{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:02:50Z","timestamp":1793318570803,"version":"4.5.0"},"reference-count":29,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The aim of this study was to investigate the effectiveness of preoperative halo-gravity traction (HGT) with subsequent growing rod (GR) treatment in patients with severe early-onset scoliosis (EOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors retrospectively reviewed a cohort of patients with severe EOS who had received preoperative HGT with subsequent GR treatment at their center between January 2008 and January 2020. Patients with a Cobb angle in the coronal or sagittal plane that was &gt; 90\u00b0 were included. All patients received at least 6 weeks of HGT before GR placement. Results of pulmonary function tests (PFTs) and blood gas tests were compared before and after HGT. Radiological parameters were compared pre-HGT, post-HGT, postindex surgery, and at the latest follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A total of 28 patients (17 boys and 11 girls, mean age 6.1 \u00b1 2.3 years) were included in this study. After a mean of 65.2 \u00b1 22.9 days of traction, the Cobb angle decreased from 101.4\u00b0 \u00b1 12.5\u00b0 to 74.5\u00b0 \u00b1 19.3\u00b0 (change rate 26.5%), and the kyphosis angle decreased from 71.1\u00b0 \u00b1 21.2\u00b0 to 42.7\u00b0 \u00b1 9.5\u00b0 (change rate 39.9%). There was a significant improvement in BMI but a decrease in hemoglobin levels following HGT. No HGT-related complications were recorded except pin site infections in 2 patients. Statistically significant improvements in PFTs after HGT were observed in forced vital capacity (FVC) (p = 0.011), the percentage predicted FVC (p = 0.007), FEV1 (p = 0.015), and the percentage predicted forced expiratory volume in 1 second (FEV1) (p = 0.005). Fourteen patients received assisted ventilation due to preoperative hypoxia, alveolar hypoventilation, or hypercapnia. Significant improvement was seen in PaCO\n                      <jats:sub>2<\/jats:sub>\n                      (p = 0.008), PaO\n                      <jats:sub>2<\/jats:sub>\n                      (p = 0.005), actual bicarbonate (p = 0.005), and oxygen saturation (p = 0.012) in these patients. After the index surgery, the Cobb angle decreased to 49.5\u00b0 \u00b1 18.9\u00b0 and the kyphosis angle decreased to 36.2\u00b0 \u00b1 25.8\u00b0. After a mean of 4.3 \u00b1 1.4 lengthening procedures, the Cobb angle was 56.5\u00b0 \u00b1 15.8\u00b0, and the kyphosis angle was 38.8\u00b0 \u00b1 19.7\u00b0. Surgical complications occurred in 14 (50%) patients, but none of these patients required revision surgery at the latest follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Preoperative HGT notably improved both spinal deformity and pulmonary function in patients with severe EOS. GR treatment after HGT is a safe and effective strategy for these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2023.7.spine23290","type":"journal-article","created":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T00:53:12Z","timestamp":1695430392000},"page":"734-741","source":"Crossref","is-referenced-by-count":7,"title":["Halo-gravity traction combined with growing rod treatment: an effective preoperative management for severe early-onset scoliosis"],"prefix":"10.3171","volume":"39","author":[{"given":"Xiaojiang","family":"Pu","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Division of Spine Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Division of Spine Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingshuang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Division of Spine Surgery, Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haojie","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Division of Spine Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Division of Spine Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zezhang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Division of Spine Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Division of Spine Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Division of Spine Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"EFORT Open Rev","first-page":"287","article-title":"Treatment strategies for early-onset scoliosis","volume":"3","author":"Helenius IJ","year":"2018","unstructured":"Helenius IJ. 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