The use of halo-femoral traction without anterior spinal release for treating severe adolescent idiopathic scoliosis

Abstract

Background Treatment of severe and rigid idiopathic scoliosis is challenging because of severity of the deformity. With the introduction of several correction techniques, decision making became more complex.Patients and methods In this study, a trial was conducted comparing halo-femoral traction under anesthesia without anterior spinal release with the traditional technique involving anterior release. A single-center, open-label, two-group prospective randomized controlled trial was implemented. A total of eight patients was recruited in each group and allocated using a simple randomization method.Results Recent follow-up after surgery radiogram showed that the average primary curve Cobb’s angle was 53° (51.2%) in group 1 and 48.6° (54.2%) in group 2. The average shoulder and pelvic balance in group 1 was 0.3° (range, 0–2) and 0°, respectively, and in group 2 was 0.3° (range, 0–2) and 0°, respectively. Postoperative thoracic kyphosis was 38.6° (range, 18–51°) in group 1 (45.3%) and 39° (range, 23–47°) in group 2 (36%). Postoperative lumbar lordosis was 44.2° (range, 30–53°) in group 1 (12.4%) and 49.8° (range, 40–58°) in group 2 (25.6%). Statistical analysis showed that there was no significant difference between correction of primary curve Cobb’s angle, postoperative thoracic kyphosis, and postoperative lumber lordosis in both groups. This indicates that patients in both groups had almost the same outcomes, and there is no difference between both surgical techniques in terms of clinical results. Patients undergoing the new technique could overcome several complication and comorbidities that may result from excessive blood loss.Conclusion The use of halo-femoral traction without anterior spinal release for treating severe adolescent idiopathic scoliosis is an effective, safe, and efficient procedure with low comorbidity.