Jianqiang Wang, Bo Han, Yong Hai, Qingjun Su, Yuxiang Chen


November 2021, Volume 30, Issue 11, pp 3162 - 3171 Review Article Read Full Article 10.1007/s00586-021-06902-4

First Online: 29 June 2021

Purpose

This study sought to evaluate the complications and clinic outcome in radiographic parameters, pulmonary function, and nutritional status of halo-gravity traction (HGT) in treating severe spinal deformity.

Methods

Embase, PubMed, Cochrane, Web of Science databases were searched comprehensively for relevant studies from inception to February 2021, by using combined text and MeSH terms and English language restriction was used. The data, including radiographic parameters, pulmonary function (FVC %), and nutritional status (BMI) was extracted from included studies. All meta-analyses were conducted using random or fixed-effects models according the between-study heterogeneity, estimated with I2.

Results

Four hundred and forty-six studies were identified and twelve studies with a total of 372 patients were included in this review. Compared with pre-traction values, there were reduction in cobb angle of 28.12° [95% CI (22.18, 34.18)], decrease in thoracic kyphosis of 26.76°[95% CI (20.73, 32.78)], improvements in spine height[SMD = -0.89, 95% CI (− 1.56, − 0.21)] and in coronal balance[WMD = − 0.03, 95% CI (− 1.56, − 0.21), P = 0.84] with preoperative halo-gravity traction for severe spinal deformity patients. Besides, our pooled analysis showed the improvement in pulmonary function (FVC %) [WMD = − 9.56, 95% CI (− 1.56, − 0.21)] and increase in nutritional status (BMI) [WMD = − 0.50, 95% CI (− 1.56, − 0.21)].

Conclusion

Partial correction can be achieved by preoperative HGT, thereby reducing the difficulty of the operation and the risk of neurologic injury caused by excessive correction. Moreover, preoperative HGT can improve pulmonary function and nutritional status and, thus, increase patients’ tolerance to surgery.


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