Traction in the treatment of spinal deformity

An independent study was undertaken whereby all members of the Scoliosis Research Society as well as orthopedic surgeons known by the authors to be involved in the treatment of spinal deformities were queried to determine 1) the role of various forms of traction, 2) methods and timing ot application, 3) the indications for use with respect to type of spinal deformity and angle of curvature, and 4) the complications encountered during use. Our results indicated a majority of spinal surgeons, 85%, used preoperative traction when curves were greater than 80° . Cotrel's traction was considered ineffective by the majority of respondents. Halofemoral traction was considered to be indicated in rigid curves greater than 80° and/or associated with pelvic obliquity, and paralytic/neuromuscular curves. Halo-pelvic traction has very limited use in "collapsing spines." Halo-gravity techniques (wheelchair, circoelectric bed) have become increasingly popular and their use issate and effective. Halo-cast is widely accepted as an effective method in the treatment of cervical spine fracture/dislocations and cervicothoracic curves.