Evaluation of the effectiveness of preoperative halo-traction in patients with severe spinal deformities using dynamography

Abstract

BACKGROUND: Surgical treatment is the main method of treatment for patients with severe forms of idiopathic scoliosis. In severe spinal deformities, halo-traction can be used as a preoperative preparation stage. However, it is difficult to assess the results of traction preparation in rigid deformities. Nevertheless, the Tergumed Pegasus 3D biofeedback device can be used to assess changes in spinal mobility. AIM: To evaluate the effectiveness of preoperative halo-traction preparation in patients with severe spinal deformities using dynamography. MATERIALS AND METHODS: We prospectively analysed the results of 15 patients with severe spinal scoliotic deformities preoperatively. All patients received halo-traction while standing in a walking frame or sitting in a wheelchair as a preoperative preparation. We calculated the deformity mobility index, measured the volume of movement and static strength of spinal muscles in three planes using the dynamographic method before and after traction preparation. The data were statistically analysed using the Wilcoxon test. RESULTS: Changes in the mobility index before and after preoperative preparation were statistically insignificant (p 0.05). Analysis of changes in the spinal movement volume revealed an increase in the range of motion in almost all dimensions, except for extension and lateral bending to the convex side of the deformity. A statistically significant increase in the movement volume was observed in axial rotations to the convex and concave sides of the deformity, and in lateral bends to the concave side (p 0.05), while spinal flexion showed a statistically insignificant improvement. The study of static spinal muscle strength showed an increase in strength in all angles, but statistically significant changes were found in lateral bending to the convex and concave sides, turning to the convex side, and back extension. CONCLUSION: The data obtained demonstrate an increase in the strength of the spinal muscles after halo-gravity training, as well as an increase in mobility. Dynamography has been shown to be effective in assessing preoperative halotraction preparation in patients with severe spinal deformities, but further studies with a higher level of evidence are required.