Halo-vest for cervical pain in a home care patient with esophageal cancer and cervical spine metastases

Abstract

Halo-vest is usually used temporary to immobilize the cervical spine after surgery or injury. We experienced a good pain relief by halo-vest attachment in one patient with metastatic tumors of cervical spine. Case： A 76-year-old male patient was diagnosed with cervical spine metastases during chemotherapy treatment for lymph node recurrence 7 years after the first surgery for his esophageal cancer. His neck and back pain did not improve even after pain management by analgesics and radiotherapy. He also experienced strong side effects due to opioid treatment. Eventually, he became immobile. Halo-vest was applied solely for the purpose of pain control. Since then, his pain diminished, opioid stopped and his gait recovered. After moving to a hospital close to his home, he was discharged from the hospital. He could stay at home without a severe complication and opioids for 2 months. Discussion： Fixation of the cervical spine with halo-vest might be a good procedure for pain relief in patients with cervical spine metastases. However, since it could also be a stressful treatment and might cause a severe complication, thorough discussion for the use of a halo-vest is mandatory with the patient, family, and orthopedists. Palliat Care Res 2015； 10(3)： 535-38 Key words： halo-vest, bone pain, cervical spine metastases, terminally ill cancer patient, home care