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Pre-operative halo-pelvic traction for neurofibromatosis patients with severe proximal thoracic spinal deformity: Indications and early treatment outcome

Introduction: To report the indications and early treatment outcomes of pre-operative halo-pelvic traction in patients with neurofibromatosis associated with severe proximal thoracic (PT) spinal deformity. Materials and methods: We reviewed four patients with neurofibromatosis with severe PT spinal...

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Main Authors: Chung, Weng Hong, Mihara, Y., Toyat, S.S., Chiu, C.K., Hasan, M.S., Saw, A., Chan, C.Y.W., Kwan, Mun Keong
Format: Article
Published: Malaysian Orthopaedic Association 2021
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R Medicine
RA0421 Public health. Hygiene. Preventive Medicine
Online Access:http://eprints.um.edu.my/35831/
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85122070283&doi=10.5704%2fMOJ.2111.015&partnerID=40&md5=c49abdb7f4fbae5124189baf85caf507
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spelling my.um.eprints.358312024-03-14T03:40:16Z http://eprints.um.edu.my/35831/ Pre-operative halo-pelvic traction for neurofibromatosis patients with severe proximal thoracic spinal deformity: Indications and early treatment outcome Chung, Weng Hong Mihara, Y. Toyat, S.S. Chiu, C.K. Hasan, M.S. Saw, A. Chan, C.Y.W. Kwan, Mun Keong R Medicine RA0421 Public health. Hygiene. Preventive Medicine Introduction: To report the indications and early treatment outcomes of pre-operative halo-pelvic traction in patients with neurofibromatosis associated with severe proximal thoracic (PT) spinal deformity. Materials and methods: We reviewed four patients with neurofibromatosis with severe PT spinal deformity. Case 1, a 16-year-old male presented with severe PT kyphoscoliosis (scoliosis: 89°, kyphosis: 124°) and thoracic myelopathy. Case 2 was a 14-year-old, skeletally immature male who presented with a PT lordoscoliosis (scoliosis: 85°). Case 3, a 13-year-old male, presented with severe PT kyphoscoliosis (scoliosis: 100°, kyphosis: 95°). Case 4, a 35-year-old gentleman, presented with severe PT kyphoscoliosis (scoliosis: 113°, kyphosis: 103°) and thoracic myelopathy. All patients underwent pre-operative halo-pelvic traction. After a period of traction, all patients underwent posterior spinal fusion (PSF) with autologous bone grafts (local and fibula bone grafts) and recombinant human bone morphogenetic protein-2 (rhBMP-2). Results: Both patients with thoracic myelopathy regained near normal neurological status after halo-pelvic traction. Following traction, the scoliosis correction rate (CR) ranged from 18.0 to 38.9, while the kyphosis CR ranged from 14.6 to 37.1. Following PSF, the scoliosis CR ranged from 24.0 to 58.8, while the kyphosis CR ranged from 29.1 to 47.4. The total distraction ranged from 50-70mm. Duration of distraction ranged from 26-95 days. The most common complication encountered during halo-pelvic traction was pin-related e.g. pin tract infection, pin loosening and migration, osteomyelitis, and halo-pelvic strut breakage. No patients had cranial nerve palsies or neurological worsening. Conclusion: Pre-operative correction of severe PT spinal deformities could be performed safely and effectively with the halo-pelvic device prior to definitive surgery. © 2021, Malaysian Orthopaedic Association. All rights reserved. Malaysian Orthopaedic Association 2021 Article PeerReviewed Chung, Weng Hong and Mihara, Y. and Toyat, S.S. and Chiu, C.K. and Hasan, M.S. and Saw, A. and Chan, C.Y.W. and Kwan, Mun Keong (2021) Pre-operative halo-pelvic traction for neurofibromatosis patients with severe proximal thoracic spinal deformity: Indications and early treatment outcome. Malaysian Orthopaedic Journal, 15 (3). pp. 99-107. ISSN 1985-2533, DOI https://doi.org/10.5704/MOJ.2111.015 <https://doi.org/10.5704/MOJ.2111.015>. https://www.scopus.com/inward/record.uri?eid=2-s2.0-85122070283&doi=10.5704%2fMOJ.2111.015&partnerID=40&md5=c49abdb7f4fbae5124189baf85caf507 10.5704/MOJ.2111.015
