title: The use of traction in the treatment of severe spinal deformity.
abstract: METHODS
  Multicenter, retrospective, nonrandomized comparison group study of patients with severe scoliosis and kyphosis treated after 1995 with halo-gravity traction and without halo-gravity traction before definitive fusion.
  
  
  OBJECTIVE
  Compare surgical correction of severe spine deformity with preoperative halo traction and without preoperative traction.
  
  
  BACKGROUND
  Prior studies have demonstrated that halo traction is a safe, well-tolerated method of applying gradual, sustained traction to maximize operative correction in patients with severe idiopathic scoliosis (IS) and kyphosis. However, these studies lack a comparison control group and study only a relatively small number of patients with IS.
  
  
  METHODS
  Fifty-three patients with severe scoliosis or kyphosis were studied using hospital records, standing preoperative, traction, postoperative, and final radiographs. Thirty were treated with traction and 23 were treated without traction. Patients within each group were analyzed based on demographics, diagnosis, perioperative, and radiographic data. In addition, patients were evaluated based on diagnosis, specifically whether patients had adolescent idiopathic scoliosis.
  
  
  RESULTS
  Within the entire study population, there was no statistically significant difference in main coronal curve correction (62% vs. 59%), operative time, blood loss, and total complication rate (27% vs. 52%). However, the nontraction group underwent vertebral column resection more often (30% vs. 3%, P = 0.015). The traction group had a statistically significant increase in average hospital stay (36 vs. 14 days) (P = 0.011). Analysis of the 23 patients with adolescent idiopathic scoliosis also showed no statistically significant differences in curve correction, blood loss, or complications.
  
  
  CONCLUSIONS
  Our study shows that patients with halo traction less frequently had a vertebral body resection, but achieved comparable deformity correction.
authors.affiliation: Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. psponse@jhmi.edu
authors.forename: Paul D
authors.initials: PD
authors.lastname: Sponseller
authors.forename: Ryan K
authors.initials: RK
authors.lastname: Takenaga
authors.forename: Peter
authors.initials: P
authors.lastname: Newton
authors.forename: Oheneba
authors.initials: O
authors.lastname: Boachie
authors.forename: Jack
authors.initials: J
authors.lastname: Flynn
authors.forename: Lynn
authors.initials: L
authors.lastname: Letko
authors.forename: Randal
authors.initials: R
authors.lastname: Betz
authors.forename: Keith
authors.initials: K
authors.lastname: Bridwell
authors.forename: Munish
authors.initials: M
authors.lastname: Gupta
authors.forename: Michelle
authors.initials: M
authors.lastname: Marks
authors.forename: Tracey
authors.initials: T
authors.lastname: Bastrom
mesh_terms: D000293:Adolescent; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012600:Scoliosis / Q000473:pathology / Q000601:surgery*; D014143:Traction / Q000379:methods / Q000706:statistics & numerical data*