Halo Vest treatment of upper cervical vertebral fracture

Year 2013, Volume: 4 Issue: 2, 171 - 174, 01.06.2013

Ergün Karavelioğlu Adem Aslan Olcay Eser İhsan Canbek

https://doi.org/10.5799/ahinjs.01.2013.02.0259

Abstract

Objective: In this study we aimed to investigate the ef­ficacy, long term result and associated complications of Halo Vest treatment for patients with upper cervical spine fractures. Methods: This study included 13 patients (11 men and 2 women) who applied Halo Vest treatment for traumatic upper cervical vertebral fracture between 2006 and 2011. We reviewed the radiological and clinical findings of pa­tients before and after the treatment. Results: Six of 13 patients had odontoid type 3 fracture, 2 patients had odontoid type 2 fracture with C1 type 1 fracture, 2 patients had odontoid type 2 fracture with Jef­ferson fracture, one patient had type 2 hangman fracture and two patients had unclassified C2 corpus fractures. The mean follow-up time with Halo Vest was 14 weeks (10-21 weeks). Ten patients had bone fusion and the mean time of bone fusion was 12 weeks. Conclusions: Halo Vest treatment for upper cervical spine fracture is a safe and effective method but the pa­tients comfort and satisfaction are low. J Clin Exp Invest 2013; 4 (2): 171-174

Keywords

Atlas fracture, odontoid fracture, halo vest

Üst servikal vertebra fraktürlerinde Halo Vest uygulaması

Abstract

Amaç: Bu çalışmada üst servikal vertebra fraktürü nede­niyle cerrahi uygulanmayan hastalarda Halo Vest uygu­lamasının etkinliğini, uzun dönem sonuçlarını, eşlik eden komplikasyonlarını ve hasta memnuniyetini araştırdık. Yöntemler: 2006-2011 yılları arasında travma sonrası üst servikal vertebra fraktürü nedeniyle kliniğimizde Halo Vest uygulanan 11\'i erkek 2\'si bayan toplam 13 hasta ça­lışmaya alınmıştır. Hastaların işlem öncesi ve sonrası kli­nik ve radyoljik bulguları da analiz edilmiştir. Bulgular: Halo Vest uygulanan 13 hastanın 6 tanesinde izole odontoid Tip 3 kırığı, 2 tanesinde odontoid Tip 2 ve C1 Tip 1 kırığı, 2 tanesinde odontoid Tip 2 ve Jefferson kırığı, 1 tanesinde Tip 2 asılmış adam kırığı ve 2 tane­sinde de sınıflandırılamayan C2 korpus kırığı mevcuttu. Hastalar Halo Vest immobilizasyon ile ortalama 14 hafta (10-21 hafta) takip edilmiştir. 10 hastada füzyon gelişmiş olup ortalama süre 12 haftaydı. Sonuç: Üst servikal vertebra fraktürlerinde Halo Vest uy­gulaması güvenilir ve etkili bir tedavi yöntemi olmakla bir­likte, hasta konforu ve memnuniyeti düşüktür.

Keywords

Atlas kırığı, odontoid kırığı, halo vest

References

• Shin JJ, Kim SJ, Kim TH, et al. Optimal use of the halo- vest orthosis for upper cervical spine injuries. Yonsei Med J 2010;51:648-652.
• Longo UG, Denaro L, Campi S, et al. Upper cervical spine injuries: indications and limits of the conserva- tive management in Halo vest. A systematic review of efficacy and safety. Injury 2010;41:1127-1135.
• likasyonlar; çivi gevşemesi ve yer değiştirmesi, çivi
• yerinde enfeksiyon ve penetresyon,, Halo Vest’in
• Dickman CA, Hadley MN, Browner C, Sonntag VK. Neurosurgical management of acute atlas-axis com- bination fractures. A review of 25 cases. J Neurosur- gery 1989;70:45-49.
• Perry J, Nickel VL. Total cervical fusion for neck paraly- sis. J Bone Joint Surg 1959;41:37-60.
• Lauweryns P. Role of conservative treatment of cervi- cal spine injuries. Eur Spine J 2010;19 (Suppl 1):523- 526.
• Glaser JA, Whitehill R, Stamp WG, Jane JA. Complica- tions associated with the halo-vest. A review of 245 cases. J Neurosurg 1986;65:762-769.
• Guiot B, Fessler RG. Complex atlantoaxial fractures. J Neurosurg 1999;91:139-143.
• Kim DH, Vaccaro AR, Affonso J, et al. Early predictive value of supine and upright X-ray films of odontoid fractures treated with halo-vest immobilization. Spine J 2008;8:612-618.
• Ochoa G. Surgical management of odontoid fractures. Injury 2005;36 Suppl 2:B54-64.
• Rockswold GL, Bergman TA, Ford SE. Halo immo- bilization and surgical fusion: relative indications and effectiveness in the treatment of 140 cervical spine injuries. J Trauma 1990;30:893-898.
• Majercik S, Tashjian RZ, Biffl WL, et al. Halo vest im- mobilization in the elderly: a death sentence? J Trau- ma 2005;59:350-356.
• Vieweg U, Schultheiss R. A review of halo vest treat- ment of upper cervical spine injuries. Arch Orthop Trauma Surg 2001;121:50-55.
• Garfin SR, Botte MJ, Waters RL, Nickel VL. Compli- cations in the use of the halo fixation device. J Bone Joint Surg Am 1986;68:320-325.
• Lind B, Sihlbom H, Nordwall A. Halo-vest treatment of unstable traumatic cervical spine injuries. Spine (Phila Pa 1976) 1988;13:425-432.
• Nickel VL, Perry J, Garrett A, Heppenstall M. The halo. A spinal skeletal traction fixation device. J Bone Joint Surg Am 1968;50:1400-1409.
• Houtkin S, Levine DB. The halo yoke: a simplified de- vice for attachment of the halo to a body cast. J Bone Joint Surg Am 1972;54:881-883.
• Bransford RJ, Stevens DW, Uyeji S, et al. Halo Vest treatment of cervical spine injuries. Spine 2009;34:1561-1566.
• Dormans JP, Criscitiello AA, Davidson RS. Complica
• tions in children managed with immobilization in a Halo
• Vest. J Bone Joint Surg 1995;77-A:1370-1373.