Pathway for Implementation of Halo-Gravity Traction for the Treatment of Severe Spinal Deformities at a New Institution

Background: Halo-Gravity Traction (HGT) is an adjunct technique for treating severe spinal deformity that has received increasing interest. Hospitals unfamiliar with these techniques may find implementation difficult due to the need for specialized equipment and coordination involving many healthcare providers. We aim to discuss critical steps for the implementation of HGT technique at new hospitals. Methods: HGT was instituted in 2019 at a single, tertiary academic center under the direction and planning of multiple pediatric orthopedic spine surgeons, each experienced in HGT through work at other centers. After successful implementation and continued process review, the required components to create and execute a HGT program were reviewed and detailed. Results: HGT initiation first requires equipment purchasing and modification. While surgeon knowledge drives clinical protocols, they must be developed in coordination with a multidisciplinary team. A sustainable HGT program requires plans for equipment maintenance as well as regular review and improvement of clinical protocols. Total institutional costs will vary but should generally be affordable to interested centers. Conclusions: Safe and efficient implementation of HGT is achievable for orthopedists across most practice settings.