Our Summary

This research paper is about a study that looked at the use of a certain kind of treatment, called halo gravity traction (HGT), before surgery for a condition called adolescent idiopathic scoliosis (AIS). This is a type of scoliosis, or curvature of the spine, that affects teenagers and the cause is usually unknown.

Between 2010 and 2020, the study focused on patients who had a severe angle of spinal curve (more than 80°) and were going to have a specific kind of surgery called posterior spinal fusion (PSF). The researchers wanted to see if HGT before surgery helped to correct the spinal curve better than no HGT. They also compared the rate of complications in the two groups.

The study found that HGT did provide better correction of the spinal curve. In the group that didn’t have HGT, the correction rate was about 59%, while in the HGT group, it was about 64%. If HGT was used for more than 30 days, the correction rate increased to 9%.

However, there were more complications in the HGT group (about 19%) compared to the non-HGT group (about 6%). But when they looked at patients with a very severe curve (more than 90°), the complication rate was similar in both groups (14% in the non-HGT group and 13% in the HGT group) and the correction rate was better in the HGT group.

In conclusion, the study recommends using HGT for at least 4 weeks before surgery for AIS patients with a severe spinal curve, as it provides a greater correction with a similar rate of complications.

FAQs

  1. How does Halo Gravity Traction (HGT) affect the correction of Adolescent Idiopathic Scoliosis (AIS) with a Cobb angle greater than 80°?
  2. What is the difference in the correction rate and complication rate between patients who underwent HGT and those who didn’t?
  3. For optimal results, what is the recommended duration for Halo Gravity Traction in the management of AIS with a Cobb angle greater than 90°?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scoliosis surgery is to consider preoperative preparation with halo gravity traction (HGT) for better frontal correction, especially for patients with a Cobb angle greater than 90°. It is recommended to undergo a minimum halo duration of 4 weeks to achieve optimal results.

Suitable For

Patients with adolescent idiopathic scoliosis (AIS) with a Cobb angle greater than 80° are typically recommended for scoliosis surgery. In particular, patients with a Cobb angle greater than 90° may benefit from preoperative preparation with halo gravity traction (HGT) to achieve better frontal correction during surgery. HGT may provide a greater ratio of Cobb angle correction and similar complication rates compared to posterior spinal fusion (PSF) alone in these patients. A minimum halo duration of 4 weeks is recommended for optimal results.

Timeline

  • Before scoliosis surgery:
  1. Patient is diagnosed with adolescent idiopathic scoliosis (AIS) with a Cobb angle greater than 80°.
  2. Patient undergoes preoperative preparation, including evaluation for halo gravity traction (HGT).
  3. If HGT is chosen, patient undergoes traction procedure with a spinal front X-ray at the end.
  4. Mean duration of HGT is 4 weeks.
  5. Mean follow-up period is 31 months.
  • After scoliosis surgery:
  1. Posterior spinal fusion (PSF) surgery is performed.
  2. Mean ratio of Cobb angle correction is 58.8% in noHGT group and 63.6% in HGT group.
  3. Complication rate is 11.7%, with a rate of 6.2% in noHGT group and 19.1% in HGT group.
  4. In patients with preoperative Cobb angle greater than 90°, mean ratio of Cobb angle correction increases to 6.7%.
  5. Complications rate increases to 14% in noHGT group and decreases to 13% in HGT group in this subgroup.
  6. HGT preparation provides greater frontal correction gain with similar complication rate compared to PSF correction alone.

What to Ask Your Doctor

  1. What is scoliosis surgery and why is it necessary for my condition?
  2. What are the potential risks and complications associated with scoliosis surgery?
  3. Is halo gravity traction (HGT) recommended for my specific case of adolescent idiopathic scoliosis (AIS)?
  4. How long would I need to undergo HGT before the surgery?
  5. What are the expected outcomes in terms of frontal correction and Cobb angle correction with and without HGT?
  6. How long is the recovery process after scoliosis surgery?
  7. What kind of post-operative care and physical therapy will be necessary?
  8. Are there any long-term effects or limitations I should be aware of after the surgery?
  9. What is the success rate of scoliosis surgery in general, and specifically for cases like mine?
  10. Are there any alternative treatments or procedures that I should consider before opting for surgery?

Reference

Authors: Langlais T, Josse A, Violas P; and the French Society of Orthopaedic Paediatric (SOFOP). Journal: Eur Spine J. 2024 Feb;33(2):713-722. doi: 10.1007/s00586-023-08062-z. Epub 2023 Dec 23. PMID: 38135731