Complications of halo fixation in the elderly

Eric M. Horn, Nicholas Theodore, Iman Feiz-Erfan, Gregory P. Lekovic, Curtis A. Dickman, Volker K.H. Sonntag

Research output: Contribution to journalArticle

48 Scopus citations

Abstract

Object. The risk factors of halo fixation in elderly patients have never been analyzed. The authors therefore retrospectively reviewed data obtained in the treatment of such cases. Methods. A discharge database was searched for patients 70 years of age or older who had undergone placement of a halo device. In a search of cases managed between April 1999 and February 2005, data pertaining to 53 patients (mean age 79.9 years [range 70-97 years]) met these criteria. Forty-one patients were treated for traumatic injuries. Ten patients had deficits ranging from radiculopathy to quadriparesis, and 43 had no neurological deficit. Adequate follow-up material was available in 42 patients (mean treatment duration 91 days). Halo immobilization was the only treatment in 21 patients, and adjunctive surgical fixation was undertaken in the other 21 patients. There were 31 complications in 22 patients: respiratory distress in four patients, dysphagia in six, and pin-related complications in 10. Eight patients died; in two of these cases, the cause of death was clearly unrelated to the halo brace. The other six patients died of respiratory failure and cardiovascular collapse (perioperative mortality rate 14%). Three patients who died had sustained acute trauma and three had undergone surgical stabilization. Conclusions. External halo fixation can be used safely to treat cervical instability in elderly patients. The high complication rate in this population may reflect the significant incidence of underlying disease processes.

Original languageEnglish (US)
Pages (from-to)46-49
Number of pages4
JournalJournal of Neurosurgery: Spine
Volume5
Issue number1
DOIs
StatePublished - Jul 1 2006

Keywords

  • Dysphagia
  • External orthosis
  • Halo vest
  • Spinal cord injury
  • Spinal fracture
  • Spinal instability

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

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    Horn, E. M., Theodore, N., Feiz-Erfan, I., Lekovic, G. P., Dickman, C. A., & Sonntag, V. K. H. (2006). Complications of halo fixation in the elderly. Journal of Neurosurgery: Spine, 5(1), 46-49. https://doi.org/10.3171/spi.2006.5.1.46