Clinical Analysis of the Result of Halo Immobilization Versus Surgical Fusion in the Management of Traumatic Cerical Spine Injury

ABSTRACT

In the mamagement of cervical spine injuries, it is difficult to determine when to use halo immobilization alone, surgical fusion alone or a combination of the two. To investigate the appropriate condition and relative effectiveness of the treatment of cervical spine injuries, a 3-year retrospective analysis was conducted. During this study the authors reviewed the medical records and X-rays of 46 patients with cervical spine injuries treated with either halo immobilization or surgical fusion. Eighteen patients were treated with the initial surgical fusion, yielding a fusion failure rate of 22%. On the other hand, the remaining 28 patients were initially treated with the halo immobilization, yielding a fusion failure rate of 35%. The main fracture types in patients that require surgical fusion after failure with halo immobilization were hyperflexion anterior subluxation and locked facet injuries. From these findings, we concluded that halo immobilization of hyperflexion anterior subluxation injury and unilateral or bilateral locked facet results in relatively high failure rates and therefore treatment by initial surgical fusion should be the method of choice. Close monitoring is mandatory following halo vest with any type of fracture and level.