-ray at the end of the traction procedure was performed. Results Sixty-four in noHGT and forty-seven in HGT group were analyzed with a 31-month mean follow-up. The mean ratio of Cobb angle correction was 58.8% in noHGT and 63.6% in HGT group ( p  = 0.023). In HGT, this ratio reached 9% if the traction lasted longer than 30 days ( p  = 0.009). The complication rate was 11.7% with a rate of 6.2% in noHGT and 19.1% in HGT group ( p  = 0.07). In patient whose preoperative Cobb angle was greater than 90°, the mean ratio of Cobb angle correction increases to 6.7% ( p  = 0.035) and the complications rate increased to 14% in the no HGT group and decreased to 13% in the HGT group ( p  = 0.9). Conclusion HGT preparation in the management of correction of AIS with a Cobb angle greater than 90° is a technique providing a greater frontal correction gain with similar complication rate than PSF correction alone. We recommend a minimum halo duration of 4 weeks.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38135731</pmid><doi>10.1007/s00586-023-08062-z</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-1427-5518</orcidid></addata></record>
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subjects Adolescent
Arthrodesis
Humans
Life Sciences
Medicine
Medicine & Public Health
Neurosurgery
Original Article
Retrospective Studies
Scoliosis
Scoliosis - diagnostic imaging
Scoliosis - surgery
Spinal Fusion
Spine
Surgery
Surgical Orthopedics
Traction
Vertebrae
title Frontal correction assessment in severe adolescent idiopathic scoliosis surgery using halo gravity traction before to posterior vertebral arthrodesis: a multicenter retrospective observational study
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