Incidence of Complications Associated with Reconditioned Halo-Vest Immobilization at Siriraj Hospital-Thailand’s Largest National Tertiary Referral Center
Chavasiri C, MD1, Chotivichit A, MD1, Wilartratsami S, MD1, Ruangchainikom M, MD1, Korwutthikulrangsri E, MD1, Luksanapruksa P, MD1
Affiliation : 1 Siriraj Spinal Unit, Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Halo-vest is an effective and high-cost immobilization modality in patients that experience trauma of the cervical
spine. To make this device available to more patients that may not be able to afford this modality, the authors refitted used halo-vests
to create what has been termed reconditioned halo-vest (RHV). The rate of complications associated with the use of the RHV is not
known.
Objective : To investigate the incidence of complications associated with RHV immobilization at Siriraj Hospital-Thailand’s largest
national tertiary referral center.
Materials and Methods : Cervical trauma patients treated with RHV immobilization at the Siriraj Spinal Unit during the February
1995 to December 2016 study period were included. A standardized chart and radiographic review protocol was developed to
identify complications associated with the use of the RHV. Radiographs and patient records were retrospectively reviewed and
analyzed.
Results : Seventy-one patients (52 men and 19 women) with an average age of 45 years (range: 16 to 86) were included. RHV
immobilization was used as a definite treatment in 49 (69.0%) patients, and in conjunction with surgical intervention in 22 (31.0%)
patients. The average period of RHV use was 69.8 days. No major complications (death or pneumonia) were observed in any study
patient. Fourteen (19.7%) minor complications developed, including pin site loosening in 5 (7.0%) patients, infection in 5 (7.0%)
patients, stress/depression in 2 (2.8%) patients, pressure sore under the body vest in 1 (1.4%) patient, and prolonged pin site pain
in 1 (1.4%) patient.
Conclusion : RHV immobilization was shown to be a viable treatment modality in selected patients. Of the 71 patients that were
treated with RHV immobilization for cervical trauma, there were no major complications and 14 minor complications, including
pin site loosening and infection. The observed rate of complications in this study was low compared to the rates reported from
many other studies.
Keywords : Incidence, Complications, Halo-vest immobilization, Cervical spine, Trauma
