Shin, Jun Jae
(Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.)
,
Kim, Sang Jin
(Department of Neurosurgery, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.)
,
Kim, Tae Hong
(Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.)
,
Shin, Hyung Shik
(Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.)
,
Hwang, Yong Soon
(Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.)
,
Park, Sang Keun
(Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.)
PurposeUpper cervical fractures can heal with conservative treatments such as halo-vest immobilization (HVI) and Minerva jackets without surgery. The most rigid of these, HVI, remains the most frequently used treatment in many centers despite its relatively high frequency of orthosis-related complic...
PurposeUpper cervical fractures can heal with conservative treatments such as halo-vest immobilization (HVI) and Minerva jackets without surgery. The most rigid of these, HVI, remains the most frequently used treatment in many centers despite its relatively high frequency of orthosis-related complications. We conducted this study to investigate the clinical outcome, effectiveness, patient satisfaction, and associated complications of HVI.Materials and MethodsFrom April 1997 to December 2008, we treated 23 patients for upper cervical spinal injuries with HVI. For analysis, we divided high cervical fractures into four groups, including C1 fracture, C2 dens fracture, C2 hangman's fracture, and C1-2 associated fracture. We evaluated the clinical outcome, complications, and patient satisfaction through chart reviews and a telephone questionnaire.ResultsThe healing rate for upper cervical fracture using HVI was 60.9%. In most cases, bony healing occurred within 16 weeks. Older patients required longer fusion time. We observed a 39.1% failure rate, and 60.9% of patients experienced complications. The most common complications were frequent pin loosening (34.8%; 8/23) and pin site infection (17.4%; 4/23). The HVI treatment failed in 66.7% of patients with pin site problems. The patient approval rate was 31.6%.ConclusionThe HVI produced frequent complications and low patient satisfaction. Bony fusion succeeded in 60.9% of patients. Pin site complications showed a tendency to influence the outcome of HVI, and would be promptly addressed to prevent treatment failure if they develop. The decision to use HVI requires an explanation to the patient of potential complications and constant vigilance to prevent such complications and unsatisfactory outcomes.
PurposeUpper cervical fractures can heal with conservative treatments such as halo-vest immobilization (HVI) and Minerva jackets without surgery. The most rigid of these, HVI, remains the most frequently used treatment in many centers despite its relatively high frequency of orthosis-related complications. We conducted this study to investigate the clinical outcome, effectiveness, patient satisfaction, and associated complications of HVI.Materials and MethodsFrom April 1997 to December 2008, we treated 23 patients for upper cervical spinal injuries with HVI. For analysis, we divided high cervical fractures into four groups, including C1 fracture, C2 dens fracture, C2 hangman's fracture, and C1-2 associated fracture. We evaluated the clinical outcome, complications, and patient satisfaction through chart reviews and a telephone questionnaire.ResultsThe healing rate for upper cervical fracture using HVI was 60.9%. In most cases, bony healing occurred within 16 weeks. Older patients required longer fusion time. We observed a 39.1% failure rate, and 60.9% of patients experienced complications. The most common complications were frequent pin loosening (34.8%; 8/23) and pin site infection (17.4%; 4/23). The HVI treatment failed in 66.7% of patients with pin site problems. The patient approval rate was 31.6%.ConclusionThe HVI produced frequent complications and low patient satisfaction. Bony fusion succeeded in 60.9% of patients. Pin site complications showed a tendency to influence the outcome of HVI, and would be promptly addressed to prevent treatment failure if they develop. The decision to use HVI requires an explanation to the patient of potential complications and constant vigilance to prevent such complications and unsatisfactory outcomes.
7 Kim DH Vaccaro AR Affonso J Jenis L Hilibrand AS Albert TJ Early predictive value of supine and upright X-ray films of odontoid fractures treated with halo-vest immobilization Spine J 2008 8 612 618 17606411
8 Ochoa G Surgical management of odontoid fractures Injury 2005 36 Suppl 2 B54 B64 15993118
9 Rockswold GL Bergman TA Ford SE Halo immobilization and surgical fusion: relative indications and effectiveness in the treatment of 140 cervical spine injuries J Trauma 1990 30 893 898 2381008
10 Majercik S Tashjian RZ Biffl WL Harrington DT Cioffi WG Halo vest immobilization in the elderly: a death sentence? J Trauma 2005 59 350 356 16294074
11 Houtkin S Levine DB The halo yoke: a simplified device for attachment of the halo to a body cast J Bone Joint Surg Am 1972 54 881 883 5055177
12 Daentzer D Flörkemeier T Conservative treatment of upper cervical spine injuries with the halo vest: an appropriate option for all patients independent of their age? J Neurosurg Spine 2009 10 543 550 19558286
13 Bransford RJ Stevens DW Uyeji S Bellabarba C Chapman JR Halo vest treatment of cervical spine injuries: a success and survivorship analysis Spine (Phila Pa 1976) 2009 34 1561 1566 19521274
14 Vieweg U Schultheiss R A review of halo vest treatment of upper cervical spine injuries Arch Orthop Trauma Surg 2001 121 50 55 11195118
15 Fabris Monterumici DA Sinigaglia R Long term results of halo-vest fixation for upper cervical spine fractures Chir Narzadow Ruchu Ortop Pol 2007 72 71 79 17639921
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