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Neonatal Halter Traction for Severe Cervical Spine Deformity: A Technical Case Report With 2-Year Follow-up
Richard P Menger1,2, Eduardo C Beauchamp3, Nikita Alexiades4
1Department of Neurosurgery, University of South Alabama, Mobile, Alabama, USA.
Insights
Halter traction is a viable treatment for severe congenital cervical spine deformity in neonates, offering neurological and radiographic improvement. This approach can correct deformities and reduce spinal cord compression, potentially avoiding surgery.
Area of Science:
- Pediatric Orthopedics
- Neonatal Care
- Spinal Deformity Correction
Background:
- Severe congenital cervical spine deformities are rare but can lead to severe outcomes.
- Halter traction is established for children but not previously reported in neonates.
- This case highlights a novel application in neonatal management.
Background And Importance:
Although rare, severe congenital cervical spine deformity can present with limited treatment options and potentially catastrophic outcomes. The use of halter traction for cervical deformity correction in children has been well described, but it has not been previously reported in the management of neonates.
Clinical Presentation:
A baby girl born at full-term gestation presented with generalized hypotonia, bilateral club feet, and significant right upper extremity weakness. Imaging demonstrated a severe congenital swan-neck deformity with spinal cord compression. Halter traction was initiated in the neonatal intensive care unit with subsequent neurological and radiographic improvement. After 7 days, traction was discontinued and she was placed in a custom-fitted cervico-thoracic orthosis. At 2 years of follow-up, she remains neurologically stable with maintained cervical alignment.
Conclusion:
Halter traction followed by external bracing is technically possible in the neonatal period. For children with severe cervical congenital deformity, this technique can reduce spinal cord compression, provide significant deformity correction, and delay the need for definitive operative spinal stabilization.
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