Spinal deformities, such as severe scoliosis and kyphosis, involve extreme and rigid curves. These deviations can place pressure on internal organs, potentially affecting heart and lung function. For difficult cases, traditional surgical correction carries a high risk of complications, especially concerning the spinal cord and nerves. Halo Gravity Traction (HGT) is a specialized preparatory technique designed to provide gradual, controlled correction before definitive surgery.
Defining Halo Gravity Traction and Its Purpose
Halo Gravity Traction is a non-surgical procedure that uses controlled, vertical force to gently stretch a severely curved or compressed spine. This process safely elongates the spinal column and surrounding soft tissues over several weeks. By pulling the head upward, HGT increases the flexibility of the stiffened spine.
HGT is primarily indicated for patients with extremely rigid spinal curves, often measuring greater than 80 to 100 degrees. The gradual stretching reduces the stiffness of the ligaments, muscles, and fascia that have adapted to the deformity. The main purpose of HGT is not final correction, but rather to make the spine more pliable and less compressed before a major operation.
The treatment duration typically lasts between four and twelve weeks, depending on the severity of the curve and the patient’s response to the stretching. Achieving this increased flexibility improves the safety profile of the subsequent corrective surgery. Patients often report immediate benefits, such as easier breathing and reduced pain, as the pressure on internal structures is lessened.
The Mechanics of the Device
The HGT system begins with the surgical placement of a halo ring, a lightweight metal or carbon fiber ring, secured to the skull. This is achieved using six to ten small metal pins that penetrate the outer layer of the skull bone. Pin placement is done under general anesthesia to ensure secure fixation and patient comfort.
Once the halo is in place, it is connected to a weighted pulley system, which provides constant, upward traction force. The system applies force against the patient’s body weight, starting light and increasing incrementally over days or weeks. The total weight applied is carefully calculated, often aiming to reach up to 50% of the patient’s total body weight.
The pulley system allows for mobility, attaching to the patient’s bed, specialized wheelchairs, and walkers. This setup ensures that the therapeutic traction force is maintained even when the patient is moving around. The pulley system translates the weight into a gentle, continuous longitudinal stretch on the spine.
The Patient Experience and Daily Care
Halo Gravity Traction requires an inpatient stay in the hospital for the entire duration of the treatment, typically spanning several weeks. This allows the medical team to closely monitor the patient’s neurological status and adjust the traction weight as needed. The care team performs daily neurological assessments, checking for changes in movement, strength, and sensation, to monitor for nerve adaptation or stress.
A significant part of the daily routine involves pin site care, performed multiple times a day to prevent infection where the pins enter the skin. The sites must be cleaned regularly using specific techniques and solutions, and daily showers are encouraged to maintain hygiene. While some initial discomfort or headache is common after the halo is placed, pain is managed with medication and typically subsides quickly.
Physical therapy is a fundamental component of the treatment, even while the patient is in traction. Patients are encouraged to be as active as possible, using specialized walkers and wheelchairs to move around the hospital. Maintaining muscle strength and flexibility through prescribed exercises is important to support the spine once the traction phase is complete.
Preparation for Definitive Surgery
Halo Gravity Traction is considered a successful bridge to surgical correction, significantly improving the conditions for the operation. By gradually stretching the spine, HGT increases flexibility and reduces the overall magnitude of the curve. This pre-stretching minimizes the amount of forceful correction required during fusion surgery, which lowers the risk of neurological damage to the spinal cord.
The medical team determines the traction phase is complete when the spine reaches a plateau in correction or the patient has safely tolerated the maximum prescribed weight. Successful traction also frequently improves lung function, making the patient a safer candidate for the lengthy surgery. If the patient proceeds directly to spinal fusion, the halo is removed in the operating room just before the procedure begins.