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine
RA0421 Public health. Hygiene. Preventive Medicine
spellingShingle R Medicine
RA0421 Public health. Hygiene. Preventive Medicine
Chung, Weng Hong
Mihara, Y.
Toyat, S.S.
Chiu, C.K.
Hasan, M.S.
Saw, A.
Chan, C.Y.W.
Kwan, Mun Keong
Pre-operative halo-pelvic traction for neurofibromatosis patients with severe proximal thoracic spinal deformity: Indications and early treatment outcome
description Introduction: To report the indications and early treatment outcomes of pre-operative halo-pelvic traction in patients with neurofibromatosis associated with severe proximal thoracic (PT) spinal deformity. Materials and methods: We reviewed four patients with neurofibromatosis with severe PT spinal deformity. Case 1, a 16-year-old male presented with severe PT kyphoscoliosis (scoliosis: 89°, kyphosis: 124°) and thoracic myelopathy. Case 2 was a 14-year-old, skeletally immature male who presented with a PT lordoscoliosis (scoliosis: 85°). Case 3, a 13-year-old male, presented with severe PT kyphoscoliosis (scoliosis: 100°, kyphosis: 95°). Case 4, a 35-year-old gentleman, presented with severe PT kyphoscoliosis (scoliosis: 113°, kyphosis: 103°) and thoracic myelopathy. All patients underwent pre-operative halo-pelvic traction. After a period of traction, all patients underwent posterior spinal fusion (PSF) with autologous bone grafts (local and fibula bone grafts) and recombinant human bone morphogenetic protein-2 (rhBMP-2). Results: Both patients with thoracic myelopathy regained near normal neurological status after halo-pelvic traction. Following traction, the scoliosis correction rate (CR) ranged from 18.0 to 38.9, while the kyphosis CR ranged from 14.6 to 37.1. Following PSF, the scoliosis CR ranged from 24.0 to 58.8, while the kyphosis CR ranged from 29.1 to 47.4. The total distraction ranged from 50-70mm. Duration of distraction ranged from 26-95 days. The most common complication encountered during halo-pelvic traction was pin-related e.g. pin tract infection, pin loosening and migration, osteomyelitis, and halo-pelvic strut breakage. No patients had cranial nerve palsies or neurological worsening. Conclusion: Pre-operative correction of severe PT spinal deformities could be performed safely and effectively with the halo-pelvic device prior to definitive surgery. © 2021, Malaysian Orthopaedic Association. All rights reserved.
format Article
author Chung, Weng Hong
Mihara, Y.
Toyat, S.S.
Chiu, C.K.
Hasan, M.S.
Saw, A.
Chan, C.Y.W.
Kwan, Mun Keong
author_facet Chung, Weng Hong
Mihara, Y.
Toyat, S.S.
Chiu, C.K.
Hasan, M.S.
Saw, A.
Chan, C.Y.W.
Kwan, Mun Keong
author_sort Chung, Weng Hong
title Pre-operative halo-pelvic traction for neurofibromatosis patients with severe proximal thoracic spinal deformity: Indications and early treatment outcome
title_short Pre-operative halo-pelvic traction for neurofibromatosis patients with severe proximal thoracic spinal deformity: Indications and early treatment outcome
title_full Pre-operative halo-pelvic traction for neurofibromatosis patients with severe proximal thoracic spinal deformity: Indications and early treatment outcome
title_fullStr Pre-operative halo-pelvic traction for neurofibromatosis patients with severe proximal thoracic spinal deformity: Indications and early treatment outcome
title_full_unstemmed Pre-operative halo-pelvic traction for neurofibromatosis patients with severe proximal thoracic spinal deformity: Indications and early treatment outcome
title_sort pre-operative halo-pelvic traction for neurofibromatosis patients with severe proximal thoracic spinal deformity: indications and early treatment outcome
publisher Malaysian Orthopaedic Association
publishDate 2021
url http://eprints.um.edu.my/35831/
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85122070283&doi=10.5704%2fMOJ.2111.015&partnerID=40&md5=c49abdb7f4fbae5124189baf85caf507
_version_ 1794548695642931200
score 13.211869

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