To evaluate the efficacy of preoperative halo gravity traction (HGT) assisted surgery for severe congenital scoliosis (CS).

From October 2016 to December 2021, clinical data were retrospectively reviewed for 55 children with severe scoliosis undergoing HGT.There were 28 boys and 27 girls with an average age of (9.4±3.8) years.According to etiology, they were divided into two groups of congenital (n=28) and non-congenital (n=27). At pre-operation, post-traction and post-operation, radiographic films of whole spine in standing position was employed for measuring main curve, compensatory curve, thoracic kyphosis and lumbar lordosis, trunk balance in coronal and sagittal planes, shoulder height and T1-S1 height and evaluate the improvement of deformity.And the differential efficacy was examined between two groups.

Cobb angle of major bend pre-operation in congenital and non-congenital groups was (88.9±14.1)° and (89.5±17.4)°; Cobb angle of compensatory bending (28.8±12.9)° and (33.3±12.9)°; thoracic kyphosis (74.1±21.0)° and (69.9±20.8)°; lumbar lordosis (47.9±13.4)° and (38.9±6.6)°; trunk balance in coronal plane (43.2±15.5) and (38.3±10.2) mm; sagittal torso balance (34.7±10.5) and (44.4±19.8) mm; shoulder height (22.8±11.8) and (13.9±12.1) mm; height of T1-S1 (24.3±5.4) and (27.2±5.2) cm.The above findings have demonstrated that after HGT, Cobb angle of major curvature in congenital and non-congenital groups were (64.2±14.6)° and (53.0±14.9)°; Cobb angle of compensated bending (16.5±10.3)° and (19.2±11.0)°; hosthoracic kypis (53.7±16.9)° and (48.3±14.4)°; lumbar lordosis (37.4±7.0)° and (30.2±8.0)°; trunk balance in coronal plane (24.6±12.0) and (20.3±11.6)mm; sagittal torso balance (30.7±2.9) and (19.1±11.6) mm; shoulder height (12.0±7.1) and (7.0±4.0) mm; T1-S1 height (28.1±5.0) and (31.5±5.0) cm; there were significant improvements as compared with those pre-traction (P<0.01). The correction rate of major curve in non-congenital group (41.3±8.7)% was significantly higher than that in congenital group (27.4±10.9)% after HGT (P<0.01) and no differences existed in other parameters between two groups (P>0.05). After operation, Cobb angle of major curvature in congenital and non-congenital groups were (41.7±13.9)° and (37.4±12.8)°; thoracic kyphosis (40.5±16.3)° and (38.4±8.9)°; lumbar lordosis (33.4±6.2)° and (25.9±7.9)°; trunk balance in coronal plane (19.4±8.2) and (19.1±6.0) mm; sagittal torso balance (18.6±11.2) and (20.3±11.4) mm; shoulder height (11.5±7.1) and (9.0±5.6) mm; height of T1-S1 (30.2±5.4) and (32.5±7.1) cm; there were significant improvements as compared with those pre-operation (P<0.01). However, there was no inter-group difference (P>0.05).

HGT for severe CS can correct structural scoliosis and compensatory scoliosis pre-operation, and correct trunk deviation in coronal and sagittal planes.Although the correction rate of CS is lower than that of non-CS, the final correction efficacy can be the same after HGT surgery.

Traction; Severe scoliosis; Congenital scoliosis; Surgical Procedures, Operative; Child