• World Neurosurg · Aug 2022

    Meta Analysis

    Halo Gravity Traction for the Correction of Spinal Deformities in the Pediatric Population: A Systematic Review and Meta-analysis.

    • Logan A Reed, Alexander Mihas, Reed Butler, Guna Pratheep, Sakthivel Rajaram Manoharan, Steven Theiss, and Vibhu Krishnan Viswanathan.
    • Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA. Electronic address: loganreed1994@gmail.com.
    • World Neurosurg. 2022 Aug 1; 164: e636-e648.

    ObjectiveHalo gravity traction (HGT) is an effective way of managing pediatric spinal deformities in the preoperative period. This study comprehensively reviews the existing literature and evaluates the effect of HGT on various radiographic parameters regarding spinal correction and, secondarily, evaluates the improvement in pulmonary function as well as nutritional status.MethodsIn accordance with PRISMA guidelines, a comprehensive search was conducted for articles on HGT in the treatment of spinal deformity. Spinal deformity after traction and surgery, change of pulmonary function, nutritional status, and prevalence of complications were the main outcome measurements. All meta-analyses were conducted using random models according to the between-study heterogeneity, estimated with I2.ResultsA total of 694 patients from 24 studies were included in this review. Compared with pretraction values, the average coronal Cobb angle reduction after traction was 27.66° (95% confidence interval [CI], 23.41-31.90; P < 0.001) and 47.43° (95% CI, 39.32-55.54; P < 0.001) after surgery. The sagittal Cobb angle reduction after HGT and surgery was 27.23° (95% CI, 22.83-31.62; P <0.001) and 36.77° (95% CI, 16.90-56.65; P < 0.001), respectively. There was a statistically significant improvement in the overall pulmonary function, as evident by an increase in a forced vital capacity of 8.44% (95% CI, -5.68 to -11.20; P < 0.001), and an increase in nutritional status, with a percentage correction of body mass index by 1.58 kg/m2 (95% CI, -2.14 to -1.02; P < 0.001) after HGT application.ConclusionsHGT has been shown to significantly improve coronal deformities, sagittal deformities, nutritional status, and pulmonary function in the preoperative period.Copyright © 2022 Elsevier Inc. All rights reserved.

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