Halo-Gravity Traction 9-30-2020
Earlier this spring I put up three blog posts on Halo-Gravity Traction. I will briefly re-present it here as a way to launch into the two other types of traction we utilize: Intraoperative Halo-Femoral Traction and Internal "Dis-traction" Technique.
What is halo-gravity traction?
As you see from the three young patients above, a “halo” is applied to their skulls when they are asleep in the operating rooms. On the two boys their halos are black, as they are made from carbon fiber, while the young lady’s halo is so nicely bedazzled you don’t see any of the black carbon fiber material. Attached to the halo you see two straps or an inverted-V which is then attached to a rope which is pulling upwards, towards the ceiling.
The rope goes through a series of pulleys and finally attach to weights.
Why do we put patients into halo-gravity traction?
The below case is a nice example of why we use halo-gravity traction, a 5 year old female with severe early-onset scoliosis at 104 degrees (picture on left) and 91 degrees of kyphosis (2nd picture from right). After 7 weeks of traction the scoliosis decreased to 75 degrees (a 28% improvement!) (2nd picture from left) and 40 degrees (a 57% improvement) of kyphosis (picture on right). Overall there was an 80 degree improvement in the spinal deformity! This was all done only with halo-gravity traction, and no spine surgery.
In general, we apply preoperative traction for any severe spinal deformities, which can be curves greater than 90 degrees.
How does it work?
Spinal traction takes advantage of the viscoelastic properties of the spinal column. Think of the spine like a spring, a person with scoliosis would be the spring on the far left, crooked/twisted and very short from the top of the spring to the bottom of the spring. As we apply more and more weight to the spine, the curves straighten out and the spine gets longer. In the case demonstrated above the spine lengthened (from the bottom of the neck to the pelvis) a total of 69 mm or 2.7 inches!
However there is a limit to how much weight we can safely put through the traction apparatus. This maximal limit varies patient to patient but we typically don’t go higher than 50% of the patient’s body weight.
In next blog post we will demonstrate another type of traction: Intraoperative Halo-Femoral Traction