Brachial plexus palsy associated with halo traction before posterior correction in severe scoliosis.
OBJECTIVE
To retrospectively analyse clinical features and related factors of brachial plexus palsy associated with halo traction before posterior correction in severe scoliosis.


METHODS
300 Cases of severe scoliosis performed with halo traction before posterior correction were considered with 7 cases suffering from brachial plexus palsy (2 males and 5 females). The average age was 14 years (range, 9-19 years). The average Cobb angle was 110 degrees (range, 90 degrees - 135 degrees); Diagnoses were idiopathic scoliosis (1), congenital scoliosis (3), and neuromuscular scoliosis (3). Halo-gravity traction was used in 3 cases preoperatively; and Halo-femoral traction used in 4 cases postoperatively (anterior release 2 cases, anterior epiphyseal arrest 1 case, combined anterior and posterior release 1 case).


RESULTS
Traction was used for an average of 3.5 weeks before spinal fusion (range, 2-6 weeks) for these 7 patients. The average traction weight was 8 kg; the average traction weight was 19 % ( range 13-26%) of the average body weight (40.2 kg). The mean stature was 175 cm; all the 7 patients had a long and thin body configuration. Duration between brachial plexus paralysis and detection was 1 to 3 hours. All the 7 patients suffered different degree from numbness of ulnaris of the hand and antebrachium. Median nerve palsy was found in 3 cases, ulnar nerve paralysis was found in 4 cases. Complete nerve functional restoration had been achieved by the end of three months after rehabilitation training, drug treatment were adopted.


CONCLUSIONS
Brachial plexus palsy associated with halo traction in severe scoliosis is related to the weight of traction, body type and patient-pathology status. If the symptoms are promptly detected with rehabilitation training and appropriate drug treatment adopted, complete nerve functional restoration can be achieved.
Qian
Bang-ping
BP
Spine Surgery, Drum Tower Hospital, Nanjing University Medical School, Nanjing, 210008, China.
Qiu
Yong
Y
Wang
Bin
B
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001917:Brachial Plexus; D002648:Child; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D010243:Paralysis; D012189:Retrospective Studies; D012600:Scoliosis / Q000628:therapy*; D014143:Traction / Q000295:instrumentation*