{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T04:17:02Z","timestamp":1776917822014,"version":"3.51.2"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T00:00:00Z","timestamp":1672963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2021YFB3800800"],"award-info":[{"award-number":["2021YFB3800800"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to investigate a new noninvasive traction method on the treatment of severe cervical kyphotic deformity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The clinical data of patients with severe cervical kyphosis (Cobb\u2009&amp;gt;\u200940\u00b0) treated in Peking University Third Hospital from March 2004 to March 2020 were retrospectively summarized. 46 cases were enrolled, comprising 27 males and 19 females. Fifteen patients underwent skull traction, and 31 patients underwent suspensory traction. Among them, seven used combined traction after one week of suspensory traction. Bedside lateral radiographs were taken every two or three days during traction. The cervical kyphosis angle was measured on lateral radiographs in and extended position at each point in time. The correction rate and evaluated Japanese Orthopedic Association (JOA) scoring for the function of the spinal cord were also measured. The data before and after the operation were compared with paired sample t-test or Wilcoxon signed-rank test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No neurological deterioration occurred during the skull traction and the cervical suspensory traction. There were 12 patients with normal neurological function, and the JOA score of the other 34 patients improved from 11.5\u2009\u00b1\u20092.8 to 15.4\u2009\u00b1\u20091.8 at the end of follow up (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05). The average kyphotic Cobb angle was 66.1\u00b0\u2009\u00b1\u200925.2, 28.7\u00b0\u2009\u00b1\u200920.1 and 17.4\u00b0\u2009\u00b1\u200925.7 pre-traction, pre-operative, and at the final follow-up, respectively (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05). The average correction rate of skull traction and suspensory traction was 34.2% and 60.6% respectively. Among these, the correction rate of patients with simple suspensory traction was 69.3%. For patients with a correction rate of less than 40% by suspensory traction, combined traction was continued, and the correction rates after suspensory traction and combined traction were 30.7% and 67.1% respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pre-correction by cervical suspensory traction can achieve good results for severe cervical kyphotic deformity, with no wound and an easy process. Combined traction is effective for supplemental traction after suspensory traction.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2022.1090199","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T13:10:37Z","timestamp":1673010637000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of cervical suspensory traction in the treatment of severe cervical kyphotic deformity"],"prefix":"10.3389","volume":"9","author":[{"given":"Pan","family":"Shengfa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Hongyu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sun","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhang","family":"Fengshan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Xin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diao","family":"Yinze","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhao","family":"Yanbin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhou","family":"Feifei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"422","DOI":"10.21037\/jss-21-54","article-title":"Etiology and treatment of cervical kyphosis: state of the art review-a narrative review","volume":"7","author":"Ogura","year":"2021","journal-title":"J Spine Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"470","DOI":"10.14245\/ns.1938288.144","article-title":"Cervical spine deformity correction techniques","volume":"16","author":"Dru","year":"2019","journal-title":"Neurospine"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e555","DOI":"10.5435\/JAAOS-D-17-00546","article-title":"Cervical spine deformity: indications, considerations, and surgical outcomes","volume":"27","author":"Cho","year":"2019","journal-title":"J Am Acad Orthop Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1093\/neuros\/nyx249","article-title":"Cervical spine deformity-part 1: biomechanics, radiographic parameters, and classification","volume":"81","author":"Tan","year":"2017","journal-title":"Neurosurgery"},{"key":"B5","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1016\/j.wneu.2016.04.020","article-title":"Assessment of surgical treatment strategies for moderate to severe cervical spinal deformity reveals marked variation in approaches, osteotomies, and fusion levels","volume":"91","author":"Smith","year":"2016","journal-title":"World Neurosurg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1093\/neuros\/nyx388","article-title":"Cervical spine deformity-part 2: management algorithm and anterior techniques","volume":"81","author":"Tan","year":"2017","journal-title":"Neurosurgery"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e95","DOI":"10.2106\/JBJS.16.00096","article-title":"Outcomes of spinal fusion for cervical kyphosis in children with neurofibromatosis","volume":"98","author":"Helenius","year":"2016","journal-title":"J Bone Joint Surg Am"},{"key":"B8","doi-asserted-by":"publisher","first-page":"2409","DOI":"10.1007\/s00381-020-04775-4","article-title":"Management of spinal deformities and tibial pseudarthrosis in children with neurofibromatosis type 1 (NF-1) [published correction appears in Childs Nerv Syst. 2021 Oct;37(10):3281]","volume":"36","author":"Mladenov","year":"2020","journal-title":"Childs Nerv Syst."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e1190","DOI":"10.1016\/j.wneu.2019.04.096","article-title":"Early and midterm outcomes of surgical correction for severe dystrophic cervical kyphosis in patients with neurofibromatosis type 1: a retrospective multicenter study","volume":"127","author":"Wang","year":"2019","journal-title":"World Neurosurg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.3390\/jcm11051441","article-title":"How is spinal cord function measured in degenerative cervical myelopathy? 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