Impact of halo-pelvic traction duration on pulmonary improvement quantified by pulmonary function tests and three-dimensional lung reconstruction in severe rigid kyphoscoliosis: a prospective cohort study

Abstract Background Severe and rigid kyphoscoliosis, characterized by extreme spinal curvature > 100° and limited flexibility < 30%, significantly impacts pulmonary function. While halo-pelvic traction (HPT) is an established method for improving lung function in patients with scoliosis, the o...

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Main Authors: Lijin Zhou, Yihan Yang, Honghao Yang, Jianqiang Wang, Zhangfu Li, Duan Sun, Yiqi Zhang, Yunsheng Wang, Yong Hai
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Orthopaedic Surgery and Research
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Online Access:https://doi.org/10.1186/s13018-025-06126-y
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author Lijin Zhou
Yihan Yang
Honghao Yang
Jianqiang Wang
Zhangfu Li
Duan Sun
Yiqi Zhang
Yunsheng Wang
Yong Hai
author_facet Lijin Zhou
Yihan Yang
Honghao Yang
Jianqiang Wang
Zhangfu Li
Duan Sun
Yiqi Zhang
Yunsheng Wang
Yong Hai
author_sort Lijin Zhou
collection DOAJ
description Abstract Background Severe and rigid kyphoscoliosis, characterized by extreme spinal curvature > 100° and limited flexibility < 30%, significantly impacts pulmonary function. While halo-pelvic traction (HPT) is an established method for improving lung function in patients with scoliosis, the optimal duration of treatment remains undefined. Methods This study included 64 patients who underwent HPT before posterior spinal fusion surgery. Patients were divided into short-term traction group (2 months < traction duration ≤ 4 months), the middle-term traction group (4 months < traction duration ≤ 6 months), and the long-term traction group (traction duration > 6 months). Pulmonary function tests (PFTs) were performed in all patients. Using three-dimensional (3D) lung reconstruction from computed tomography, changes in lung volume were analyzed. The statistical analyses were conducted using SPSS (version 26.0; IBM) and GraphPad Prism (version 10.1.2). Results Among 64 patients, total lung capacity (TLC) increased significantly in the middle‑term traction (2.62 ± 0.89 L to 3.10 ± 0.85 L) and long‑term traction (2.39 ± 0.98 L to 2.98 ± 0.80 L) groups. Total lung volume (TLV) improved significantly in the short‑term (1.81 ± 0.50 L to 2.13 ± 0.44 L), middle‑term (2.62 ± 0.89 L to 3.10 ± 0.85 L), and long‑term (2.39 ± 0.98 L to 2.98 ± 0.80 L) traction groups. Concave-side lung volume also increased significantly in three groups. Middle-term HPT exhibited greater TLV and concave-side lung volume change rate improvement than the short-term group, while long-term HPT showed no additional advantage over middle-term treatment. HPT also significantly improved T1-T12 distance, thoracic kyphosis, and main Cobb angle. Conclusions HPT is an effective treatment for severe and rigid kyphoscoliosis, and 4 to 6 months may be the optimal HPT duration to improve pulmonary function.
