{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:02:51Z","timestamp":1793318571368,"version":"4.5.0"},"reference-count":26,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: This study aimed to evaluate the effect of preoperative halo-gravity traction (HGT) on surgical outcomes in adolescents with severe idiopathic scoliosis (AIS), comparing posterior spinal fusion (PSF) performed with versus without traction in terms of curve correction, complication rates, and overall surgical efficacy. Methods: A retrospective cohort study was conducted on 46 adolescents (mean age 14.6 \u00b1 1.9 years) with severe AIS (Cobb &gt; 65\u00b0) treated at a single tertiary center between 2011 and 2024. Sixteen patients underwent primary PSF, and 30 received preoperative HGT followed by PSF. Radiographic parameters\u2014including Cobb angle and Risser grade\u2014were analyzed pre- and postoperatively. Statistical tests (t-test, Mann\u2013Whitney U, and multivariable linear regression) assessed differences in correction and predictors of outcome, with p &lt; 0.05 considered significant. Results: Baseline characteristics were comparable between groups (mean preoperative Cobb: 83.6\u00b0 \u00b1 11.2\u00b0 vs. 83.1\u00b0 \u00b1 15.6\u00b0, p = 0.91). The traction cohort achieved significantly smaller postoperative Cobb angles (30.9\u00b0 \u00b1 7.8\u00b0 vs. 42.7\u00b0 \u00b1 18.9\u00b0, p = 0.027), greater absolute correction (52.7\u00b0 \u00b1 7.4\u00b0 vs. 40.4\u00b0 \u00b1 10.5\u00b0, p &lt; 0.001), and higher percentage correction (63.3% \u00b1 6.7% vs. 50.0% \u00b1 14.0%, p = 0.002). Regression analysis confirmed HGT as an independent predictor of improved correction (+14.6%, 95% CI +6.9\u201322.3%, p = 0.00047). No neurological or major complications occurred, and most correction was achieved within the first three weeks of traction. Conclusions: Preoperative halo-gravity traction significantly enhances deformity correction and surgical safety in severe AIS without added morbidity. Most benefit occurs within 21 days, supporting shorter, standardized traction protocols. HGT remains a valuable adjunct for optimizing outcomes in rigid scoliosis prior to posterior spinal fusion.<\/jats:p>","DOI":"10.3390\/jcm15010142","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T16:41:19Z","timestamp":1766594479000},"page":"142","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Preoperative Halo Traction Versus Direct Posterior Fusion in Severe Adolescent Idiopathic Scoliosis: A Comparative Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Mihai Bogdan","family":"Popescu","sequence":"first","affiliation":[{"name":"11th Department of Pediatric Orthopedics, Carol Davila University of Medicine and Pharmacy, Bd. Eroii Sanitari Nr. 8, 050474 Bucharest, Romania"},{"name":"Pediatric Orthopedics Department, Grigore Alexandrescu Children\u2019s Emergency Hospital, 011743 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0401-4368","authenticated-orcid":false,"given":"Harun","family":"Marie","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics Department, Grigore Alexandrescu Children\u2019s Emergency Hospital, 011743 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1018-1506","authenticated-orcid":false,"given":"Alexandru","family":"Ulici","sequence":"additional","affiliation":[{"name":"11th Department of Pediatric Orthopedics, Carol Davila University of Medicine and Pharmacy, Bd. Eroii Sanitari Nr. 8, 050474 Bucharest, Romania"},{"name":"Pediatric Orthopedics Department, Grigore Alexandrescu Children\u2019s Emergency Hospital, 011743 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4974-8661","authenticated-orcid":false,"given":"Sebastian Nicolae","family":"Ionescu","sequence":"additional","affiliation":[{"name":"11th Department of Pediatric Orthopedics, Carol Davila University of Medicine and Pharmacy, Bd. Eroii Sanitari Nr. 8, 050474 Bucharest, Romania"},{"name":"Emergency Hospital for Children Maria Sklodowska Curie, 075534 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihai Codrut","family":"Dragomirescu","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics Department, Grigore Alexandrescu Children\u2019s Emergency Hospital, 011743 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiana","family":"Popescu","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics Department, Grigore Alexandrescu Children\u2019s Emergency Hospital, 011743 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6697-2561","authenticated-orcid":false,"given":"Alexandru","family":"Herdea","sequence":"additional","affiliation":[{"name":"11th Department of Pediatric Orthopedics, Carol Davila University of Medicine and Pharmacy, Bd. Eroii Sanitari Nr. 8, 050474 Bucharest, Romania"},{"name":"Pediatric Orthopedics Department, Grigore Alexandrescu Children\u2019s Emergency Hospital, 011743 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Amadi, I.J., Kabangu, J.L.K., Bhargav, A.G., and Camarata, P.J. (2024). The Legacy of Harrington\u2019s Rod and the Evolution of Long-Segment Constructs in Spine Surgery. J. Clin. Med., 13.","DOI":"10.3390\/jcm13185556"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Block, A.M., Tamburini, L.M., Zeng, F., Mancini, M.R., Jackson, C.A., Antonacci, C.L., Karsmarski, O.P., Stelzer, J.W., Wellington, I.J., and Lee, M.C. (2022). Surgical Treatment of Pediatric Scoliosis: Historical Origins and Review of Current Techniques. 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