Upper cervical spine injuries: Indications and limits of the conservative management in Halo vest. A systematic review of efficacy and safety

Longo, Umile Giuseppe; Denaro, Luca; Campi, Stefano; Maffulli, Nicola; Denaro, Vincenzo

doi:10.1016/j.injury.2010.09.025

Cited by 71 publications

(59 citation statements)

References 65 publications

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“…Halo-vest orthoses are associated with high rates of complications, and the risk of mortality in the geriatric population is elevated [15][16][17].…”

Section: Nonoperative Managementmentioning

confidence: 99%

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Fractures of the axis: a review of pediatric, adult, and geriatric injuries

Gornet

Kelly

2016

Curr Rev Musculoskelet Med

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Fractures of the second cervical vertebra (C2, axis) are common in adult spine surgery. Those fractures occurring in younger adult patients are often associated with highenergy mechanism trauma, resulting in a "Hangman's Fracture." Management of these fractures is often successful with nonoperative means, though surgery may be needed in those fractures with greater displacement and injury to the C2-C3 disc. Older patients are more likely to sustain fractures of the odontoid process. The evidence supporting surgical management of these fractures is evolving, as there may be a mortality benefit to surgery. Regardless of treatment, longerterm mortality rates are high in this patient population, which should be discussed with the patient and family at the time of injury. Pediatric patients may suffer fractures of the axis, though differentiation of normal and pathologic findings is necessary and more difficult with the skeletally immature spine.

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“…Halo-vest orthoses are associated with high rates of complications, and the risk of mortality in the geriatric population is elevated [15][16][17].…”

Section: Nonoperative Managementmentioning

confidence: 99%

“…The most concerning risk is mortality associated with the halo-vest, which may be as high as 20 % in the geriatric population [17]. In younger patients, halo-vest orthoses are considered to be safer [16]. In the geriatric population, halo-vest immobilization is frequently associated with high mortality rates.…”

Section: Nonoperative Managementmentioning

confidence: 99%

Fractures of the axis: a review of pediatric, adult, and geriatric injuries

Gornet

Kelly

2016

Curr Rev Musculoskelet Med

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“…However, if we cannot acquire a reduction in the displacement, then osteosynthesis should be adapted. Furthermore, we must also consider potential complications (pin site infection, loss of reduction, pressure sores) of wearing an external orthosis for a prolonged duration of time [16]. Longo et al [16] performed a systematic review focusing on the management of upper cervical spine fractures with a halo fixator, and noted that 96 % of the patients showing non-classifiable fractures of C2 (not odontoid fractures or hangman's fractures) demonstrated bony union.…”

Section: Conservative Treatmentmentioning

confidence: 99%

Clinical findings of conservative cases with a coronally oriented vertical fracture of the posterior region of the C2 vertebral body

et al. 2015

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The patients with a coronally oriented vertical fracture of the posterior region of the C2 vertebral body consisted were all elderly males in our study. Six of the eight patients demonstrated associated cervical spinal fractures; however, all patients acquired solid bony union, including fusion of the associated cervical spinal fractures. We suggest that a Philadelphia collar may be sufficient for conservatively treating coronally oriented vertical C2 body fractures, including associated cervical spinal fractures.

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“…The management options include traction followed by immobilization, semirigid immobilization with cervical collar, rigid immobilization with halo, Minerva, sterno-occipito-mandibular immobilizer, posterior C1-2 fusion and anterior odontoid screw fixation [33]. Longo et al [34] in a systematic review on halo immobilization, concluded that halo immobilization is a safe and effective treatment modality in combination injuries. sufficient in most cases (approximate healing in 12 weeks) [35].…”

Section: Combination Fractures Of Atlas and Axismentioning

confidence: 99%

Guidelines on the Management of Atlanto-Axial Fractures in Adults: A Short Review

Viswanathan¹

2018

OPROJ

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Upper cervical spine injuries: Indications and limits of the conservative management in Halo vest. A systematic review of efficacy and safety

Cited by 71 publications

References 65 publications

Fractures of the axis: a review of pediatric, adult, and geriatric injuries

Fractures of the axis: a review of pediatric, adult, and geriatric injuries

Clinical findings of conservative cases with a coronally oriented vertical fracture of the posterior region of the C2 vertebral body

Guidelines on the Management of Atlanto-Axial Fractures in Adults: A Short Review

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