Halo-gravity traction

Halo-gravity traction (HGT) is a safe and effective method to correct EOS deformity prior to operative management, or as a delaying tactic. It is well tolerated, providing instant patient mobilization in the upright position, and is especially useful in patients with thoracic insufficiency/respiratory impairment. Preoperative deformity correction (scoliosis and kyphosis) and thoracic height improvement is typically ~30 %, achieving valuable non-operative correction in patients where osteopenia and rigidity likely will prevent successful acute instrumented correction. Vital capacity is frequently improved 5–10 % due to improved diaphragmatic excursion, and weight gain occurs from elongation of the abdominal cavity. Contraindications to HGT include insufficient skull bone stock, intra- or extra-medullary space-occupying lesions in the spinal cord, and severe canal distortion with stenosis. Complications of traction include pin sepsis in 10–20 % of patients, usually managed with oral antibiotics, and neurologic injury in 1–1.5 %, which may not recover following HGT discontinuation.