Background/Objectives: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity often requiring surgical correction in severe cases. Halo-gravity traction (HGT) is commonly employed preoperatively to enhance spinal flexibility and reduce curve severity. This study aimed to evaluate the effectiveness of HGT in reducing Cobb angles in AIS and to assess how patient age, skeletal maturity (Risser score), and curve type (Lenke classification) influence treatment response. Methods: We conducted a retrospective cohort study of 28 AIS patients with Cobb angles > 65° who underwent preoperative HGT followed by posterior spinal fusion. Traction was applied for a mean of 24.64 days, reaching 40–50% of each patient’s body weight. Radiographic measurements were collected pre-traction, post-traction, and postoperatively. Statistical analyses included paired t-tests, Pearson correlations, Kruskal–Wallis tests, and linear regression. Results: Mean primary Cobb angle was reduced from 82.46° pre-traction to 61.00° post-traction (26.09% reduction) and further to 29.54° postoperatively (64.58% total reduction). Similar reductions were observed in secondary curves. No statistically significant correlations were found between age or Risser score and the magnitude of correction. Lenke type 3 showed the highest traction response, while type 5 had the greatest surgical gain. Curve type and skeletal maturity did not significantly affect final outcomes. Conclusions: Halo-gravity traction is a safe and effective adjunct in the surgical treatment of severe AIS, achieving substantial Cobb angle reduction. The degree of correction was not significantly influenced by age, Risser score, or curve type, supporting the broad applicability of HGT across adolescent patients.

Background/Objectives: This study aimed to evaluate the effect of preoperative halo-gravity traction (HGT) on surgical outcomes in adolescents with severe idiopathic scoliosis (AIS), comparing posterior spinal fusion (PSF) performed with versus without traction in terms of curve correction, complication rates, and overall surgical efficacy. Methods: A retrospective cohort study was conducted on 46 adolescents (mean age 14.6 ± 1.9 years) with severe AIS (Cobb > 65°) treated at a single tertiary center between 2011 and 2024. Sixteen patients underwent primary PSF, and 30 received preoperative HGT followed by PSF. Radiographic parameters—including Cobb angle and Risser grade—were analyzed pre- and postoperatively. Statistical tests (t-test, Mann–Whitney U, and multivariable linear regression) assessed differences in correction and predictors of outcome, with p < 0.05 considered significant. Results: Baseline characteristics were comparable between groups (mean preoperative Cobb: 83.6° ± 11.2° vs. 83.1° ± 15.6°, p = 0.91). The traction cohort achieved significantly smaller postoperative Cobb angles (30.9° ± 7.8° vs. 42.7° ± 18.9°, p = 0.027), greater absolute correction (52.7° ± 7.4° vs. 40.4° ± 10.5°, p < 0.001), and higher percentage correction (63.3% ± 6.7% vs. 50.0% ± 14.0%, p = 0.002). Regression analysis confirmed HGT as an independent predictor of improved correction (+14.6%, 95% CI +6.9–22.3%, p = 0.00047). No neurological or major complications occurred, and most correction was achieved within the first three weeks of traction. Conclusions: Preoperative halo-gravity traction significantly enhances deformity correction and surgical safety in severe AIS without added morbidity. Most benefit occurs within 21 days, supporting shorter, standardized traction protocols. HGT remains a valuable adjunct for optimizing outcomes in rigid scoliosis prior to posterior spinal fusion.

Osteogenesis imperfecta (OI) is the most common heritable bone-fragility disorder, with type I (non-deforming OI) representing its mildest classical phenotype (historically referred to as Lobstein disease). Intramedullary (IM) rodding is essential for managing recurrent long-bone fractures and progressive deformities, with the Fassier–Duval (FD) telescopic rod now being the standard choice. This narrative review, based on a structured search from the seminal 1959 description of IM rodding to 2026, synthesizes the design principles, the minimally invasive technique and the comparative outcomes of FD rodding of the lower limb, with explicit attention to type I disease. Across cohort studies, comparative series and a recent systematic review, telescopic rods consistently achieve lower revision rates and longer implant survival than static or non-telescopic devices, reducing reoperation odds by roughly three-quarters. Overall complication rates nonetheless remain high (commonly 33–55%) and are dominated by implant migration and failure of telescoping. Younger age and eccentric epiphyseal positioning after incomplete deformity correction increase migration risk. Type-I-specific evidence remains limited. A report published under the “Lobstein” designation involved a Sillence type IV patient and therefore does not constitute type-I-specific evidence. Retrospective data nevertheless suggest favorable implant survival with telescopic fixation, but definitive conclusions cannot yet be drawn. Proper technique, adjunctive bisphosphonate therapy and multidisciplinary care remain decisive. Phenotype-stratified prospective data are the principal unmet need.