title: Atlas and axis injuries role of Halovest.
abstract: BACKGROUND
  The literature regarding the different patterns of atlas and axis injuries and their appropriate management and the progressive development in the management of these injuries is scarce from our world, so we presenting here our experience of management of these injuries by applying Halovest.
  
  
  METHODS
  Thirty patients (22 males, 8 females) with atlas and axis injuries were treated and then followed-up for an average of 24 months. The data was analysed with respect to type of injury and use of Halovest in the treatment of these injuries. The patients with neuro defecit were scored as per ASIA grading scale (from Grade A to Grade E).
  
  
  RESULTS
  The halo-vest immobilization was used for a mean period of 12 ± 3weeks (range 9 to 15 weeks) for atlas and axis injuries. Four patients had neurodeficit. Two patients recovered from ASIA Grade C to ASIA Grade D. One patient improved from ASIA grade D to ASIA grade E while as one patient with neurodeficit was lost to follow up. No death or worsening of the neurodeficit was observed during the follow up period.
  
  
  CONCLUSIONS
  The clinical as well as radiological outcome of these injuries is mostly satisfactory with the conservative management using Halovest. More studies should be conducted to form the guidelines regarding patient selection for conservative management using halovest.
authors.affiliation: Senior Resident, Postgraduate Department of Orthopaedics GMC SRINAGAR, Email kdryounis@gmail.com.
authors.forename: Younis
authors.initials: Y
authors.lastname: Kamal
authors.affiliation: Senior Resident, Postgraduate Department of Orthopaedics GMC SRINAGAR, Email kdryounis@gmail.com.
authors.forename: M S
authors.initials: MS
authors.lastname: Ortho
authors.affiliation: DNB ortho, Senior Resident, Postgraduate Department of Orthopaedics, GMC SRINAGAR, Email drhayatkhan@gmail.com.
authors.forename: Hayat Ahmad
authors.initials: HA
authors.lastname: Khan
authors.affiliation: Assistant Professor, Postgraduate Department of Orthopaedics, GMC SRINAGAR.
authors.forename: Naseemul
authors.initials: N
authors.lastname: Gani
authors.affiliation: Resident, Postgraduate Department of Orthopaedics, GMC, Jammu.
authors.forename: Ansar Ul
authors.initials: AU
authors.lastname: Haq
authors.affiliation: PGDMCH Scholar, GMC Srinagar, Email snobaryounis@gmail.com.
authors.forename: Snobar
authors.initials: S
authors.lastname: Gul
authors.affiliation: Professor, Postgraduate Department of Orthopaedics, GMC, Jammu.
authors.forename: Dara
authors.initials: D
authors.lastname: Singh
keywords: atlas fracture; axis fracture; halovest; upper cervical spine injuries