Evaluation of the Effect of Halo Gravity Traction on Lung Volume in Advanced and Severe Kyphoscoliosis Patients in Chest Radiography
Abstract
Aim: To evaluate the effect of preoperative halo gravity traction on lung volume in patients with advanced and rigid kyphoscoliosis using planimetric measurements from chest radiography.
Method: Ten patients with a mean age of 20.5±0.9 with a diagnosis of severe and severe kyphoscoliosis who underwent halo gravity traction between 2019 and 2021 were included in our study. Direct chest radiographs taken before and after traction were analyzed retrospectively. In order to evaluate the effectiveness of traction, planimetric evaluations were made on radiographs.
Results: In the evaluation of radiological parameters, mean thoracic coronal cobb angle, lumbar cobb angle, thoracic kyphosis angle, lumbar lordosis angle, C1-S1 distance and lung volume before and after the procedure were 96.670°±8.4535°, 88,090°±4.5989°, 37.020°±11.5893°, 38.540°±11.1269°, 73.150°±7.0412°, 65.590°±7.3927°, 59.100°±9.5467°, 55.100°±9.0238°, It was 371.590mm± 64.2410mm, 408.330 mm±80.8229 mm and 967.730 mm3±318.404 mm3, 1155.180mm3±332.868 mm3. The decrease in thoracic kyphosis, lumbar lordosis, thoracic cobb and lumbar cobb angles and the increase in lung volume and distance between C1-S1 were statistically significant (p<0.05).
Conclusion: Traction application is a safe method for deformities. It is effective in correcting sagittal and coronal curvatures. It is a method that is effective in pulmonary functions as well as increasing the lung volume radiologically.
References
- 1. Koller H, Zenner J, Gajic V, Meier O, Ferraris L, Hitzl W. The impact of halo-gravity traction on curve rigidity and pulmonary function in the treatment of severe and rigid scoliosis and kyphoscoliosis: a clinical study and narrative review of the literature. Eur Spine J. 2012;21:514-29. doi: 10.1007/s00586-011-2046-5.
- 2. Wang Y, Li C, Liu L, Li H, Yi X. Presurgical short-term halo-pelvic traction for severe rigid scoliosis (Cobb Angle >120°): A 2-Year Follow-up Review of 62 Patients. Spine (Phila Pa 1976). 2021;46(2):E95-104. doi: 10.1097/BRS.0000000000003740.
- 3. Iyer S, Duah HO, Wulff I, et al. The use of halo gravity traction in the treatment of severe early onset spinal deformity. Spine (Phila Pa 1976). 2019;44(14):E841-5. doi: 10.1097/BRS.0000000000002997.
- 4. Shi B, Liu D, Shi B, et al. A retrospective study to compare the efficacy of preoperative halo-gravity traction and postoperative halo-femoral traction after posterior spinal release in corrective surgery for severe kyphoscoliosis. Med Sci Monit. 2020;26:e919281. doi: 10.12659/MSM.919281.
- 5. Garabekyan T, Hosseinzadeh P, Iwinski HJ, et al. The results of preoperative halo- gravity traction in children with severe spinal deformity. J Pediatr Orthop B. 2014;23(1):1-5. doi: 10.1097/BPB.0b013e32836486b6.
- 6. Yang C, Wang H, Zheng Z, et al. Halo-gravity traction in the treatment of severe spinal deformity: a systematic review and meta-analysis. Eur Spine J. 2017;26(7):1810-6. doi: 10.1007/s00586-016-4848-y.
- 7. Li X, Zeng L, Li X, Chen X, Ke C. Preoperative halo-gravity traction for severe thoracic kyphoscoliosis patients from tibet: radiographic correction, pulmonary function ımprovement, nursing, and complications. Med Sci Monit. 2017;23:4021-7. doi: 10.12659/msm.905358.
- 8. Lenke LG, Bridwell KH, Blanke K, O’Brien MF, Baldus C. Preoperative spinal canal investigation in adolescent idiopathic scoliosis curves ≥70°. Spine. 1994;19:1606–10. doi: 10.1097/00007632-199407001-00007.
