Evidence map›Paper›PMID 39656310›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025

The use of skin traction as an intraoperative adjunct for correction during pediatric neuromuscular scoliosis correction.

Grace H Coughlin, Suken A Shah, Apeksha Gupta, Jennifer M Bauer

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Grace H CoughlinUniversity of Washington School of Medicine, Seattle, WA, USA.
Suken A ShahDepartment of Orthopedics, Nemours Children's Hospital at AI duPont, Wilmington, DE, USA.
Apeksha GuptaBiostatistics, Epidemiology and Analytics in Research (BEAR) Core, Seattle Children's Hopsital, Seattle, WA, USA.
Jennifer M BauerDepartment of Orthopaedic Surgery, Seattle Children's Hospital, University of Washington, 4800 Sand Point Way NE, Seattle, WA, 98105, USA. jennifer.bauer@seattlechildrens.org.ORCID 0000-0001-5326-8383

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIntraoperative traction can improve deformity correction during posterior spinal fusion (PSF). This is commonly done with invasive distal femoral or pelvic pins, or traction boots. The novel technique of intraoperative skin traction (ISkinT) avoids risks associated with intraoperative skeletal traction (ISkelT) or hyperlordosis with extended hip position. We aimed to describe ISkinT and assess its safety and efficacy in PSF in non-ambulatory scoliosis.

methodsRetrospective review of patients aged 10-21yo who underwent T2-pelvis PSF with ISkinT from 2017 to 2023. Demographics and radiographic measurements were statistically compared to a published cohort that used ISkelT.

results42 patients treated with ISkinT were included and compared to 41 patients treated with ISkelT. ISkinT was applied by a cranial attachment and an average of 12% body weight to the pelvis with the hips and knees flexed, using tape-rope-weight system with Trendelenburg assistance. The preop major Cobb was 90°±21° in the ISkinT cohort and 91°±17° in the ISkelT cohort (p = 0.743; d = 0.07), which corrected 75% in ISkinT and 53% in ISkelT (p < 0.0001; d = 1.3). Preop pelvic obliquity averaged 23°± 10° in ISkinT and 34°±14° in ISkelT that corrected 74% in ISkinT and 65% in ISkelT (p < 0.0001; d = 0.95). No intraop or postoperative skin traction-related complications occurred, including neuromonitoring complications (obtained in 88%).

conclusionIn non-ambulatory neuromuscular pediatric scoliosis patients, ISkinT during PSF to the pelvis is a safe and effective technique for deformity correction. There were no associated complications and no difference of corrective capacity for ISkinT compared to ISkelT. ISkinT can be considered for T2-pelvis PSF for pediatric scoliosis.

Indexed as

Intraoperative CareNeuromuscular DiseasesScoliosisSpinal FusionTractionAdolescentChildFemaleHumansMaleRetrospective StudiesTreatment OutcomeYoung AdultIntraoperative tractionNeuromuscular scoliosisPediatric scoliosisPosterior spinal fusion

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.