[Preoperative halo-traction in severe paralytic scoliosis].
OBJECTIVE
During the past decades the treatment of severe paralytic scoliosis has developed towards surgical treatment. However there is controversial discussion about the need of pre-operative Halo-traction. The aim of this study was to built two groups of patients -- one group with and another one without pre-operative Halo-traction -- and to compare the results after surgical correction of scoliotic deformity with data from literature.


METHODS
Between 2000-2003 twenty-five patients with severe neuromuscular spine deformity were treated surgically. Eight patients had preoperative Halo-traction, seventeen patients underwent directly operative correction and instrumentation. The evaluation included the pre- and postoperative X-rays as well those after Halo-traction before surgery.


RESULTS
In the group without Halo-traction the scoliotic angle according to Cobb was reduced from 77 degrees to 33 degrees on average (mean correction of 44 degrees [57 %]). In the group with Halo-traction scoliosis was reduced from 85 degrees to 33 degrees on average (mean correction of 52 degrees [61 %]).


CONCLUSIONS
The preoperative Halo-traction in patients with severe neuromuscular scoliosis indeed leads to radiologically higher correction, but this is not significant (p = 0.19) and only in single cases clinically relevant. In our point of view except from specific indications Halo-traction should not be applied in general as a standard procedure.
Seller
K
K
Orthopädische Universitätsklinik Leipzig. Konrad.Seller@medizin.uni-leipzig.de
Haas
S
S
Raab
P
P
Krauspe
R
R
Wild
A
A
D000293:Adolescent; D002648:Child; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D010243:Paralysis / Q000150:complications*; D011300:Preoperative Care / Q000379:methods*; D020127:Recovery of Function; D012600:Scoliosis / Q000209:etiology* / Q000628:therapy*; D012720:Severity of Illness Index; D014143:Traction / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome