Clinical Efficacy And Related Research Of High-weight Halo-femoral Traction For The Treatment Of Severe And Rigid Scoliosis

ObjectiveTo analyze orthopaedic contribution rate of high-weight Halo-femoral traction in the treatment of severe and rigid scoliosis and discuss the related applications.MethodsFifty eight patients severe and rigid scoliosis treated with Halo-femoral traction from December2010through December2012were made a retrospective review.According to the cause,they were individed into idiopathic scoliosis group(group A) and non-idiopathic scoliosis group(group B).All the patients underwent preoperative Halo-femoral traction.After the maximum weight traction for2-3weeks, one-stage posterior instrumentation and fusion was performed with intraoperative traction.The Cobb angles in coronal plane of the major curve before surgery,on Bending film,on pushing film,after Halo-femoral traction and immediately after surgery were measured,The absolute and relative contribution rate of every orthopaedic element(Bending,pushing, traction,surgery)were compared,The correlation between absolute contribution rate of traction and final correction rate, correlation between traction time and weight and changed Cobb angle after surgery were evaluated as well.ResultsThe duration of follow-up was25months on average (range,12-40months). There were no other related complications occurring.no death or paralysis occurred intra-and post-operatively. No screw or rod fracture was found during follow-up.In group A the mean coronal Cobb angle of major curve were87.3°±11.3°(76°-131°), the mean coronal Cobb angle of major curve on Bending film were74.5°±12.0°(62°-118°),and the mean coronal Cobb angle of major curve on pushing film were71.5°±11.8°(59°118°).The mean coronal Cobb angle of major curve afer traction were52.3°±11.2°(42°-96°),The mean coronal Cobb angle of major curve afer posterior surgery were35.2°±10.0°(22°-76°).The absolute contribution rate of every orthopaedic element(Bending,pushing, traction,surgery) and whole contribution rate were15.0%±2.9%、3.4%±1.4%、22.2%±3.0%、19.8%±2.4%、60.3%±5.2%.The relative contribution rate of every orthopaedic element were24.7%±3.9%、5.7%±2.3%、36.8%±3.8%、32.8%±3.6%.Traction absolute contribution and correction rate after surgery were positively correlated, traction time and traction weight and changed size of Cobb angle were positively correlated,too.In group B the mean coronal Cobb angle of major curve were89.1°±12.0°(73°-125°), the mean coronal Cobb angle of major curve on Bending film were78.4°±13.0°(60°-117°),and the mean coronal Cobb angle of major curve on pushing film were75.2°±13.5°(55°-114°).The mean coronal Cobb angle of major curve afer traction were58.9°±14.3°(46°-105°),The mean coronal Cobb angle of major curve afer posterior surgery were43.4°±13.3°(32°-81°).The absolute contribution rate of every orthopaedic element(Bending,pushing, traction,surgery) and whole contribution rate were12.3%±2.9%、3.8%±1.5%、18.6%±4.5%、17.5%±2.7%、52.1%±7.8%.The relative contribution rate of every orthopaedic element were23.4%±3.9%、7.1%±2.4%、35.5%±6.3%、34.0%±5.4%。 Traction absolute contribution and correction rate after surgery were positively correlated, traction time and traction weight and changed size of Cobb angle were positively correlated,too.Conclusionl.The research shows that in the treatment of severe and rigid scoliosis in orthopaedic elements, the absolute contribution rate of Halo-femoral traction is the largest.2.To make contribution rate of Halo-femoral traction in the treatment of severe and rigid scoliosis has a guiding significance to evaluate orthopaedic effecacy and make operation scheme.3.We first propose the concept of absolute contribution rate and relative contribution rate, and reveal operation contribution rate is not necessarily the biggest of all in the treatment of severe rigid scoliosis.4.For severe rigid scoliosis patients, do not blindly make release or osteotomy first, we do it when traction is invalid.