Rehabilitation and care of the patient with halo-gravity traction for correction of kyphoscoliosis secondary to neurofibromatosis: case report
DOI:
https://doi.org/10.11606/issn.2317-0190.v31i2a200242Keywords:
Scoliosis, Physical Therapy Modalities, Skull, Spine, TractionAbstract
Type 1 neurofibromatosis may be associated with rigid kyphoscoliosis with a high angular value and the need for halogravitational traction prior to definitive arthrodesis. The results of this type of treatment with halo-gravitational traction are well established, however, results on the care management of this patient are scarce in the literature. Objective: To describe the care provided to a patient with kyphoscoliosis under halogravitational traction before arthrodesis. Methods: Retrospective case report study. Data were collected from the patient's medical record. After installation of traction, the patient underwent a care and rehabilitation plan that included daily sensory-motor assessments, rehabilitation and traction care. Results: The maximum weight reached was 32% of the patient's body weight, in 42 days with the use of traction, the complications observed were severe postoperative pain, surgical site infection and lower limb paresthesia after weight gain. Due to complications, the rehabilitation sessions were intensified and the patient was discharged after 79 days without sequelae. Conclusion: Due to a multidisciplinary therapeutic plan, it was possible to identify and intervene early on complications related to surgery, weight progression and the prevention of complications from immobility, enabling the patient's full recovery at hospital discharge.
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References
Gerber PA, Antal AS, Neumann NJ, Homey B, Matuschek C, Peiper M, et al. Neurofibromatosis. Eur J Med Res. 2009;14(3):102-5. Doi: https://doi.org/10.1186/2047-783x-14-3-102
Koptan W, ElMiligui Y. Surgical correction of severe dystrophic neurofibromatosis scoliosis: an experience of 32 cases. Eur Spine J. 2010;19(9):1569-75. Doi: https://doi.org/10.1007/s00586-010-1464-0
Rinella A, Lenke L, Whitaker C, Kim Y, Park SS, Peelle M, et al. Perioperative halo-gravity traction in the treatment of severe scoliosis and kyphosis. Spine (Phila Pa 1976). 2005;30(4):475-82. Doi: https://doi.org/10.1097/01.brs.0000153707.80497.a2
Li X, Zeng L, Li X, Chen X, Ke C. Preoperative halo-gravity traction for severe thoracic kyphoscoliosis patients from tibet: radiographic correction, pulmonary function improvement, nursing, and complications. Med Sci Monit. 2017;23:4021-4027. Doi: https://doi.org/10.12659/msm.905358
Porto MA, Herreo CFPS, Nogueira-Barbosa MH, Defino HLA. Utilização da tração halocraniana pré-operatória no tratamento de deformidades vertebrais de alto valor angular Coluna/Columna. 2010;9(3):258-64. https://doi.org/10.1590/S1808-18512010000300002
Popescu MB, Ulici A, Carp M, Haram O, Ionescu NS. The use and complications of halo gravity traction in children with scoliosis. Children (Basel). 2022;9(11):1701. Doi: https://doi.org/10.3390/children9111701
Cechin IE, Alves GF, Barros AGC, Silva LECT. Complications of prolonges halo-gravitational tractional in spinal deformity surgeries. Coluna/Columna. 2023:e2625394. Doi: https://doi.org/10.1590/S1808-185120222201265394
Parry SM, Puthucheary ZA. The impact of extended bed rest on the musculoskeletal system in the critical care environment. Extrem Physiol Med. 2015;4:16. Doi: https://doi.org/10.1186/s13728-015-0036-7
Ginsburg GM, Bassett GS. Hypoglossal nerve injury caused by halo-suspension traction. A case report. Spine (Phila Pa 1976). 1998;23(13):1490-3. Doi: https://doi.org/10.1097/00007632-199807010-00011
Yang C, Wang H, Zheng Z, Zhang Z, Wang J, Liu H, et al. Halo-gravity traction in the treatment of severe spinal deformity: a systematic review and meta-analysis. Eur Spine J. 2017;26(7):1810-1816. Doi: https://doi.org/10.1007/s00586-016-4848-y
Naqvi U, Sherman AL. Muscle Strength Grading. In: StatPearls [Internet]. Treasure Island (FL): StatPearls; 2024.
Childs JD, Piva SR, Fritz JM. Responsiveness of the numeric pain rating scale in patients with low back pain. Spine (Phila Pa 1976). 2005;30(11):1331-4. Doi: https://doi.org/10.1097/01.brs.0000164099.92112.29
Jin C, Wang S, Yang G, Li E, Liang Z. A Review of the Methods on Cobb Angle Measurements for Spinal Curvature. Sensors (Basel). 2022;22(9):3258. Doi: https://doi.org/10.3390/s22093258
Sponseller PD, Takenaga RK, Newton P, Boachie O, Flynn J, Letko L, et al. The use of traction in the treatment of severe spinal deformity. Spine (Phila Pa 1976). 2008;33(21):2305-9. Doi: https://doi.org/10.1097/BRS.0b013e318184ef79
Yang C, Wang H, Zheng Z, Zhang Z, Wang J, Liu H, et al. Halo-gravity traction in the treatment of severe spinal deformity: a systematic review and meta-analysis. Eur Spine J. 2017;26(7):1810-1816. Doi: https://doi.org/10.1007/s00586-016-4848-y
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