title: Severe cervical kyphosis complicating halo traction in a patient with Marfan syndrome.
abstract: METHODS
  A case report of complications from using halo traction in a patient with Marfan Syndrome (MFS).
  
  
  OBJECTIVE
  The aim of the article is to describe a complication of halo traction in a patient with MFS.
  
  
  BACKGROUND
  Scoliosis is a common presentation in MFS and may require surgery. Halo traction is a well-recognized adjunct for correcting severe, complex, rigid scoliotic curves. No articles have been published describing complications from the use of halo traction in patients with MFS.
  
  
  METHODS
  Review of records and radiographs.
  
  
  RESULTS
  A patient with MFS and severe scoliosis of 145 degrees underwent an anterior and posterior release with halo-gravity traction for 2 weeks duration, followed by a posterior fusion. Her postoperative major scoliosis curve correction was stable at 26 degrees. The patient developed cervical kyphosis and neck stiffness after the traction. Ultimately, 23 months later with 66 degrees of angulation, the increasing kyphosis warranted anterior and posterior fusion. Seven months after cervical surgery, her cervical kyphosis stabilized at 22 degrees.
  
  
  CONCLUSIONS
  This complication may be explained by the laxity of the connective tissue in MFS. Also, halo traction creates more tension in the cervical spine than the thoracolumbar spine. For patients with MFS and perhaps other connective tissue disorders, halo-gravity traction should be used with caution, especially when some pre-existing cervical kyphosis is present.
authors.affiliation: Department of Orthopedic Surgery, Johns Hopkins Medical Institutions, 601 North Caroline Street, Baltimore, MD 21287, USA.
authors.forename: Justin S
authors.initials: JS
authors.lastname: Yang
authors.forename: Paul D
authors.initials: PD
authors.lastname: Sponseller
mesh_terms: D000293:Adolescent; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000601:surgery; D008382:Marfan Syndrome / Q000628:therapy*; D011859:Radiography; D012307:Risk Factors; D013123:Spinal Fusion / Q000379:methods; D014143:Traction / Q000009:adverse effects* / Q000295:instrumentation*