Juvenile Scoliosis

Traction

Treatment for patients with a progressive deformity who is not a candidate for bracing or casting can be more difficult, for example those with weakness, skin or chest wall intolerance, mental retardation, or with large and stiff curves that do not correct much during serial casting. In these instances, halo-gravity traction is a method to achieve deformity correction, and indirectly, improve respiratory mechanics. The traction method of treatment has recently regained popularity in some centers.

A halo (metal ring around the head) is applied under general anesthesia. Multiple pins attach the ring to the patient's skull. The halo is not painful and is well tolerated after the patient becomes accustomed to its presence. Traction is applied the following day with the use of ropes, pulleys, and weights or springs that can be applied to the child's bed or a wheelchair. Some patients can be treated as outpatients if the family is comfortable. The children are followed with serial X-rays after successive increases in the weight of the traction. Once the spine has shown the maximal amount of improvement, your surgeon will decide the next course of treatment which is usually surgical fusion of the scoliotic curve.

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