[Halo-pelvic traction combined with stageⅡsurgical correction for the treatment of severe and rigid scoliosis].

OBJECTIVE

To investigate the clinical effects of the Halo-pelvic traction combined with posterior instrumentation correction and internal fixation for the treatment of severe and rigid scoliosis.

METHODS

From January 2015 to 2019 May, 16 patients with severe and rigid scoliosis were treated by the Halo-pelvic traction combined with posterior instrumentation correction. There were 7 males and 9 females, aged 14 to 28 years with an average of 17.6 years, Cobb angle was 90° to 140° with an average of (108.84±17.93) °. Including congenital scoliosis in 10 cases (6 cases of dyssegmented scoliosis, 3 cases of dysplasia, 1 case of mixed scoliosis), idiopathic scoliosis in 4 cases and neurofibromatosis in 2 cases. All patients in group had scoliosis corrected by Halo-pelvic distraction combined with posterior instrumentation correction and internal fixation. Among them, 7 cases were treated with self-made guide device for iliac bone puncture, and the other cases with traditional bare hands. The height, scoliosis Cobb angle, kyphosis Cobb angle and correction rate of 16 patients before and after surgery were observed.

RESULTS

The body height was corrected from (144.88±6.32) cm to (154.56±7.87) cm ; Cobb angle of scoliosis was corrected from (108.84±17.93) ° to (42.12±7.29) °, Cobb angle of kyphosis was corrected from (64.18±16.39) ° to (33.81±6.06) °. After the Halo pelvic traction, the body height increase, Cobb angle of scoliosis and kyphosis were changed with the mean of (7.06± 5.65) cm, (41.50±9.09)%, (30.52±9.66)%, respectively. After the stage Ⅱ surgical correction, the body height increase, Cobb angle of scoliosis and kyphosis were changed with the mean of (2.63±1.78) cm, (32.47±10.80)%, (15.55±9.47)% (The baseline Cobb angle referenced by the correction rate was the Cobb angle of the previous treatment). The body height increase and correction rate of Cobb angle of scoliosis and kyphosis with staged traction combined with surgery was (9.69±5.42) cm, (61.09 ± 5.03)%, (46.07±8.60)%. There was significant difference in body height increase, correction rate of Cobb angle of scoliosis and kyphosis between before and after each period of treatment (P<0.05).

CONCLUSION

Treatment of severe and rigid scoliosis with Halo-pelvic traction combined with stage Ⅱ surgical correction can significantly correct deformities and improve appearance, and has fewer surgical complications and strong clinical operability.