Pediatric Spine Foundation

Title: The Association Between the Utilization of Traction and Postoperative Complications Following Growing Rod Instrumentation for Early-onset Scoliosis

Authors: Benjamin D. Roye, MD, MPH, Michael W. Fields, BS, Hiroko Matsumoto, PhD, Paul Sponseller, MD, Francisco J.S. Pérez-Grueso, MD, Oheneba Boachie-Adjei, MD, Kim Hammerberg, MD, Michelle C. Welborn, MD, and Michael G. Vitale, MD, MPH; Pediatric Spine Study Group

Journal: J Pediatr Orthop

Date: October 01, 2020

Excerpt: This is the first multicenter study to investigate the association between preoperative/intraoperative traction and complications following growth-friendly instrumentation for EOS.

Keywords: early-onset scoliosis, halo-gravity traction, intra- operative traction, growth-friendly instrumentation, MCGR, VEPTR, TGR

Summary:

Purpose

Traction before and during surgery have been suggested as a way to limit complications that come with growth-friendly surgical treatment for early-onset scoliosis (EOS). The purpose of this study was to review the relationship between traction before and during surgery and complications following that surgery.

Results

  • Patients who had traction treatment before surgery, had a 1.8% rate of hardware failures. This is compared to a 9.6% rate in patients who did not have traction surgery.
  • Patients treated with traction during surgery were 61% less likely to have any issues after surgery.
  • The group that had traction during surgery had a larger percent curve correction at the follow-up visit right after surgery (46% vs 38%) and follow-up visit 2 years later(43.8% vs 31.6%).
  • Patients that had traction treatment during surgery had fewer overall issues, fewer hardware failures, fewer cases of anchor migration, and fewer UPROR when compared with patients that did not receive traction treatment of any kind.

Discussion Points

  • Before the study, researchers thought that by lowering stress on the construct at the time of surgery using traction before surgery, the risk of hardware-related complications would also lower. Results from this study were unable to prove that traction before surgery caused less issues.
  • Future studies to review the complete benefits and risks for the use of traction in surgical intervention for EOS may be helpful.