Halo-Gravity Traction

What Is Halo-Gravity Traction?

Halo-gravity traction is a way to pull the head and spine upward carefully, applying a slow stretch to the spine. Doctors do this by attaching a halo (a metal ring that surrounds the head) to a pulley system. Over several weeks, weights are added to the pulley system to slowly pull the head upward. This pulling is called "traction." Kids stay in the hospital during halo-gravity traction.

Doctors use halo-gravity traction to treat different conditions, including:

• scoliosis and kyphosis (curvature of the spine)
• basilar invagination (where the top of the spine pushes into the skull, pinching the brain and spinal cord)

Why Is Halo-Gravity Traction Done?

For kids with scoliosis or kyphosis, halo-gravity traction is a way to stretch the spine slowly into a straighter position. Doctors usually do it to help a child get ready for a second, bigger surgery, called spinal fusion. This surgery fuses the bones together to hold them in their new, straighter position.

Some children can have spinal fusion surgery without halo traction. But others need it to get ready for surgery because:

• The spine is too stiff or crooked to straighten safely all at once. 
• The bones of the spine are too weak to straighten it safely all at once.
• The nerves around the brain and spinal cord require that the spine be straightened slowly, so they're not damaged or irritated.

How Is the Halo Put On?

A surgeon puts the halo on in a procedure done while a child is under general anesthesia. This means the child sleeps through the surgery. The surgeon attaches the halo with 6–10 small pins. These pins go into the bone and keep the halo from moving.

What Happens After the Halo Is On?

After the halo is on the head, it's attached to a pulley system with weights. Over several weeks, more weights are added. This slowly pulls the head and spine upward and stretches the muscles and ligaments (bands that hold bones together) around the spine.

During this time, special equipment will help a child sleep, sit, walk around, go to the bathroom, and shower.

Is Halo-Gravity Traction Painful?

Kids may have some pain for the first few days of halo-gravity traction or when more weights are added. Medicine can help relax the muscles and control pain.

Although halo-gravity traction can look a little scary, most kids get used to it quickly. They soon realize they can walk, play, and do many of the same things they did before the halo-gravity traction.

Who Is on the Hospital Team for Children With Halo-Gravity Traction?

A care team works together to care for kids with halo-gravity traction. The team will prepare the child and family for the hospital stay, take care of them while in the hospital, and follow up with them after they leave.

The care team can include:

• an orthopedic surgeon (bone doctor)
• a neurosurgeon (brain and spinal cord doctor)
• nurse practitioners and physician assistants
• nurses
• an occupational therapist to help with everyday activities like brushing teeth
• a physical therapist to help with moving around, muscle strength, and flexibility
• Child Life staff trained to work with children and their families to make the hospital stay better

What Happens During the Hospital Stay for Halo-Gravity Traction?

Kids stay in the hospital during halo-gravity traction so that:

• The doctors can check their progress.
• Weights can be added as needed.
• They can get physical therapy (PT) and occupational therapy (OT).

The care team can show them how to:

• Use a special walker and/or a special wheelchair so they can keep the weights attached while moving around.
• Use special equipment to keep the weights attached while going to the bathroom and sleeping.

Kids with halo-gravity traction are up and moving around most of the day. The care team helps kids get into a regular schedule of physical therapy, going for walks, activities, schoolwork, and games. This helps kids stay active and busy while in the hospital.

While in the hospital, kids will need:

• regular X-rays to guide how much weight to add
• nerve checks (done by checking movement and strength) 
• regular cleaning of the pins to prevent skin infections
• PT and OT to help them strengthen their muscles and improve their heart and lung function

Are There Any Risks From Halo-Gravity Traction?

There are risks to any surgery. The care team reviews the risks with families and can answer any questions.

Risks from halo-gravity traction include:

• skin infection around pins (treated with antibiotics)
• pain from pins (treated by pain medicines and, if needed, moving pins)
• nerve injury (usually temporary and treated by removing some of the weights)

What Can Parents Do?

Staying in the hospital for weeks can be tough for kids. If your child is going to have halo-gravity traction, it will help to:

• Talk to your child before you come to the hospital about what will happen. Let them know that after the halo-gravity traction is on, they will be up and moving around and can stay busy with lots of activities.
• Bring activities that your child enjoys, such as favorite games, crafts, music, or movies.
• Bring something comforting from home like a special pillow, stuffed animal, or toy.
• Decorate the hospital room in a fun way.
• Help your child keep up with schoolwork so they feel ready to go back to school.
• Schedule visitors (if possible), video chatting, and phone calls with friends and family to help your child feel connected.
• Work with the Child Life department to find activities to keep your child busy and pass the time.

To help your child continue to heal well at home:

• Take your child to all follow-up care visits.
• Take your child to PT and OT as recommended.
• Help your child get back to the routines of home, school, and activities.