Use of a Noninvasive Halo in Children

Skaggs, David L.; Lerman, Lawrence D.; Albrektson, Josh; Lerman, Max J.; Stewart, David G.; Tolo, Vernon T.

doi:10.1097/brs.0b013e31817d8241

Cited by 12 publications

(8 citation statements)

References 22 publications

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“…Skaggs et al 22 have reported a very low complication rate in their study with pinless halos. In their cohort of 30 patients, only 1 patient developed a complication who had anterior migration of the fibular strut graft following cervical fusion without instrumentation; the fusion healed without further surgical intervention.…”

Section: Discussionmentioning

confidence: 74%

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Pinless Halo in the Pediatric Population

Bakhshi

Kushare

Banskota

et al. 2015

Journal of Pediatric Orthopaedics

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Section: Discussionmentioning

confidence: 74%

“…22 In addition to these indications, we also used the pinless halo for stable occipital condyle fractures, which healed well with the pinless halo. In our cohort, no patients treated with a pinless halo had unstable fractures or unstable cervical fusions.…”

Section: Discussionmentioning

confidence: 99%

Pinless Halo in the Pediatric Population

Bakhshi

Kushare

Banskota

et al. 2015

Journal of Pediatric Orthopaedics

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“…Although commonly used in radiosurgery for the treatment of intracranial lesions this method may not be ideal for fractionated treatments over the course of multiple days. Other attractive options are the use of the Lerman non-invasive halo system [ 29 ] or the cervical-thoracic orthosis (CTO/Minerva brace) [ 30 , 31 ] in combination with the conventional head and shoulder mask for added reinforcement and better immobilization of the lower C-spine. The Lerman halo system has been developed as a non-invasive immobilization system in children.…”

Section: Discussionmentioning

confidence: 99%

Spine Stereotactic Body Radiation Therapy Residual Setup Errors and Intra-Fraction Motion Using the Stereotactic X-Ray Image Guidance Verification System

Yamoah¹,

Zaorsky²,

Siglin³

et al. 2014

IJMPCERO

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Purpose To determine the precision of our institution’s current immobilization devices for spine SBRT, ultimately leading to recommendations for appropriate planning margins. Methods We identified 12 patients (25 treatments) with spinal metastasis treated with spine Stereotactic Body Radiation Therapy (SBRT). The Body-FIX system was used as immobilization device for thoracic (T) and lumbar (L) spine lesions. The head and shoulder mask system was used as immobilization device for cervical (C) spine lesions. Initial patient setup used the infrared positioning system with body markers. Stereotactic X-ray imaging was then performed and correction was made if the initial setup error exceeded predetermined institutional tolerances, 1.5 mm for translation and 2° for rotation. Three additional sets of verification X-rays were obtained pre-, mid-, and post-treatment for all treatments. Results Intrafraction motion regardless of immobilization technique was found to be 1.28 ± 0.57 mm. The mean and standard deviation of the variances along each direction were as follows: Superior-inferior, 0.56 ± 0.39 mm and 0.77 ± 0.52 mm, (p = 0.25); Anterior-posterior, 0.57 ± 0.43 mm and 1.14 ± 0.61 mm, (p = 0.01); Left-right, 0.48 ± 0.34 mm and 0.74 ± 0.40 mm, (p = 0.09) respectively. There was a significantly greater difference in the average 3D variance of the BodyFIX as compared to the head and shoulder mask immobilization system, 1.04 ± 0.46 mm and 1.71 ± 0.52 mm; (p = 0.003) respectively. Conclusions Overall, our institution’s image guidance system using stereotactic X-ray imaging verification provides acceptable localization accuracy as previously defined in the literature. We observed a greater intrafraction motion for the head and shoulder mask as compared with the BodyFIX immobilization system, which may be a result of greater C-spine mobility and/or the suboptimal mask immobilization. Thus, better immobilization techniques for C-spine SBRT are needed to reduce setup error and intrafraction motion. We are currently exploring alternative C-spine immobilization techniques to improve set up accuracy and decrease intrafraction motion during treatment.

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“…Skaggs et al [4] berichten über gute Ergebnisse mit einem sog. noninvasiven Halo, letztlich einem erweiterten Orthesensystem, das den Kopf helmförmig, jedoch mit ausreichenden Freiräumen umfasst.…”

Section: Alternativenunclassified

“…Hierbei sind insbesondere Krankheitsbilder wie die Osteogenesis imperfecta, die fibröse Dysplasie und auch Kinder mit Hydrozephalus zu beachten. Bei diesen Konstellationen ist eine vorherige Abklärung mittels CT notwendig[4]. Arkader et al[8] führen eine solche CT-Abklärung bei allen Kindern unter 3 Jahren durch, um die Dicke der Schädelkalotte und die Suturen sicher beurteilen zu können.…”

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Halo Fixator and Halo Traction – Value for the Treatment of Spinal Disorders in Childhood

et al. 2019

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The application of the Halo fixateur in case of spinal pathologies in childhood is a standardized technique. The halo fixateur may be used for treatment of injuries of the cervical spine, for additional stabilization following extended surgery at the cervical spine and their transitional regions as well as to achieve preoperative reduction in case of severe and rigid deformity. These indications are, referred to the early age, rare. However, the successful use of the Halo fixateur presumes a certain familiarity with the device and experiences regarding the underlying diseases to minimize related risks and to avoid possible complications. In this article the use and specific features regarding the application of the halo fixateur in childhood based on presented cases and the literature will be discussed.

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Use of a Noninvasive Halo in Children

Cited by 12 publications

References 22 publications

Pinless Halo in the Pediatric Population

Pinless Halo in the Pediatric Population

Spine Stereotactic Body Radiation Therapy Residual Setup Errors and Intra-Fraction Motion Using the Stereotactic X-Ray Image Guidance Verification System

Halo Fixator and Halo Traction – Value for the Treatment of Spinal Disorders in Childhood

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