title: Posterior-only surgery with preoperative skeletal traction for management of severe scoliosis.
abstract: OBJECTIVE
  The surgical treatment of severe adolescent spinal deformities is challenging and carries substantial risks of mortality and morbidity. To mitigate this risk, surgeons have employed various methods as this study designed to evaluate the safety and effectiveness of preoperative halo-femoral or halo gravity traction (HGT) followed by posterior-only surgery in the management of severe scoliosis.
  
  
  METHODS
  A total number of 23 patients with severe scoliosis treated by preoperative skeletal traction (halo gravity or halo femoral) followed by posterior fusion and instrumentation in one stage. All patients were followed for a minimum of 2 years after surgery.
  
  
  RESULTS
  The average age of the patients was 12.7 years at the time of surgery. Mean of the Cobb angle improved from 99.9° ± 8.2° preoperatively to 75.3° ± 8° post-traction and 49.5° ± 7.7° postoperatively. Kyphosis angle corrected from 56.4° ± 9.5° to 38.6° ± 5.8°. The preop-FVC% was 41 ± 6.1% and after 1 year follow-up FVC% was 45.7 ± 7.7%. No patients required an anterior release due to amount of their deformity.
  
  
  CONCLUSIONS
  Despite the benefits of modern instrumentation procedures, the treatment of severe scoliosis can be very competing. We think that by applying preoperative halo femoral traction and halo-gravity traction, managing severe scoliosis will be in safe and easy manner and can lead to better deformity correction and less neurological complications and facilitate to avoid anterior operation for severe scoliosis and its related complications.
authors.affiliation: School of Medicine, Shariati Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
authors.forename: Saeedreza
authors.initials: S
authors.lastname: Mehrpour
authors.affiliation: School of Medicine, Students' Scientific Research Center (SSRC), Exceptional Talent Development Center (ETDC), Tehran University of Medical Sciences (TUMS), Tehran, Iran. r.sorbi@yahoo.com.
authors.forename: Reza
authors.initials: R
authors.lastname: Sorbi
authors.affiliation: School of Medicine, Shariati Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Rezaei
authors.affiliation: Department of Pediatric Orthopaedics, Robert Debré Hospital, Paris Diderot University, Paris, France.
authors.forename: Keyvan
authors.initials: K
authors.lastname: Mazda
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005269:Femur; D006801:Humans; D007738:Kyphosis / Q000601:surgery*; D008297:Male; D011300:Preoperative Care / Q000379:methods*; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D014143:Traction / Q000379:methods*; D016896:Treatment Outcome
keywords: Halo femoral and halo gravity traction; Pulmonary function; Severe scoliosis