The charts of 512 patients were reviewed. These included infection at pin sites, loosening of pins, radiating pain or numbness around pins, pain with mastication, localized discomfort about a pin, residual scars left by pins, and pressure sores beneath the vest or cast. Emphasis was placed on identifying specific complications that resulted from the placement and use of the halo device.
Requirements for inclusion in the study included: (1) a history of continuous treatment with a halo device for a minimum of two weeks, (2) availability of the hospital chart and radiographs, and (3) a minimum follow-up of three months after the halo was removed.
The medical records from the University of California at San Diego and affiliated hospitals and the Rancho Los Amigos Medical Center, Downey, California, of all patients with a diagnosis of fracture, dislocation, or instability of the cervical spine that occurred during the period from 1973 to 1983 were reviewed. The purpose of this study is to evaluate the problems that we have observed. Compared with conventional orthoses, the halo vest or halo body jacket offers more rigid immobilization of the cervical spine, the ability to more precisely position the neck to obtain or maintain cervical alignment, and less interference with mandibular motion and eating.1,7-12,14-17 However, the majority of the reviews in the literature concerning the halo have concentrated on its ease of application, the tolerance of the device by the patient, the degree of immobilization obtained, and its success in maintaining reduction and achieving healing after a fracture or arthrodesis.Īlthough other authors have reported complications in their patients, no prior report has concentrated specifically on the complications that may be associated with use of the halo fixation device. The advantages include early mobilization of the patient and avoidance of the complications associated with prolonged bed rest, psychological benefits to the patient in terms of being able to walk or more fully participate in the rehabilitation program, and a shorter hospital stay. Although it was initially designed to be used after surgery on patients paralyzed by poliomyelitis, its current use is primarily related to spinal trauma or reconstructive procedures on the cervical spine. Since its introduction in 1959 by Perry and Nickel,15 the halo fixation device has become the most common means used to immobilize the unstable cervical spine.
Reprinted with permission from The Journal of Bone and Joint Surgery, Volume 68-A, No. For more information about the Academy please visit our website at You can help expand theĬomplications in the Use of the Halo Fixation Device* Steven R. However, this does not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the Federal Government. Funding for this project was provided by the American Academy of Orthotists and Prosthetists through a grant from the US Department of Education (grant number H235K080004).
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