Artikel
Conservative treatment of injuries of the upper cervical spine – our experience with the Bremer® Halo System
Konservative Behandlung von Verletzungen der oberen Halswirbelsäule - unsere Erfahrung mit dem Bremer®-Halo-System
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Autoren
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Johannes Schröder
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster, Münster
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H. Wassmann
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster, Münster
| Veröffentlicht: | 23. April 2004 |
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Gliederung
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Objective
Fractures of the upper cervical spine account for about 20% of all cervical spinal injuries. Only in a minority of cases will neurological damage occur. With the exception of the type-2-dens fracture, the treatment of choice is nonoperative in the Halo-thoracic brace. We report on our experience with the Bremer® Halo System, an open ring carbon fibre design which facilitates the treatment of head injured patients in bed.
Methods
We treated 10 patients (m/w 8/2), mean ages 39 years (range 19 - 73) with 8 dens fractures Anderson&D‘Alonzo- type III and two hangman‘s fractures Effendi- type I. Five patients had additional head injuries. Two of them were unconscious at the time of application of the halo device. Our routine follow-up included roentgenogramms after halo-application and repeat X-rays 6 weeks later. After 3 months, CT-scans were performed to evaluate fracture union.
Results
After 12-20 weeks the halo-device could be removed. We observed one halo ring loosening in a patient with a oversize skull resulting in earlier removal in the presence of an already established union. In one case we had a delayed union which eventually united in stiff collar after 6 months. 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.
Conclusions
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 facilitates the treatment of an accompanying head injury. However we experienced a problem with a limited size of the halo ring.
