Conservative treatment of upper cervical spine injuries with the halo vest: an appropriate option for all patients independent of their age?
OBJECTIVE
Most upper cervical spine injuries are able to heal conservatively by halo vest application. The acceptance of the halo is different among patients due to the weight of the apparatus and the limited mobility it causes. Additionally, the fracture healing rate in older patients seems to be inferior to that in younger patients, which would make an operative stabilization procedure more appropriate for the elderly. Furthermore, the risk of complications is assumed to be higher in older people. The purpose of this retrospective study was to find out if there are differences in the clinical and radiological results and in complication rates between 2 patient groups with upper cervical spine injuries and halo vest treatment with special interest of their age group.


METHODS
A total of 29 patients with upper cervical spine injuries were treated by halo vest application. The clinical and radiological results and the complication and revision surgery rates were identified. Patients were divided into 2 groups (18 patients were < 65 years and 11 were > 65 years), and the results were evaluated to examine whether there were any differences.


RESULTS
The clinical and radiological results and the complication rate were not statistically significantly different between the 2 patient groups; however, there was a tendency for a longer time interval for fracture healing and more complications in the elderly people.


CONCLUSIONS
If the conditions for conservative treatment of upper cervical spine injuries with halo fixation are right, the clinical and radiological results are good and almost similar in patients regardless of their age, although there is a tendency for more complications in older people.
Daentzer
Dorothea
D
Orthopedic Department, Hannover Medical School, Hannover, Germany. d.daentzer@t-online.de
Flörkemeier
Thilo
T
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001368:Axis, Cervical Vertebra / Q000000981:diagnostic imaging / Q000293:injuries*; D001270:Cervical Atlas / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices / Q000009:adverse effects / Q000706:statistics & numerical data; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult