Diplopia and tongue deviation following halo-pelvic traction for severe congenital scoliosis: a case report

Objective: To report a case of diplopia and tongue deviation following halo-pelvic traction (HPT) in a patient with severe congenital scoliosis (CS) and to analyze the potential causes. Methods: A retrospective analysis of the patient's clinical data was conducted, including medical history, physical examination, imaging findings, treatment course, and outcomes. Results: A 12-year-old female with CS was admitted. After 40 days of traction (with a total longitudinal lengthening of approximately 12 cm), she developed painless horizontal diplopia and leftward deviation of the protruded tongue. Physical examination revealed limited abduction of the left eye and leftward deviation of the protruded tongue. Traction was discontinued, and neurotrophic therapy (including corticosteroids, mecobalamin, and B-complex vitamins) was initiated. Symptoms gradually resolved within 50 days, with complete resolution of diplopia and normalized tongue protrusion. Conclusion: Early recognition and discontinuation of traction, combined with multimodal therapy, may prevent permanent cranial nerve injury in patients undergoing HPT.