Work

Impact of halo-pelvic traction duration on pulmonary improvement quantified by pulmonary function tests and three-dimensional lung reconstruction in severe rigid kyphoscoliosis: a prospective cohort study

Year: 2025

Type: article

Abstract: BACKGROUND: Severe and rigid kyphoscoliosis, characterized by extreme spinal curvature > 100° and limited flexibility < 30%, significantly impacts pulmonary function. While halo-pelvic traction (HPT) is an established method for improving lung function in patients with scoliosis, the optimal duration of treatment remains undefined. METHODS: This study included 64 patients who underwent HPT before posterior spinal fusion surgery. Patients were divided into short-term traction group (2 months < traction duration ≤ 4 months), the middle-term traction group (4 months < traction duration ≤ 6 months), and the long-term traction group (traction duration > 6 months). Pulmonary function tests (PFTs) were performed in all patients. Using three-dimensional (3D) lung reconstruction from computed tomography, changes in lung volume were analyzed. The statistical analyses were conducted using SPSS (version 26.0; IBM) and GraphPad Prism (version 10.1.2). RESULTS: Among 64 patients, total lung capacity (TLC) increased significantly in the middle‑term traction (2.62 ± 0.89 L to 3.10 ± 0.85 L) and long‑term traction (2.39 ± 0.98 L to 2.98 ± 0.80 L) groups. Total lung volume (TLV) improved significantly in the short‑term (1.81 ± 0.50 L to 2.13 ± 0.44 L), middle‑term (2.62 ± 0.89 L to 3.10 ± 0.85 L), and long‑term (2.39 ± 0.98 L to 2.98 ± 0.80 L) traction groups. Concave-side lung volume also increased significantly in three groups. Middle-term HPT exhibited greater TLV and concave-side lung volume change rate improvement than the short-term group, while long-term HPT showed no additional advantage over middle-term treatment. HPT also significantly improved T1-T12 distance, thoracic kyphosis, and main Cobb angle. CONCLUSIONS: HPT is an effective treatment for severe and rigid kyphoscoliosis, and 4 to 6 months may be the optimal HPT duration to improve pulmonary function.

Source: Journal of Orthopaedic Surgery and Research

DOI: 10.1186/s13018-025-06126-y