[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.

CONCLUSION

Halo-vest immobilization is an effective method for conservative treatment and stable reconstruction of unstable upper cervical spine.