[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.
Wang
Jixing
J
Department of Orthopedic and Spinal Surgery, Nanfang Hospital, First Military Medical University, Guangzhou Guangdong 510515, PR China. wjxwsy@yahoo.com
Jin
Dadi
D
Yao
Jun
J
Chen
Jianting
J
Jiang
Jianming
J
Zhai
Dongbin
D
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*