The impact of halo-pelvic traction on deformity correction and bone mineral density in patients with severe spine deformity.

Abstract

Severe spinal deformities require surgical intervention, with preoperative traction commonly used to improve spinal flexibility and surgical safety. However, the impact of traction on bone mineral density (BMD) and its relationship with correction outcomes remains poorly understood. This retrospective study analyzed patients with severe spinal deformities who underwent halo-pelvic traction before surgical correction. Key parameters including Cobb angle, thoracic kyphosis (TK), height, and BMD were measured before and after traction. Paired t-tests and Pearson correlation analysis were performed to assess treatment effects and relationships between variables. Twenty-six patients (10 males, 16 females; mean age 25.31 ± 7.52 years) underwent traction for an average of 3.88 ± 1.31 months. Traction significantly improved spinal parameters: Cobb angle decreased by 37.56 ± 7.45° (P < 0.001), thoracic kyphosis reduced by 35.72 ± 13.32° (P < 0.001), and height increased by 10.2 ± 3.36 cm (P < 0.001). However, BMD decreased significantly by 17.90 ± 15.58 (P < 0.001). Correlation analysis revealed strong positive correlations between BMD loss and Cobb angle correction(r = 0.730) and Thoracic kyphosis correction(r = 0.683), indicating greater correction was associated with more pronounced BMD reduction. While preoperative traction effectively corrects severe spinal deformities and improves flexibility, it significantly decreases BMD. The strong correlation between correction effectiveness and bone loss highlights the need for careful monitoring of bone quality during traction, especially in high-risk patients. Further research is needed to optimize traction protocols and prevent bone loss.