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spelling doaj-art-44a79535ebbe433e9844afd0d8383a412025-08-20T03:05:10ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-07-0120111110.1186/s13018-025-06126-yImpact of halo-pelvic traction duration on pulmonary improvement quantified by pulmonary function tests and three-dimensional lung reconstruction in severe rigid kyphoscoliosis: a prospective cohort studyLijin Zhou0Yihan Yang1Honghao Yang2Jianqiang Wang3Zhangfu Li4Duan Sun5Yiqi Zhang6Yunsheng Wang7Yong Hai8Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University of ChinaDepartment of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University of ChinaDepartment of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University of ChinaDepartment of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University of ChinaDepartment of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University of ChinaDepartment of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University of ChinaDepartment of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University of ChinaDepartment of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University of ChinaDepartment of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University of ChinaAbstract Background Severe and rigid kyphoscoliosis, characterized by extreme spinal curvature > 100° and limited flexibility < 30%, significantly impacts pulmonary function. While halo-pelvic traction (HPT) is an established method for improving lung function in patients with scoliosis, the optimal duration of treatment remains undefined. Methods This study included 64 patients who underwent HPT before posterior spinal fusion surgery. Patients were divided into short-term traction group (2 months < traction duration ≤ 4 months), the middle-term traction group (4 months < traction duration ≤ 6 months), and the long-term traction group (traction duration > 6 months). Pulmonary function tests (PFTs) were performed in all patients. Using three-dimensional (3D) lung reconstruction from computed tomography, changes in lung volume were analyzed. The statistical analyses were conducted using SPSS (version 26.0; IBM) and GraphPad Prism (version 10.1.2). Results Among 64 patients, total lung capacity (TLC) increased significantly in the middle‑term traction (2.62 ± 0.89 L to 3.10 ± 0.85 L) and long‑term traction (2.39 ± 0.98 L to 2.98 ± 0.80 L) groups. Total lung volume (TLV) improved significantly in the short‑term (1.81 ± 0.50 L to 2.13 ± 0.44 L), middle‑term (2.62 ± 0.89 L to 3.10 ± 0.85 L), and long‑term (2.39 ± 0.98 L to 2.98 ± 0.80 L) traction groups. Concave-side lung volume also increased significantly in three groups. Middle-term HPT exhibited greater TLV and concave-side lung volume change rate improvement than the short-term group, while long-term HPT showed no additional advantage over middle-term treatment. HPT also significantly improved T1-T12 distance, thoracic kyphosis, and main Cobb angle. Conclusions HPT is an effective treatment for severe and rigid kyphoscoliosis, and 4 to 6 months may be the optimal HPT duration to improve pulmonary function.https://doi.org/10.1186/s13018-025-06126-yHalo-pelvic tractionSevere and rigid kyphoscoliosisPulmonary function tests3D lung reconstructionTotal lung volume
spellingShingle Lijin Zhou
Yihan Yang
Honghao Yang
Jianqiang Wang
Zhangfu Li
Duan Sun
Yiqi Zhang
Yunsheng Wang
Yong Hai
Impact of halo-pelvic traction duration on pulmonary improvement quantified by pulmonary function tests and three-dimensional lung reconstruction in severe rigid kyphoscoliosis: a prospective cohort study
Journal of Orthopaedic Surgery and Research
Halo-pelvic traction
Severe and rigid kyphoscoliosis
Pulmonary function tests
3D lung reconstruction
Total lung volume
title Impact of halo-pelvic traction duration on pulmonary improvement quantified by pulmonary function tests and three-dimensional lung reconstruction in severe rigid kyphoscoliosis: a prospective cohort study
title_full Impact of halo-pelvic traction duration on pulmonary improvement quantified by pulmonary function tests and three-dimensional lung reconstruction in severe rigid kyphoscoliosis: a prospective cohort study
title_fullStr Impact of halo-pelvic traction duration on pulmonary improvement quantified by pulmonary function tests and three-dimensional lung reconstruction in severe rigid kyphoscoliosis: a prospective cohort study
title_full_unstemmed Impact of halo-pelvic traction duration on pulmonary improvement quantified by pulmonary function tests and three-dimensional lung reconstruction in severe rigid kyphoscoliosis: a prospective cohort study
title_short Impact of halo-pelvic traction duration on pulmonary improvement quantified by pulmonary function tests and three-dimensional lung reconstruction in severe rigid kyphoscoliosis: a prospective cohort study
title_sort impact of halo pelvic traction duration on pulmonary improvement quantified by pulmonary function tests and three dimensional lung reconstruction in severe rigid kyphoscoliosis a prospective cohort study
topic Halo-pelvic traction
Severe and rigid kyphoscoliosis
Pulmonary function tests
3D lung reconstruction
Total lung volume
url https://doi.org/10.1186/s13018-025-06126-y
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