STUDY DESIGN: A retrospective study comparing patients having traction and a control group not having traction during posterior spinal instrumentation and fusion (PSIF) for adolescent idiopathic scoliosis (AIS). OBJECTIVE: To evaluate the effect of intraoperative traction on surgical correction of AIS. SUMMARY OF BACKGROUND DATA: When the Cotrel-Dubousset instrumentation system was introduced, the use of intraoperative traction was advocated. However, there is no specific report documenting the effect of intraoperative traction on the correction of AIS. METHODS: The medical and radiologic records of 140 AIS patients treated by PSIF were reviewed. Forty of these patients had intraoperative traction using a head halter associated with lower extremity skin traction. The radiologic outcome was compared between the two groups intraoperatively (before instrumentation with the first rod) and after surgery using Student t tests (level of significance = 0.05). RESULTS: The intraoperative and postoperative corrections of the coronal primary Cobb angle were similar for both groups, although the patients in the traction group had smaller preoperative Cobb angles and more flexible curves and were instrumented with more screws. The postoperative thoracic kyphosis was significantly increased in both groups. The lumbar lordosis at the 1-year follow-up was maintained in the control group, but it was significantly decreased in the traction group. CONCLUSION: The authors do not recommend the routine use of intraoperative traction using a head halter combined with skin traction for all AIS patients undergoing PSIF. However, it could be helpful in selected cases, such as in patients having pelvic obliquity and requiring instrumentation of the pelvis.
STUDY DESIGN: A retrospective study comparing patients having traction and a control group not having traction during posterior spinal instrumentation and fusion (PSIF) for adolescent idiopathic scoliosis (AIS). OBJECTIVE: To evaluate the effect of intraoperative traction on surgical correction of AIS. SUMMARY OF BACKGROUND DATA: When the Cotrel-Dubousset instrumentation system was introduced, the use of intraoperative traction was advocated. However, there is no specific report documenting the effect of intraoperative traction on the correction of AIS. METHODS: The medical and radiologic records of 140 AIS patients treated by PSIF were reviewed. Forty of these patients had intraoperative traction using a head halter associated with lower extremity skin traction. The radiologic outcome was compared between the two groups intraoperatively (before instrumentation with the first rod) and after surgery using Student t tests (level of significance = 0.05). RESULTS: The intraoperative and postoperative corrections of the coronal primary Cobb angle were similar for both groups, although the patients in the traction group had smaller preoperative Cobb angles and more flexible curves and were instrumented with more screws. The postoperative thoracic kyphosis was significantly increased in both groups. The lumbar lordosis at the 1-year follow-up was maintained in the control group, but it was significantly decreased in the traction group. CONCLUSION: The authors do not recommend the routine use of intraoperative traction using a head halter combined with skin traction for all AIS patients undergoing PSIF. However, it could be helpful in selected cases, such as in patients having pelvic obliquity and requiring instrumentation of the pelvis.
Authors: Marinus de Kleuver; Stephen J Lewis; Niccole M Germscheid; Steven J Kamper; Ahmet Alanay; Sigurd H Berven; Kenneth M Cheung; Manabu Ito; Lawrence G Lenke; David W Polly; Yong Qiu; Maurits van Tulder; Christopher Shaffrey Journal: Eur Spine J Date: 2014-06-24 Impact factor: 3.134
Authors: So Kato; Stephen J Lewis; Ohm Sharma; Sooyong Chua; Doron Rabin; Ahmed Al-Jahwari; Sarah Bacon; Randolph J Gray; Sam Keshen; Sofia Magana; Reinhard D Zeller Journal: Global Spine J Date: 2019-10-21