Efficacy of perioperative halo-gravity traction in the treatment of severescoliosis in children

Perioperative halo traction was used in the treatment of severe scoliosis i n 19 children. Diagnoses included neuromuscular, idiopathic, and congenital scoliosis. Traction was transferable between the bed and a walker or wheel chair, Thirteen patients had Drier spinal surgery, and most required osteot omy. Traction was used for 6 to 21 weeks. All patients underwent spinal fus ion surgery after traction, with instrumentation used in 15 patients. Impro vement was achieved in all patients. The Cobb angle improved 35% from an av erage 84 degrees before traction (range 63 degrees -100 degrees) to 55 degr ees preceding fusion. Trunk decompensation improved in all patients. Trunk height increased 5.3 cm in traction. Response to traction did not correlate with diagnosis, patient age, or prior surgery. There were no neurologic co mplications. Perioperative halo-gravity traction improves trunk balance and frontal and sagittal alignment in children with severe spinal deformity. S urgical fusion was enhanced by the improved alignment, and neurologic injur y was avoided.