Inpatient versus outpatient halo-gravity traction in children with severe spinal deformity.
Spine Deform
; 8(4): 711-715, 2020 08.
Article
en En
| MEDLINE
| ID: mdl-32096139
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, t test 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.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Pacientes Ambulatorios
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Curvaturas de la Columna Vertebral
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Tracción
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Cuidados Preoperatorios
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Pacientes Internos
Tipo de estudio:
Observational_studies
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Prevalence_studies
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Risk_factors_studies
Límite:
Adolescent
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Child
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Female
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Humans
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Male
Idioma:
En
Revista:
Spine Deform
Año:
2020
Tipo del documento:
Article
País de afiliación:
Argentina
Pais de publicación:
Reino Unido