- 9. Greiner KA. Adolescent idiopathic scoliosis: radiologic decision-making. Am Fam Physician. 2002;65:1817–22.
- 10. Nepple JJ, Lenke LG. Severe idiopathic scoliosis with respiratory insufficiency treated with preoperative traction and staged anteroposterior spinal fusion with a 2-level apical vertebrectomy. Spine J. 2009;9(7):e9-e13. doi: 10.1016/j.spinee.2009.01.009.
- 11. Harris TR, Pratt PC, Kilburn KH. Total lung capacity measured by roentgenograms. Am J Med. 1971;50:756–63. doi: 10.1016/0002-9343(71)90183-5.
- 12. Park CH, Haam SJ, Lee S, Han KH, Kim TH. Prediction of anatomical lung volume using planimetric measurements on chest radiographs. Acta Radiol. 2016;57(9):1066-71. doi: 10.1177/0284185115618548.
- 13. LaMont LE, Jo C, Molinari S, et al. Radiographic, pulmonary, and clinical outcomes with halo gravity traction. Spine Deform. 2019;7(1):40-6. doi: 10.1016/j.jspd.2018.06.013.
- 14. Yang Z, Liu Y, Qi L, et al. Does preoperative halo-gravity traction reduce the degree of deformity and improve pulmonary function in severe scoliosis patients with pulmonary insufficiency? A systematic review and meta-analysis. Front Med (Lausanne). 2021;8:767238. doi: 10.3389/fmed.2021.767238.
- 15. Li D, Weinkauf J, Hirji A, et al. Chest X-ray sizing for lung transplants reflects pulmonary diagnosis and body composition and is associated with primary graft dysfunction risk. Transplantation. 2021;105(2):382-9. doi: 10.1097/TP.0000000000003238.
- 16. Wallet F, Delannoy B, Haquin A, et al. Evaluation of recruited lung volume at inspiratory plateau pressure with PEEP using bedside digital chest X-ray in patients with acute lung injury/ARDS. Respir Care. 2013;58(3):416-23. doi: 10.4187/respcare.01893.
- 17. Watanabe K, Lenke LG, Bridwell KH, et al. Efficacy of perioperative halo-gravity traction for treatment of severe scoliosis (>/=100 degrees). J Orthop Sci. 2010;15:720–30. doi: 10.1007/s00776-010-1523-8.
- 18. Shimizu T, Lenke LG, Cerpa M, Lehman RA Jr, Pongmanee S, Sielatycki JA. Preoperative halo-gravity traction for treatment of severe adult kyphosis and scoliosis. Spine Deform. 2020;8(1):85-95. doi: 10.1007/s43390-019-00017-z.
- 19. Wang DG, Zhang CM, Zhang Q, Yang S, Luo F. Design and preliminary clinical application of new Halo-gravity device. Journal of Regional Anatomy and Operative Surgery. 2019;28:829–33.
- 20. McIntosh AL, Ramo BS, Johnston CE. Halo gravity traction for severe pediatric spinal deformity: A clinical concepts review. Spine Deform. 2019;7(3):395-403. doi: 10.1016/j.jspd.2018.09.068.
- 21. Mejabi JO, Sergeenko OM, Ryabykh SO. Correction using halo gravity traction for severe rigid neuromuscular scoliosis: A report of three cases. Malays Orthop J. 2019;13(1):49-53. doi: 10.5704/MOJ.1903.010.
Göğüs Radyografilerde İleri ve Sert Kifoskolyoz Hastalarında Kullanılan Halo Yer Çekimi Traksiyonunun Akciğer Hacmi Üzerindeki Etkisinin Değerlendirilmesi
Abstract
Amaç: İleri ve sert kifoskolyozlarda cerrahi öncesi halo gravite traksiyonunun hastalarda göğüs radyografisinden planimetrik ölçümler kullanılarak akciğer hacmi üzerinde etkisini değerlendirmektir.
