| Autor: |
Davies, Nestor Ricardo, Vasquez Rodriguez, Victor, Remondino, Rodrigo German, Galaretto, Eduardo, Piantoni, Lucas, Rodriguez, Susana, Leonardelli, Eduardo, Francheri Wilson, Ida Alejandra, Bersusky, Ernesto Salomon, Tello, Carlos Alberto, Noel, Mariano Augusto |
| Zdroj: |
Spine Deformity; 20240101, Issue: Preprints p1-5, 5p |
| Abstrakt: |
Study design: A retrospective, comparative study. Objective: To compare the results, complications, and costs of preoperative halo-gravity traction in in- and outpatient settings. Background data: Surgical management of severe spinal deformities remains complex and controversial. Preoperative halo-gravity traction results in a decreased need for aggressive surgical techniques, lower incidence of intraoperative neurologic complications, and improvement of nutritional parameters and preoperative cardiopulmonary function. Methods: Twenty-nine patients younger than 18 years with kyphoscoliosis undergoing preoperative halo-gravity traction were divided into two groups: inpatients (n: 15) and outpatients (n: 14, home care or care at the Foundation). Traction time (weeks), traction weight (kg), radiographic curve correction, complications, and costs were compared. For statistical analysis, ttest and odds ratio were calculated with a significance of p< 0.05. Results: Mean traction time was 6 weeks for in- and 4 weeks for outpatients (p= 0.038). Initial traction weight was 6 kg in both groups, while final traction weight was 13 kg for in- and 15 kg for outpatients (p= 0.50). At the end of the traction period, coronal correction was 24° in in- and 28° in outpatients (p= 0.5), while sagittal correction was 27° and 29°, respectively (p= 0.80). Pin loosening was observed in 2 patients in each group, of whom 1 outpatient developed pin-site infection. In each group, one patient developed transient neurologic complications (odds ratio 1.091). Mean treatment cost per patient was 2.8-fold higher in inpatients. Conclusions: Considering complications and costs, our results show that preoperative halo-gravity traction in an outpatient setting is an option to be taken into account. Level of evidence: Grade III. |
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