Stabilizing Properties of the Halo Apparatus

Mirza, Sohail K.; Moquin, Ross R.; Anderson, Paul A.; Tencer, Allan F.; Steinmann, John C.; Varnau, David

doi:10.1097/00007632-199704010-00002

Cited by 25 publications

(15 citation statements)

References 13 publications

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“…There are few previous biomechanical studies with which our results may be compared. [21][22][23][24] Mirza et al 21 used the skull-neck-thorax model to study the neck stabilizing properties of a halo-vest using C2 through T2 specimens. Ligaments were transected at C5/6 creating severe instability at this spinal level.…”

Section: Discussionmentioning

confidence: 99%

“…21 The whole cervical spine was anatomically positioned between the plastic skull and the mannequin thorax. The plastic skull was rigidly fixed to the occipital mount, while the T1 mount was rigidly fixed to the mannequin thorax.…”

Section: Skull-neck-thorax Model With the Halo-vestmentioning

confidence: 99%

“…The previous in vitro biomechanical studies have measured motion only at 1 or 2 spinal levels to evaluate the effectiveness of the halo-vest in stabilizing cadaveric neck specimens following simulated injuries. [21][22][23][24] No previous biomechanical studies have determined the three-dimensional intervertebral motion patterns throughout the injured cervical spine in the presence of a halo-vest or studied the effect of halo-vest components on these motions. These data may provide information to the clinician when prescribing the halo-vest based on specific pathological conditions and may be used towards improving halo-vest design.…”

mentioning

confidence: 99%

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Effect of Halo-Vest Components on Stabilizing the Injured Cervical Spine

Ivancic¹,

Beauchman²,

Tweardy³

2009

Spine

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Section: Discussionmentioning

confidence: 99%

Section: Skull-neck-thorax Model With the Halo-vestmentioning

confidence: 99%

mentioning

confidence: 99%

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Effect of Halo-Vest Components on Stabilizing the Injured Cervical Spine

Ivancic¹,

Beauchman²,

Tweardy³

2009

Spine

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“…[4][5][6] Persistent instability seems to be more common in cases with sole halo fixation and was observed more frequently by Mirza et al 7 in lesions of the middle and lower cervical spine. On the other hand, trauma surgery under limited sterile conditions increases the risk of screw or pin track infection.…”

Section: Discussionmentioning

confidence: 99%

Management of a Tetraplegic Patient in a Small Rural Hospital in Uganda

Lederer¹

1999

Academic Emergency Medicine

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“…Through the years, Halo has remained a mainstay in the treatment of different cervical spine pathologies due to its consistent attainment of results. 36,37 Absolute contraindications for the use of Halo orthosis include cranial fracture, infections, and severe soft-tissue injury at the proposed pin sites. Relative contraindications include severe chest trauma, obesity, advanced age, and a barrel-shaped chest.…”

Section: Halo Orthosismentioning

confidence: 99%

Halo-Vesting in Preschool Aged Children with Synchondrosis Fracture: A Case Series which Explores the Current Techniques Associated with this Procedure

Rahimizadeh¹,

Williamson²,

Rahimizadeh³

et al. 2017

Orthop Res Traumatol Open J

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Upper cervical spine injuries are the most common form of spinal cord trauma that occur in preschool children. Among such injuries, odontoid synchondrosis fractures are the most frequently observed, though relatively few cases have been reported in the medical literature. The most appropriate approach to describe such cases is physeal injuries of the basilar synchondrosis plate between the odontoid process and the body of the axis. Acute odontoid synchondrosis fractures are further classified into 3 subtypes based on the amount of dense displacement and the degree of fracture angulation. Type Ic, the most severe subtype, will require a posterior atlantoaxial fixation for an associated atlantoaxial subluxation. The majority of Type Ia and type Ib odontoid synchondrosis fractures that display only mild to moderate dense displacement and angulation, can be adequately addressed through proper fusion. Complete fusion may be achieved through external immobilization after careful alignment is reached by either Minerva Orthosis or the use of a Halo-vest. Regardless of the technique applied, prior to immobilization, acute synchondrosis fractures should be brought together through either neck hyperextension or by using the skull traction procedure. While Minerva orthosis has been effective in the treatment for two case series and a few case reports, the use of Halo-vesting in young children presents challenges due to decreased skull thickness and the presence of a certain amount of soft osseous tissue. For these reasons, a certain level of controversy exists in the medical literature as to whether the use of such a device is warranted. According to the opponents of this practice, Halo-vesting is often a frustrating and anxiety-provoking experience for young patients. They likewise draw attention to the concerns and hospitality anticipated from the caregivers of such children who have been vested. Furthermore, these authors document that Halo orthosis is associated with a higher percentage of complications such as pin site infections, pin loosening or dislodgement, the breakdown of skin, dysphagia, dural tears and even brain abscesses. Conversely, proponents believe that Halo-vesting is a well-tolerated procedure in a majority of children as well as in toddlers. In accordance with this belief, existing evidence demonstrates that with a modification in the pin number, pin design, location of insertion, and insertion torque, the incidence of pin dislodgement and pin loosening may be reduced. Moreover, pin-site infections can be prevented through periodic medical supervision of the child patient as well as educating caregivers on how to properly clean and monitor pin sites. Overall, the number of the children with odontoid synchondrosis fractures, who have been treated with Halo-vesting accounts for roughly 40 cases with a mean percentage of complication rate recorded at 40%. Herein, 3 young children with acute odontoid synchondrosis fractures are reported in whom solid fusion at the synchondrosis plate was achieved t...

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Stabilizing Properties of the Halo Apparatus

Abstract: Increasing vest tightness, decreasing the deformability of the vest, and ensuring a good fit can reduce motion in the fractured spine. Most commercially available halo vests provide similar mechanical stability to the injured cervical spine.

Cited by 25 publications

References 13 publications

Effect of Halo-Vest Components on Stabilizing the Injured Cervical Spine

Effect of Halo-Vest Components on Stabilizing the Injured Cervical Spine

Management of a Tetraplegic Patient in a Small Rural Hospital in Uganda

Halo-Vesting in Preschool Aged Children with Synchondrosis Fracture: A Case Series which Explores the Current Techniques Associated with this Procedure

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