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Stuedemann A, Huston M, Saddler N, Schwend RM, Anderson J, Pierce E, Koivuniemi-Berg T, Fryatt J, Herman K. Implementing a Halo Gravity Traction Program: A Multidisciplinary Endeavor. Orthop Nurs 2024; 43:202-211. [PMID: 39047271 DOI: 10.1097/nor.0000000000001040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
Halo gravity traction (HGT) is a preoperative modality for children with severe spinal deformity used to optimize spine flexibility and balance while decreasing the likelihood of neurologic injury. HGT is a dependable solution for these challenging spinal deformities. Aligning treatment guidelines and providing resources, education, and training for staff are key components for a successful HGT program. The HGT program at Children's Mercy Hospital was then developed with a systems approach with the holistic goal of multidisciplinary collaboration with physical/occupational therapy, hospital medicine, pulmonology, psychology, nutrition, child life, and complex care management. Education, research, and national collaboration to standardize this therapy should improve patient safety and support quality improvement.
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Affiliation(s)
- Anne Stuedemann
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - Michon Huston
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - Nicolette Saddler
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - Richard M Schwend
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - John Anderson
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - Elizabeth Pierce
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - Tiffany Koivuniemi-Berg
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - Jamie Fryatt
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - Katrina Herman
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
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Shengfa P, Hongyu C, Yu S, Fengshan Z, Li Z, Xin C, Yinze D, Yanbin Z, Feifei Z. Effect of cervical suspensory traction in the treatment of severe cervical kyphotic deformity. Front Surg 2023; 9:1090199. [PMID: 36684247 PMCID: PMC9852755 DOI: 10.3389/fsurg.2022.1090199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 11/28/2022] [Indexed: 01/08/2023] Open
Abstract
Objective This study aimed to investigate a new noninvasive traction method on the treatment of severe cervical kyphotic deformity. Methods The clinical data of patients with severe cervical kyphosis (Cobb > 40°) treated in Peking University Third Hospital from March 2004 to March 2020 were retrospectively summarized. 46 cases were enrolled, comprising 27 males and 19 females. Fifteen patients underwent skull traction, and 31 patients underwent suspensory traction. Among them, seven used combined traction after one week of suspensory traction. Bedside lateral radiographs were taken every two or three days during traction. The cervical kyphosis angle was measured on lateral radiographs in and extended position at each point in time. The correction rate and evaluated Japanese Orthopedic Association (JOA) scoring for the function of the spinal cord were also measured. The data before and after the operation were compared with paired sample t-test or Wilcoxon signed-rank test. Results No neurological deterioration occurred during the skull traction and the cervical suspensory traction. There were 12 patients with normal neurological function, and the JOA score of the other 34 patients improved from 11.5 ± 2.8 to 15.4 ± 1.8 at the end of follow up (P < 0.05). The average kyphotic Cobb angle was 66.1° ± 25.2, 28.7° ± 20.1 and 17.4° ± 25.7 pre-traction, pre-operative, and at the final follow-up, respectively (P < 0.05). The average correction rate of skull traction and suspensory traction was 34.2% and 60.6% respectively. Among these, the correction rate of patients with simple suspensory traction was 69.3%. For patients with a correction rate of less than 40% by suspensory traction, combined traction was continued, and the correction rates after suspensory traction and combined traction were 30.7% and 67.1% respectively. Conclusions Pre-correction by cervical suspensory traction can achieve good results for severe cervical kyphotic deformity, with no wound and an easy process. Combined traction is effective for supplemental traction after suspensory traction.
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Affiliation(s)
- Pan Shengfa
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China,Beijing Key Laboratory of Spinal Disease Research, Beijing, China
| | - Chen Hongyu
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China,Beijing Key Laboratory of Spinal Disease Research, Beijing, China
| | - Sun Yu
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China,Beijing Key Laboratory of Spinal Disease Research, Beijing, China
| | - Zhang Fengshan
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China,Beijing Key Laboratory of Spinal Disease Research, Beijing, China
| | - Zhang Li
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China,Beijing Key Laboratory of Spinal Disease Research, Beijing, China
| | - Chen Xin
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China,Beijing Key Laboratory of Spinal Disease Research, Beijing, China
| | - Diao Yinze
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China,Beijing Key Laboratory of Spinal Disease Research, Beijing, China
| | - Zhao Yanbin
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China,Beijing Key Laboratory of Spinal Disease Research, Beijing, China
| | - Zhou Feifei
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China,Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China,Beijing Key Laboratory of Spinal Disease Research, Beijing, China,Correspondence: Zhou Feifei
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Abu-Bonsrah N, Dada OE, Haizel-Cobbina J, Ukachukwu A, Spann M, Adu KO, Banson M, Bandoh D, Sarpong K, Dadey D, Ametefe M, Kanmounye US, Totimeh T, Groves ML. Understanding the Ghanaian Neurosurgical Literature: A Scoping Review and Bibliometric Analysis. World Neurosurg 2023; 169:12-19. [PMID: 36265747 DOI: 10.1016/j.wneu.2022.10.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Research serves to bolster clinical neurosurgery by critically assessing various disease pathologies, while identifying important challenges and opportunities. However, there is limited information on the landscape of the Ghanaian neurosurgical literature. METHODS A scoping review and bibliometric analysis was conducted in accordance with PRISMA guidelines. PubMed, Embase, Global Index Medicus, and Web of Science electronic databases were searched from inception until December 21, 2021 for English language articles about neurosurgery in Ghana. RESULTS 927 articles were identified and 66 were ultimately included in the analysis. A majority of them, 42.4%, were retrospective cohort studies, with 62.1% published after 2010. There were no randomized controlled or basic science studies. Most articles were published in the West African Journal of Medicine (24.2%) and non-infectious/non-traumatic spinal pathology was the most commonly discussed topic (22.7%); 66.7% of articles included only authors affiliated with Ghanaian institutions, and international collaborators frequently originated from the United States (15.9%). Only 22.7% of the manuscripts reported a funding source. Commonly reported challenges included limited sample sizes, delays in diagnosis and treatment, and lack of proper diagnostic tools and specialized care. CONCLUSIONS This review revealed that while the Ghanaian academic neurosurgery output has been increasing over time, these have been limited to cohort studies largely assessing spine pathology. The Ghanaian neurosurgical research environment may be bolstered by an increase in research funding, the establishment of longitudinal clinical databases, training in research methodology, increased incentives for researchers, strengthening of research collaborative networks, and increased engagement of neurosurgical trainees in research.
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Affiliation(s)
- Nancy Abu-Bonsrah
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.
| | | | - Joseline Haizel-Cobbina
- Vanderbilt Institute of Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Alvan Ukachukwu
- Duke Global Neurosurgery and Neurology, Duke Hospital Department of Neurosurgery, Durham, North Carolina, USA
| | - Marcus Spann
- Informationist Services, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Kojo Okyere Adu
- Department of Internal Medicine, LEKMA Hospital, Accra, Ghana
| | - Mabel Banson
- Department of Neurosurgery, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Dickson Bandoh
- Department of Neurosurgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Kwadwo Sarpong
- Department of Neurosurgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - David Dadey
- Department of Neurosurgery, Stanford University School of Medicine, San Francisco, California, USA
| | - Mawuli Ametefe
- Department of Neurosurgery, Korle-Bu Teaching Hospital, Accra, Ghana
| | | | - Teddy Totimeh
- Department of Neurosurgery, University of Ghana Medical Center, Accra, Ghana
| | - Mari L Groves
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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