Halo gravity traction for pediatric scoliosis and kyphoscoliosis - A review of current evidence and best practices

Sep 28, 2026

Uploaded by Kurz

The surgical management of severe scoliosis and kyphoscoliosis in children is challenging, with elevated morbidity and mortality and frequent pre-existing pulmonary compromise. Traditional anterior and posterior release or osteotomy strategies may be limited by respiratory constraints, and acute deformity correction can increase neurologic injury risk. Halo gravity traction (HGT) enables progressive, gradual, sustained correction across coronal, sagittal, and axial planes, reducing the correction required at definitive posterior fusion. This review consolidates evidence on indications, application protocols, traction duration, and associated complications.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Introduction

Rationale

Indications and contraindications

Application techniques

Posttraction protocols

Clinical benefits

Possible complications

Prevention and management

| W | J | O | World Journal of
Orthopedics | | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Orthop 2025 December 18; 16(12): 110510 DOI: 10.5312/wjo.v16.i12.110510 ISSN 2218-5836 (online) MINIREVIEWS Halo gravity traction for pediatric scoliosis and kyphoscoliosis: Areview of current evidence and best practices Meet A Jain, Arjun Dhawale, Md Zafar Iqbal, Atif Naseem, Bhushan Sagade, Apurba Gorain, Abhay Nene Specialty type: Orthopedics Provenance and peer review: Invited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade B, Grade C Novelty: Grade B, Grade C Creativity or Innovation: Grade B, Grade C Scientific Significance: Grade B, Grade C P-Reviewer: Li ZP, MD, Assistant Professor, China Received: June 9, 2025 Revised: July 9, 2025 Accepted: October 20, 2025 Published online: December 18, 2025 Processing time: 192 Days and 15.2 Hours Meet A Jain, Arjun Dhawale, Md Zafar Iqbal, Bhushan Sagade, Department of Pediatric Orthopedics, Bai Jerbai Wadia Hospital for Children, Maharashtra 400012, Mumbai, India Atif Naseem, Apurba Gorain, Abhay Nene, Department of Orthopedics, Lilavati Hospital and Research Centre, Maharashtra 400050, Mumbai, India Co-corresponding authors: Meet A Jain and Arjun Dhawale. Corresponding author: Meet A Jain, Postdoctoral Fellow, Department of Pediatric Orthopedics, Bai Jerbai Wadia Hospital for Children, Acharya Donde Marg, Parel, Maharashtra 400012, Mumbai, [India.](India. meetjain2295@gmail.com)[ meetjain2295@gmail.com](India. meetjain2295@gmail.com) Abstract The surgical treatment of severe scoliosis and kyphoscoliosis in the pediatric population is complicated and has high morbidity and mortality risks. Severe scoliosis has traditionally been defined by a coronal Cobb angle of greater than 90° or 100° . The usual corrective methods for these patients have been anterior or posterior release and osteotomies using a combined anterior-posterior or posterior-only approach. Many of these patients have pre-existing pulmonary compromise; therefore, an anterior approach is often not reasonable or possible. Acute correction of a deformity may also cause neurologic injury. Halo gravity traction (HGT) allows for progressive, gradual, and sustained correction of the spinal deformity in the coronal, sagittal, and axial planes, leading to a decrease in the amount of correction needed at definitive posterior fusion. This relates to decreased postoperative neurologic deficit and improved pulmonary function. Preoperative HGT has evolved to be the surgical adjunct in the treatment of severe spinal deformity. Indications for HGT, best protocols of application, and optimal duration of traction still lack uniformity; thus, a review of the literature remains relevant and necessary. This review summarizes the existing literature on HGT, including its indications, applications, duration of traction, and associated complications. Key Words: Halo gravity traction; Severe pediatric scoliosis; Severe pediatric kyphoscoliosis; Cobb angle; Scoliosis; Kyphoscoliosis ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved. WJO [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 18, 2025 Volume 16 Issue 12 Jain MA et al. HGT for pediatric scoliosis and kyphoscoliosis Core Tip: Halo gravity traction (HGT) provides a safe and gradual approach to more severe scoliosis and kyphoscoliosis in the pediatric population, while decreasing the risk of surgery, as well as improving spinal flexibility, pulmonary function, and nutritional status. It minimizes the need for extensive procedures like vertebral column resection. Even though protocols do vary, there is initial evidence to support 3-11 weeks of traction, and to monitor carefully for pin-site complications as well as neurological complicat

FAQs

What problem does halo gravity traction address in pediatric severe scoliosis or kyphoscoliosis?

It provides gradual, sustained correction of the spinal deformity in multiple planes, aiming to decrease the amount of correction required at definitive posterior fusion and reduce associated risks.

Why might anterior surgical approaches be difficult in this patient population?

Many patients have pre-existing pulmonary compromise, making an anterior approach often unreasonable or not possible.

What does the review focus on regarding HGT?

It summarizes existing literature on HGT, including indications, applications, traction duration, and associated complications, along with best practices for monitoring.

Sep 28, 2026

Uploaded by Kurz