1524. Complications related to immobilization of cervical spine fractures with a halo vest  

Authors: Nikolay L. Martirosyan, MD; Mauricio Avila, MD; Travis Dumont, MD; R Hurlbert, MD, PhD (Tucson, AZ)

Introduction. The halo immobilization commonly used for a variety of cervical spine injuries. Here we review a case series of patients with cervical spine trauma to determine halo related complications.  


Methods. All patients with cervical spine injuries managed with halo immobilization over a 10-year period. Patients’ medical records were accessed to determine the type of injury, length of halo immobilization, complication profile, outcome.


 Results. Total of 39 patients (23 males) were identified with a mean age of 41 years (12-81 years). 30 sustained their injury after traffic accidents, 5 after fall. There were 11 (28%) C2 hangman’s type fractures, 11 (28%) type II-III odontoid fractures, 7 (18%) complex C1-2 fractures, 4 (10%) C1 Jefferson fractures. Halo was applied in average within 1 day after injury and stayed on for an average of 106 days (range of 27-300). 18 (46%) patients had pin site infection and 7 (18%) required the short antibiotic course. Only 5 (13%) required halo removal due to infection and transition to another type of brace. 18 (46%) patients had pin loosening in average after 1.5 months of halo application, which required repositioning of the pin. 2 (5%) developed pressure sores from the halo vest. Average follow up was 8 months (range 3-19). 32 (82%) patients had fractured healed with halo, 5 (13%) developed stable pseudoarthrosis and 2 (5%) did not heal and required surgical stabilization.


Conclusions. Halo provides a certain degree of discomfort for patients, however it allows for motion preservation after the injury is healed. Despite multiple pin site complications, most of them were self-limited and did not affect fracture healing.