Preoperative Halo-Gravity Traction for Severe Thoracic Kyphoscoliosis Patients from Tibet: Radiographic Correction, Pulmonary Function Improvement, Nursing, and Complications.

Background: This study investigated the outcomes of preoperative HGT as an adjunct treatment for severe thoracic kyphoscoliosis, its role in radiographic correction, and pulmonary function improvement, together with nursing strategy and incidence of complications. Material/Methods: Eleven patients with a mean age of 18.8 years were retrospectively reviewed. Inclusion criteria were: patients with severe kyphoscoliosis (coronal Cobb angle and kyphosis angle >= 80 degrees); duration of HGT >= 8 weeks; patients undergoing HGT for at least 12 h per day; traction weight no less than 40% of body weight; and patients not receiving physical therapies. All patients underwent respiratory training. Results: The major coronal curve scoliosis averaged 114.00 +/- 24.43 degrees and was reduced to 80.55 +/- 17.98 degrees after HGT. The major kyphosis was 103.91 +/- 18.95 degrees and was reduced to 80.55 +/- 17.98 degrees. Significantly improved percent-predicted values for FVC was found after HGT (p=0.014), and significantly increased forced expiratory volume in 1 s (FEV1%) was also observed (p<0.001), with significantly improved percent-predicted values for PEF (p=0.003) after HGT. Conclusions: Our data reveal that preoperative HGT can be performed safely, and can help achieve excellent curve correction in both the coronal and sagittal planes, together with improved respiratory function and no severe complications in patients with severe thoracic kyphoscoliosis.