Halo-gravity traction in the treatment of severe spinal deformity: a systematic review and meta-analysis
Correction and stabilisation of the scoliotic spine in osteogenesis imperfecta is difficult. The optimal technique has yet to be determined, since no large series in which a single procedure has been carried out by a single surgeon using a single protocol has yet been described. The charts of 20 patients with osteogenesis imperfecta who had undergone halo gravity traction (HGT) and a posterior spondylodesis with Cotrel-Dubousset (n = 18) or Harrington (n = 2) instrumentation were reviewed. No correction was made at the time of the surgical spondylodesis. The average follow-up was 4.8 years (range 2–10.5 years). The preoperative traction improved the Cobb angle of the scoliosis by 32% (from a mean of 78.5° to a mean of 53.3°) and improved the kyphosis by 24% (from a mean of 56.0° to mean of 42.5°). This correction deteriorated slightly at final follow-up, for both the scoliosis and the kyphosis (mean 57.6° and 44.4° respectively). Few complications were encountered during the HGT period. In 16 cases no complications occurred during the follow-up period. Ambulation and functional ability were upgraded for 7 of 20 patients.