[On the problem of halo vest treatment in the elderly. Results of a retrospective analysis].
BACKGROUND
The treatment of unstable cervical spine injuries with the halo vest represents an established procedure. So far no data reflecting the quality of life of patients following a halo vest treatment are available. Elderly people make up a large part of the inpatients in our hospital. Therefore special attention is payed to this group of patients in this study.


METHODS
In this study 41 patients (average age of 51.8 +/- 23.5 years) with an unstable injury of the upper cervical spine were investigated. All of them underwent a halo vest therapy in our hospital during 1988-2003. The health-related quality of life was assessed in the mean 8.0 years after the trauma by using the SF-36 Health Survey. Additionally, the incidence of complications and the union rate over time were observed.


RESULTS
The evaluation of the data obtained from the SF-36 revealed a reduced quality of life in the patient group in comparison to the reference population. This was particularly apparent in patients older than 60 years. The fracture healing under halo vest treatment was comparably slow. In 17% of the cases no fracture union was obtained after 12 weeks. This was only seen for patients older than 60 years. The complication rate associated to the halo vest amounted to 43% and was independent of age.


CONCLUSIONS
The treatment of unstable fractures of the upper cervical spine with a halo vest results in a prolongated fracture healing for elderly people. Furthermore a halo vest therapy reduces the health related quality of life. Therefore, even for elderly patients an internal osteosynthetic stabilization of an unstable injury of the upper cervical spine should be considered if indicated.
Lögters
T
T
Zentrum für Operative Medizin, Klinik und Poliklinik für Unfall-, Hand und Wiederherstellungschirurgie, Universitätsklinikum Hamburg-Eppendorf.
Hoppe
S
S
Linhart
W
W
Habermann
C
C
Windolf
J
J
Rueger
J
J
Briem
D
D
D001416:Back Pain / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D006801:Humans; D007103:Immobilization / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011788:Quality of Life; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000150:complications / Q000175:diagnosis* / Q000534:rehabilitation*; D016896:Treatment Outcome