At Children's Memorial Hermann Hospital, our affiliated Halo Gravity Traction (HGT) team offers a cutting-edge approach in treating pediatric scoliosis. As one of the few hospitals in the region providing this advanced therapy, our Halo Gravity Traction program delivers a tailored treatment approach that prepares children and adolescents for surgical intervention and supports every aspect of a child's journey towards spinal alignment and an improved quality of life.
HGT is a method of gently stretching and straightening a severely compressed or curved spine. The halo is secured to the upper part of the skull with pins that grip the skull bone. The halo is then connected to a spring system that gently pulls on the spine, helping to straighten it over time.
This technique is a temporary measure before a more permanent surgery. The goal is to gradually correct the spine's shape, making it easier to perform the final surgery that locks the spine in its improved position. In certain cases, if the child is still growing, rods can be used to support the spine as the child continues to grow or the halo treatment might need to be repeated to maintain the spine's condition until the child is older.
HGT is often used to treat various severe spinal conditions, including:
HGT gently stretches and straightens the spine in these cases, making it easier to perform corrective surgery or manage the condition more effectively.
Traditionally, a counterweight system was used for HGT. This previous method involved a pulley system where a rope ran through a pulley and attached to a weight, typically half the patient's body weight. However, this setup could be uncomfortable due to the swinging and swaying of the dangling weight. At Children’s Memorial Hermann Hospital, we use a more advanced spring apparatus that applies tension to the spine gradually, allowing it to stretch and unwind over time. This method is more comfortable compared to previous systems involving weights. The spring system provides tension based on how relaxed the patient is. When they relax, they feel the full tension, similar to the weight, and if they lift up slightly, the tension reduces, allowing them to control how much stretch they experience. Initially, patients might experience stiffness, but over time as they get used to it, their body adapts and the halo can work effectively.
The halo apparatus is securely attached to the skull through specially designed pins and connects to the traction system via a heavy duty carabiner, allowing for easy attachment and detachment. In our implementation, traction is only applied during daytime hours. This is because the traction apparatus, even the advanced spring system, requires the patient to be upright, which isn't feasible while sleeping. At night, patients get a break from the traction.
The duration of HGT can vary, but it does not necessarily mean children will be in the hospital for the entire two to six weeks. Once families learn how to manage the equipment, children typically become comfortable with getting in and out of the stretching apparatus. It's not a painful process. Many patients feel more comfortable and alert with this device. They are less burdened by their spinal deformity, which means their muscles do not have to work as hard to keep them upright. This reduces their energy expenditure, allowing them to be more engaged and less withdrawn, even if they are non-verbal.
HGT is a crucial step before spinal surgery for children with severe spinal deformities like scoliosis. One of the biggest risks during spinal surgery is the tension placed on the spinal cord and nerve roots due to the sudden straightening of the spine. Scoliosis involves multiple contortions of the spine—side to side, front to back and twisting—causing the spinal cord and nerve roots to adapt to these abnormal positions over many years. Correcting these deformities all at once can put significant stress on the spinal cord and sensitive nerves, potentially leading to irreversible injury or paralysis.
HGT provides a more gradual, natural stretching of the spine, allowing the body to slowly adjust to the straightened position. This process helps prime the spine and associated ligaments for the definitive surgical procedure. By gradually stretching and preparing the spine, HGT can allow for better correction during surgery, as the ligaments are loosened and the spine is more flexible. Overall, HGT reduces the potential risk of spinal cord injury by providing a gentler approach to spinal correction, leading to a safer and more effective surgical outcome for the patient.
The wait time until a child is ready for surgery after starting HGT varies and is patient dependent. Each case is unique, influenced by factors such as the severity or stiffness of the scoliosis. Some patients may be ready for surgery in as little as two weeks if their spine responds quickly to the traction. Others may need up to six weeks or more if their spine is stiffer and requires more gradual correction. The medical team closely monitors the patient's progress through regular X-rays. If significant improvement continues, traction may be extended. Traction decisions are made collectively by a team of affiliated surgeons, based on medical experience, the latest medical literature and the individual patient’s response to HGT.
The affiliated HGT team employs a multidisciplinary approach to patient care. Orthopedic surgeons specialize in spinal care, supported by nursing staff who manage protocols, adjust traction setups and monitor patients' neurologic status. Our spine care coordinator facilitates complex cases receiving care in the program.
Additionally, physical and occupational therapists evaluate patients, provide therapy to maintain muscle tone and prepare them for future procedures. They also help patients adjust to their new body positions within the halo gravity setup. This coordinated effort across surgical, nursing, administrative and therapy disciplines provides comprehensive care and enhances outcomes for our patients.
At Children's Memorial Hermann Hospital, our HGT program offers a unique and comprehensive approach to patient care. Our multidisciplinary team works cohesively to care for each child. We integrate both patients and parents them into the treatment process, providing them with the necessary skills and confidence to manage traction adjustments.
Our program is built on the following key elements:
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Children's Memorial Hermann Hospital
6411 Fannin
Houston, TX 77030
Phone: (713) 486-4880
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