gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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

Meeting Abstract

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  • corresponding author Johannes Schröder - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster, Münster
  • H. Wassmann - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Münster, Münster

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocP 14.145

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0429.shtml

Published: April 23, 2004

© 2004 Schröder et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

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.