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Non-operative treatment of injuries of the upper cervical spine: our experience with a new carbon fibre halo system

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Abstract

Fractures of the upper cervical spine account for about 20% of all cervical spinal injuries. Only in a minority of cases a neurological damage occurs. With exception of the type-2-dens fracture the treatment of choice is non-operatively in the halo-thoracic brace. We report about our experience with Bremer® Halo System, an open ring carbon fibre design which especially facilitates the treatment of head injured patients in bed. We treated 13 patients (m/w 9/4), mean ages 40 years (range 18–73) with 10 dens fractures Anderson and d’Alonzo-type III and 3 hangman’s fractures Effendi-type I. Five patients had additional head injury. Two of them were unconscious at the time of application of the halo-device. Our routine follow-up included roentgenograms after halo-application and 6 weeks later. After 3 months CT-scans were performed to evaluate fracture union. After 12–20 weeks the halo-device could be removed. We observed one halo ring loosening in a patient with oversize skull resulting in earlier removal in presence of an already established union. In one case we had a delayed union which eventually united in stiff collar after 6 month. No pin tract infection was observed. All patients returned to their pre-injury activities. A slightly limited rotation of the head was observed in most of the patients. The Bremer® Halo System proved to be a reliable unsophisticated halo system in the treatment of upper cervical spinal injuries. The feature of the open ring design especially facilitates the treatment of an accompanying head injury. We experienced a problem with a limited size of the halo ring.

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References

  1. Anderson LD, D’Alonzo RT (1974) Fractures of the odontoid process of the axis. J Bone Joint Surg Am 56(8):1663–1674

    PubMed  CAS  Google Scholar 

  2. Boran S, Hurson C, Gul R, Higgins T, Poynton AR, OByrne J, McCormack D (2005) Functional outcome following teardrop fracture of the axis. Europ J Orthop Traumatol 15(3):229–232

    Article  Google Scholar 

  3. Dussault RG, Effendi B, Roy D, Cornish B, Laurin CA (1983) Locked facets with fracture of the neural arch of the axis. Spine 8(4):365–367

    Article  PubMed  CAS  Google Scholar 

  4. Effendi B, Roy D, Cornish B, Dussault RG, Laurin CA (1981) Fractures of the ring of the axis. A classification based on the analysis of 131 cases. J Bone Joint Surg Br 63-B(3):319–327

    PubMed  CAS  Google Scholar 

  5. Francis WR, Fielding JW, Hawkins RJ, Pepin J, Hensinger R (1981) Traumatic spondylolisthesis of the axis. J Bone Joint Surg Br 63-B(3):313–318

    PubMed  CAS  Google Scholar 

  6. Hadley MN (2002) Isolated fractures of the axis in adults. Neurosurgery 50(Suppl 3):S125–S139

    Google Scholar 

  7. Junge A, El-Sheik M, Celik I, Gotzen L (2002) Pathomorphology, diagnosis and treatment of “hangman’s fractures” (German). Unfallchirurg 105(9):775–782

    Article  PubMed  CAS  Google Scholar 

  8. Komadina R, Brilej D, Kosanovic M, Vlaovic M (2003) Halo jacket in odontoid fractures type II and III. Arch Orthop Trauma Surg 123(2–3):64–67

    PubMed  Google Scholar 

  9. Korres DS, Papagelopoulos PJ, Petrou HG, Tzagarakis GP, Tritafyllidis P, Tsarouchas J, Koundis G (1999) Combined double fracture of the odontoid process and fracture of the atlas. Europ J Orthop Traumatol 9(3):195–199

    Article  Google Scholar 

  10. Korres DS, Papagelopoulos PJ, Petrou HG, Tzagarakis GP, Tritafyllidis P, Tsarouchas J, Koundis G (2005) Occult fracture-dislocation of the cervical spine. A case report and review of the literature. Europ J Orthop Traumatol 15(1):34–36

    Article  Google Scholar 

  11. Muller EJ, Wick M, Muhr G (2000) Traumatic spondylolisthesis of the axis: treatment rationale based on the stability of the different fracture types. Eur Spine J 9(2):123–128

    Article  PubMed  CAS  Google Scholar 

  12. Schneider RC, Livingson KE, Cave AJE (1965) “Hangman’s fracture” of the cervical spine. J Neurosurgery 22:141–154

    Article  CAS  Google Scholar 

  13. Vaccaro AR, Madigan L, Bauerle WB, Blescia A, Cotler JM (2002) Early halo immobilization of displaced traumatic spondylolisthesis of the axis. Spine 27(20):2229–2233

    Article  PubMed  Google Scholar 

  14. Vieweg U, Schultheiss R (1904) A review of halo vest treatment of upper cervical spine injuries. Arch Orthop Trauma Surg 121(1–2):50–55

    Google Scholar 

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Conflict of interest statement

No funds were received in support of this study. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Munster, Albert-Schweitzer-Str. 33, 48129, Munster, Germany

    J. Schröder & H. Wassmann

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  1. J. Schröder
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  2. H. Wassmann
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Correspondence to J. Schröder.

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Schröder, J., Wassmann, H. Non-operative treatment of injuries of the upper cervical spine: our experience with a new carbon fibre halo system. Eur J Orthop Surg Traumatol 19, 423–426 (2009). https://doi.org/10.1007/s00590-009-0441-y

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  • DOI: https://doi.org/10.1007/s00590-009-0441-y

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