Halo-pelvic Traction

Tuberculosis of the spine and poliomyelitis resulting in severe spinal deformities were common in Hong Kong in the 1950s. Dr. Arthur Hodgson, then head of the Orthopaedic and Trauma Unit, University of Hong Kong and his team introduced the halo-pelvic apparatus for immobilization and correction of severe and rigid kyphosis or kyphoscoliosis in the 1970s. The “Halo”, a metal ring, was secured with four screws into the outer dipole of the skull while the pelvic ring was secured to the two halves of the pelvis by two threaded pins that traverse the whole length of the two halves of the pelvis. The patient also had to remain in bed during traction. With this device, controlled distraction was made while the patient was awake and ambulant. Because the distraction forces along the spinal cord are powerful, complications such as injuries to cranial nerves, compression of the spine and even “coning” of the medulla oblongata through the foramen magnum, could arise. With improvements in public health especially in infectious diseases control and school screening programmes for spinal abnormalities, severe deformities requiring traction or surgery are becoming rare.