[Application of Halo-vest in stable reconstruction of unstable upper cervical spine].
OBJECTIVE
To evaluate the clinical effect of Halo-vest in treatment of unstable upper cervical spine.


METHODS
From March 1997 to October 2002, 16 cases of unstable upper cervical spines were treated and immobilized by Halo-vest, aged from 14 to 53 years. There were 3 cases of isolated Jefferson fractures, 4 cases of isolated Hangman fractures and 1 case of Anderson type I fracture. The 8 cases were immobilized for 3-4 months by Halo-vest. There were 3 cases of old odontoid fractures with dislocations treated by occipitocervical plate fixation and fusion, 1 case of C1 malignant tumor by posterior resection and internal fixation, 2 cases of C2 malignant tumor by anterior resection, fusion, and internal fixation; these cases were immobilized by Halo-vest during surgery. There were 1 case of C2.3 tuberculosis were treated by anterior debridement and fusion, and 1 case of gooseneck deformity by anterior decompression, fusion and screw fixation after resection of C2.7, the 2 cases were immobilized for 3 months by Halo-vest. Of 16 cases, there were 8 cases accompanied with spinal cord syndrome.


RESULTS
Fifteen cases were followed up 6 months to 5 years. Anterior arch ununion and posterior arch osseous healing occurred in 1 case of Jefferson fracture. Other fractures and embedded bones became osseous fusion. One case of C2 malignant tumor recurred 8 months after operation. Spinal cord syndrome of all patients disappeared.


CONCLUSIONS
Halo-vest immobilization is an effective method for conservative treatment and stable reconstruction of unstable upper cervical spine.
Department of Orthopedic and Spinal Surgery, Nanfang Hospital, First Military Medical University, Guangzhou Guangdong 510515, PR China. wjxwsy@yahoo.com
Jixing
J
Wang
Dadi
D
Jin
Jun
J
Yao
Jianting
J
Chen
Jianming
J
Jiang
Dongbin
D
Zhai
D000293:Adolescent; D000328:Adult; D001268:Atlanto-Axial Joint / Q000293:injuries; D001860:Bone Plates; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007103:Immobilization / Q000379:methods; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D016103:Spinal Fractures / Q000145:classification / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*