Türk Nöroşirürji Dergisi 2020 , Vol 30 , Num 3
Use of Halo in Upper and Lower Cervical Traumas; Indications and Problems
Orkhan ALIZADA1,Rahşan KEMERDERE1,Mehmet Murat HANCI1
1İstanbul Üniversitesi - Cerrahpaşa, Cerrahpaşa Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, İstanbul, Türkiye Halo-vest decreases cervical motion by 30% to 96%, providing the most rigid cervical immobilization among all orthoses. Despite decreased use, a halo remains a useful method of stabilizing the cervical spine in adults and children. Halo-vest is most commonly used for definitive treatment of cervical injuries with the appropriate indication, for preoperative reduction in the patient with a spinal deformity, and additional postoperative stabilization after surgery. Highly life-threatening complications such as respiratory distress in the elderly have been reported, but it is unclear whether these complications developed due to halo use or whether they were the result of underlying diseases that existed prior to administration. Improvements in design, materials, and application methods have been instituted recently and new designs have improved biomechanical stability, but these do not appear to reduce the rate of screw loosening and screw entry site infection, the two most common complications. Appreciation of local anatomy, adherence to established application guidelines, and the proper care should minimize pin-related problems. Future efforts may be towards better identification of injury subgroups and appropriate patient characteristics that indicate ideal candidates for successful halo therapy. Despite a paucity of contemporary data, recent retrospective studies have demonstrated acceptable results for halo fixation in managing some cervical spine injuries. Anahtar Kelimeler : Halo-vest, Cervical spine injury, Complication, Fracture, Cervical orthosis