title: Strong halo-femoral traction with wide posterior spinal release and three dimensional spinal correction for the treatment of severe adolescent idiopathic scoliosis.
abstract: BACKGROUND
  Many investigators advocate anterior release combined with halo-femoral traction and posterior fusion when treating stiff thoracic curves in patient with adolescent idiopathic scoliosis (AIS). But the anterior operations often induce severe complications. Some surgeons choose posterior-only surgery with halo-femoral traction, posterior wide release and correction. But to the best of our knowledge, there are only rare prospective studies on these posterior-only surgeries for AIS patients who have a rigid curve more than 80° and flexibility less than 35%.
  
  
  METHODS
  Sixty-four AIS patients were recruited from September 2006 to June 2009. All patients had rigid curves and underwent spinal correction. They were randomly divided into group A (combined anteroposterior surgery) and group B (posterior-only surgery). Images and scoliosis research society-22 questionnaire (SRS-22) scores were performed pre- and post-operation and during follow-up visits. The operation time, blood loss, hospital days, and hospital charges were compared between the two groups.
  
  
  RESULTS
  These patients were followed for an average of 37.5 months (range, 24 - 65 months). No serious complications were observed. There were no significant differences between the two groups in gender, age, preoperative radiographic data, or preoperative SRS-22 score. The average operation time, blood loss, hospital days and hospital charges in group B were less than those in group A. The SRS-22 score in group B was better than in group A at post-operation and at final follow-up.
  
  
  CONCLUSIONS
  In AIS with a rigid curve more than 80° and flexibility less than 35%, strong halo-femoral traction with wide posterior spinal release and three dimensional spinal correction can provide better SRS-22 scores, comparable curve correction, shorter operation time, less blood loss, shorter hospital stays and lower charges when compared to combined anterior and posterior surgery.
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hosptial Affiliated to Central South University, Changsha, Hunan, China. zhq9996@yahoo.com.cn
authors.forename: Hong-qi
authors.initials: HQ
authors.lastname: Zhang
authors.forename: Qi-le
authors.initials: QL
authors.lastname: Gao
authors.forename: Lei
authors.initials: L
authors.lastname: Ge
authors.forename: Jian-huang
authors.initials: JH
authors.lastname: Wu
authors.forename: Jin-yang
authors.initials: JY
authors.lastname: Liu
authors.forename: Chao-feng
authors.initials: CF
authors.lastname: Guo
authors.forename: Shao-hua
authors.initials: SH
authors.lastname: Liu
authors.forename: Shi-jin
authors.initials: SJ
authors.lastname: Lu
authors.forename: Jin-song
authors.initials: JS
authors.lastname: Li
authors.forename: Xin-hua
authors.initials: XH
authors.lastname: Yin
authors.forename: Feng
authors.initials: F
authors.lastname: Li
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D012600:Scoliosis / Q000000981:diagnostic imaging* / Q000601:surgery