The Modernization of Preoperative Scoliosis Curvature Correction Methods for Pediatric Patients

Abstract

Scoliosis is the lateral curvature of the spine in the coronal plane, and kyphosis is the posterior curvature of the spine in the sagittal plane. For pediatric patients, these conditions can occur independently or in conjunction with one another and vary in severity. Most pediatric scoliosis cases are treated through bracing, but severe cases require surgical curvature correction. To reduce the risk of damaging soft tissues as well as strengthen the musculoskeletal tissues of the spine, patients undergo preoperative curvature correction before the procedure. The most common form of preoperative correction is Halo Gravity Traction (HGT), in which weights apply upward vertical forces to a patient's halo ring via a system of ropes, pulleys, and a gantry. HGT is effective, and responsible for up to half of all curvature corrections, but its bulky form factor often requires costly inpatient implementation, restricts age-appropriate play, and limits transportation for the patient and their family during treatment times of 4–6 weeks to multiple months. Furthermore, the inpatient requirement makes it less accessible to the most severely impacted portion of the patient population as they require more time in HGT. This paper describes the Halo Intrinsic Traction (HIT) system, designed to modernize halo traction by making treatment more affordable and available, and less disruptive to young patients and their families. HIT has the same traction capabilities and force resolution as the current method but in a significantly smaller and wearable form factor. The HIT system is designed to interface with the currently available braces and only be adjusted by qualified clinicians on-site. The safety and efficacy of the HIT force application system were established through benchtop testing evaluating consistent, controlled force output with minimal unintended torques on the patient's halo. The HIT system holds promise to improve current medical treatment options for severe pediatric kyphoscoliosis patients.