Yöntem: Çalışmaya, 2019-2021 yılları arasında halo yerçekimi traksiyon uygulaması yapılan ileri ve sert kifoskolyoz tanılı yaş ortalaması 20,5±0i9 olan 10 hasta dahil edildi. Traksiyon öncesi ve sonrası hastalara çekilen direkt akciğer grafileri geriye dönük incelendi. Traksiyonun etkinliğini değerlendirebilmek için grafiler üzerinden planimetrik değerlendirmelere tabi tutuldu.
Bulgular: Radyolojik parametrelerin değerlendirilmesinde işlem öncesi ve işlem sonrası ortalama torakal koronal cobb açısı, lomber cobb açısı, torakal kifoz açısı, lomber lordoz açısı, C1-S1 mesafesi ve akciğer volümü sırasıyla; 96,670°±8,4535°, 88,090°±4,5989°, 37,020°±11,5893°, 38,540°±11,1269°, 73,150°±7,0412°, 65,590°±7,3927°, 59,100°±9,5467°, 55,100°±9,0238°, 371,590mm±64,2410mm, 408,330mm±80,8229mm ve 967,730 mm3±318,404 mm3, 1155,180 mm3±332,868 mm3 idi. Torakal kifoz, lomber lordoz, torakal cobb ve lomber cobb açılarındaki azalma ile akciğer hacmi ve C1-S1 arasındaki mesafe artışı istatistiksel olarak anlamlıydı (p <0,05).
Sonuç: Traksiyon uygulaması deformitelerde güvenli bir yöntemdir. Sagital ve koronal eğriliklerin düzelmesinde etkilidir. Pulmoner fonksiyonlar üzerine etkili olduğu gibi radyolojik olarak akciğer volümü üzerinde de artış yönünde fayda sağlayan bir yöntemdir.
References
- 1. Koller H, Zenner J, Gajic V, Meier O, Ferraris L, Hitzl W. The impact of halo-gravity traction on curve rigidity and pulmonary function in the treatment of severe and rigid scoliosis and kyphoscoliosis: a clinical study and narrative review of the literature. Eur Spine J. 2012;21:514-29. doi: 10.1007/s00586-011-2046-5.
- 2. Wang Y, Li C, Liu L, Li H, Yi X. Presurgical short-term halo-pelvic traction for severe rigid scoliosis (Cobb Angle >120°): A 2-Year Follow-up Review of 62 Patients. Spine (Phila Pa 1976). 2021;46(2):E95-104. doi: 10.1097/BRS.0000000000003740.
- 3. Iyer S, Duah HO, Wulff I, et al. The use of halo gravity traction in the treatment of severe early onset spinal deformity. Spine (Phila Pa 1976). 2019;44(14):E841-5. doi: 10.1097/BRS.0000000000002997.
- 4. Shi B, Liu D, Shi B, et al. A retrospective study to compare the efficacy of preoperative halo-gravity traction and postoperative halo-femoral traction after posterior spinal release in corrective surgery for severe kyphoscoliosis. Med Sci Monit. 2020;26:e919281. doi: 10.12659/MSM.919281.
- 5. Garabekyan T, Hosseinzadeh P, Iwinski HJ, et al. The results of preoperative halo- gravity traction in children with severe spinal deformity. J Pediatr Orthop B. 2014;23(1):1-5. doi: 10.1097/BPB.0b013e32836486b6.
- 6. Yang C, Wang H, Zheng Z, et al. Halo-gravity traction in the treatment of severe spinal deformity: a systematic review and meta-analysis. Eur Spine J. 2017;26(7):1810-6. doi: 10.1007/s00586-016-4848-y.
- 7. Li X, Zeng L, Li X, Chen X, Ke C. Preoperative halo-gravity traction for severe thoracic kyphoscoliosis patients from tibet: radiographic correction, pulmonary function ımprovement, nursing, and complications. Med Sci Monit. 2017;23:4021-7. doi: 10.12659/msm.905358.
