Halo gravity traction for pediatric scoliosis and kyphoscoliosis: A review of current evidence and best practices

Table 5 Comparisons between halo gravity traction and alternative preoperative strategies

Ref.		Sample size	Preoperative deformity	Deformity after temporary internal distraction (stage 1)	Deformity after final fusion (stage 2)	Complication	Blood loss (mL)	FEV1%	FVC%	Loss of Correction at final follow up
Grabala et al[38]	HGT	20	Cobb angle: 124°; K angle: 96.5°	NA	Cobb angle: 45°; K angle: 45.8°	Neuromonitoring alerts in 15% cases; pin tract infection: 35%; deep infections: 5%; pneumonia: 10%; neck/back pain: 55%	588	60.8 to 70.1 after HGT; 74.4 after fusion; 74.9 at final follow-up	54.5 to 66.7 after HGT; 73.4 after fusion; 75.9 at final follow up	NR
	TID	42	Cobb angle: 122°; K angle: 92°	NA	Cobb angle: 37.4°; K angle: 36.2°	Neuromonitoring alerts in 12% cases; deep infections: 2%; pneumonia: 5%; neck/back pain: 7%	282 + 458 in each stage	58 to 66 after TID; 71.2 after fusion; 78 at final follow up	49 to 55.2 after TID; 67 after fusion; 76 at final follow up	NR
Oliveira et al[39]	HGT	12	Cobb angle: 104.6°; K angle: 43.5°	Cobb after HGT: 85.6°	Cobb angle: 49.5°; K angle: 30.3°	Intraoperative neurodeficit: 3 cases; pneumothorax: 6 cases; implant failure: 1 case; infection: 1 case	1642.22 ± 1058.79	NA	NA	NR
	TID	7	Cobb angle: 100°; K angle: 40.7°	Cobb after TID: 94.7°	Cobb angle: 39.5°; K angle: 30.5°	Intraoperative neurodeficit: 4 cases; pneumothorax: 3 cases; implant failure: 2 cases; infection: 1 case	1400.00 ± 718.33	NR	NR	NR
Caubet and Emans[40]	HGT	13	Cobb angle: 92°; K angle: 99.5°	NA	Cobb angle: 40% improved	3 patients with neurodeficit; implant loosening in 7 patients	NA	NA	NA	Loss of kyphosis correction: 29%; loss of scoliosis correction: 20%
	SR	14	Cobb angle: 73.3°; K angle: 67.6°	NA	Cobb angle: 63% improve	2 patients with neurodeficit; implant loosening in 9 patients	NA	NA	NA	Loss of kyphosis correction: 26%; loss of scoliosis correction: 9%
	Control group	71		NA	Cobb angle: 41% improved	3 patients with neurodeficit; implant loosening in 20 patients	NA	NA	NA	Loss of kyphosis correction: 15%; loss of scoliosis correction: 5%

HGT: Halo gravity traction; TID: Temporary internal distraction; SR: Surgical release; K: Kyphosis; NA: Not available; NR: Not report; FEV1: Forced expiratory volume in 1 second; FVC: Forced vital capacity.