LAUSR

STUDY DESIGN Description of technique. OBJECTIVES Describes the redesign of free-weight-based halo gravity traction wheelchairs and walkers to a spring-based system. The treatment of severe pediatric spinal deformities is challenging and associated with significant morbidity. Halo gravity traction (HGT) can be utilized to assist in the correction of severe spinal deformities. A time period of traction may also be used to medically optimize patients prior to surgery. Implementing HGT therapy requires specialized equipment, specially trained hospital staff, as well as significant commitment from caregivers. This study describes the transition from a free weight-based HGT equipment to a spring-based weight system. The new system is expected to decrease the burden of care and improve safety for patients and their families. METHODS A thorough interview process was carried out to gather data on existing HGT systems. All stakeholders, including orthopedic technicians, nurses, surgeons, patients and their families were asked questions on how to improve the equipment and process. With colleagues at a partner children's hospital, new HGT wheelchairs and walkers with a spring-based weight system were designed and built. RESULTS Spring-based weight HGT wheelchairs and walkers are more economical to build, safer, and easier to operate than free-weight-based systems. A cost analysis found that spring-based systems cost $780 less compared to free weight-based systems. In addition, the new spring-based wheelchairs and walkers are about 50% lighter with improved weight distribution making them safer to operate and easier to transport. There is consensus among surgeons, nurses, and families that the redesigned units are easier to operate. CONCLUSIONS Spring-based weight HGT systems are economically viable and clinically effective for pre-operative traction for children with severe spinal deformities. They are well tolerated by patients and easy to care for by nursing and surgical staff. LEVELS OF EVIDENCE III.