- 8. Lenke LG, Bridwell KH, Blanke K, O’Brien MF, Baldus C. Preoperative spinal canal investigation in adolescent idiopathic scoliosis curves ≥70°. Spine. 1994;19:1606–10. doi: 10.1097/00007632-199407001-00007.
- 9. Greiner KA. Adolescent idiopathic scoliosis: radiologic decision-making. Am Fam Physician. 2002;65:1817–22.
- 10. Nepple JJ, Lenke LG. Severe idiopathic scoliosis with respiratory insufficiency treated with preoperative traction and staged anteroposterior spinal fusion with a 2-level apical vertebrectomy. Spine J. 2009;9(7):e9-e13. doi: 10.1016/j.spinee.2009.01.009.
- 11. Harris TR, Pratt PC, Kilburn KH. Total lung capacity measured by roentgenograms. Am J Med. 1971;50:756–63. doi: 10.1016/0002-9343(71)90183-5.
- 12. Park CH, Haam SJ, Lee S, Han KH, Kim TH. Prediction of anatomical lung volume using planimetric measurements on chest radiographs. Acta Radiol. 2016;57(9):1066-71. doi: 10.1177/0284185115618548.
- 13. LaMont LE, Jo C, Molinari S, et al. Radiographic, pulmonary, and clinical outcomes with halo gravity traction. Spine Deform. 2019;7(1):40-6. doi: 10.1016/j.jspd.2018.06.013.
- 14. Yang Z, Liu Y, Qi L, et al. Does preoperative halo-gravity traction reduce the degree of deformity and improve pulmonary function in severe scoliosis patients with pulmonary insufficiency? A systematic review and meta-analysis. Front Med (Lausanne). 2021;8:767238. doi: 10.3389/fmed.2021.767238.
- 15. Li D, Weinkauf J, Hirji A, et al. Chest X-ray sizing for lung transplants reflects pulmonary diagnosis and body composition and is associated with primary graft dysfunction risk. Transplantation. 2021;105(2):382-9. doi: 10.1097/TP.0000000000003238.
- 16. Wallet F, Delannoy B, Haquin A, et al. Evaluation of recruited lung volume at inspiratory plateau pressure with PEEP using bedside digital chest X-ray in patients with acute lung injury/ARDS. Respir Care. 2013;58(3):416-23. doi: 10.4187/respcare.01893.
- 17. Watanabe K, Lenke LG, Bridwell KH, et al. Efficacy of perioperative halo-gravity traction for treatment of severe scoliosis (>/=100 degrees). J Orthop Sci. 2010;15:720–30. doi: 10.1007/s00776-010-1523-8.
- 18. Shimizu T, Lenke LG, Cerpa M, Lehman RA Jr, Pongmanee S, Sielatycki JA. Preoperative halo-gravity traction for treatment of severe adult kyphosis and scoliosis. Spine Deform. 2020;8(1):85-95. doi: 10.1007/s43390-019-00017-z.
- 19. Wang DG, Zhang CM, Zhang Q, Yang S, Luo F. Design and preliminary clinical application of new Halo-gravity device. Journal of Regional Anatomy and Operative Surgery. 2019;28:829–33.
- 20. McIntosh AL, Ramo BS, Johnston CE. Halo gravity traction for severe pediatric spinal deformity: A clinical concepts review. Spine Deform. 2019;7(3):395-403. doi: 10.1016/j.jspd.2018.09.068.
- 21. Mejabi JO, Sergeenko OM, Ryabykh SO. Correction using halo gravity traction for severe rigid neuromuscular scoliosis: A report of three cases. Malays Orthop J. 2019;13(1):49-53. doi: 10.5704/MOJ.1903.010.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Articles |
| Authors | |
| Early Pub Date | April 27, 2024 |
| Publication Date | April 30, 2024 |
| Acceptance Date | February 29, 2024 |
| Published in Issue | Year 2024 Issue: 22 |
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