6 points on intraoperative traction during pediatric scoliosis surgery

A study published in Spinal Deformity examined intraoperative traction in pediatric scoliosis surgery to determine whether there are benefits for use.

The researchers examined the MEDLINE and EMBASE tools for studies on intraoperative skeletal traction for scoliosis correction. There were nine papers included in the study with six being retrospective case control, one being a case report and two being retrospective case series. Here are six findings from the report:

1. There were seven studies showing the positive impact of intraoperative skeletal traction on diverse outcomes measures. These outcomes measures include:

• Pelvic obliquity correction
• Cobb angle
• Axial plane deformity

2. The intraoperative skeletal traction also precluded the need for an anterior release before posterior instrumentation for large curves.

3. There was only one paper reporting postoperative traction-related complications. The complication was anterosuperior iliac spine pressure sores.

4. There was one paper reporting intraoperative traction could evoke neuro monitoring signal changes for many patients who undergo surgery for adult idiopathic scoliosis.

5. Surgeons responded to these changes by decreasing or removing weight intraoperatively.

6. None of the patients reported postoperative neurologic deficits.

“Isolated intraoperative skeletal traction may be a low-morbidity adjunct to facilitate scoliosis surgery,” concluded the study authors. However, there is also a need for additional studies to compare outcomes for scoliosis surgery with or without intraoperative skeletal traction.


Source: Becker's Spine, 23rd Dec 2014