Staged Halo-Pelvic Traction Combined With Posterior Spinal Fusion versus One-Stage Surgery for Severe Rigid Spine Deformity Requiring Three-Column Osteotomy: A Comparative Study

Study design A retrospective cohort study. Objective Severe rigid spine deformity presents major challenges in surgical correction. Although three-column osteotomies (3-CO) provide powerful correction, they are associated with prolonged operative time, increased blood loss, and high neurological risk. This study aimed to compare the radiographic correction, surgical parameters, and complication profiles between staged halo-pelvic traction combined with posterior spinal fusion (HPT+PSF) and one-stage posterior spinal fusion (PSF) in patients with severe rigid spine deformity requiring 3-CO. Methods This retrospective cohort study included 110 patients (mean age, 25.7 ± 8.5 years) with severe rigid deformity (Cobb angle or maximal kyphosis >90°, flexibility