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 with the halo vest - A comparative study between patients younger and older than 65 years

Konservative Behandlung bei Verletzungen der oberen HWS mit dem Halo-Fixateur – eine vergleichende Untersuchung zwischen Patienten jünger und älter als 65 Jahre

Meeting Abstract

Suche in Medline nach

  • corresponding author Dorothea Daentzer - Neurochirurgische Klinik der Justus-Liebig-Universität, Klinikstraße 29, 35392 Gießen
  • H. Mewes - Neurochirurgische Klinik der Justus-Liebig-Universität, Klinikstraße 29, 35392 Gießen
  • M. Winking - Neurochirurgische Klinik der Justus-Liebig-Universität, Klinikstraße 29, 35392 Gießen
  • D.-K. Böker - Neurochirurgische Klinik der Justus-Liebig-Universität, Klinikstraße 29, 35392 Gießen

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. DocDI.03.01

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0167.shtml

Veröffentlicht: 23. April 2004

© 2004 Daentzer et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Many injuries of the upper cervical spine are appropriate to heal with conservative treatment after application of a halo vest for rigid external stabilization. The acceptance of the halo is different among the patients, because some patients suffer from the weight of the apparatus and the limitations in mobility. In contrast, possible complications of the alternative treatment with operation are avoided which is important in the older patient. The purpose of the following study is to find out if there are any differences in the results, complications, and acceptance of the halo vest in patients younger and older than 65 years.

Methods

Between 12/1999 and 11/2003 29 patients with injuries of the upper cervical spine were conservatively treated by application of a halo vest. 15 patients were female, 14 were male. The mean age was 54 years (17,9-82,6 years). 18 patients were younger than 65 years (mean 41 years), and 11 patients were older than 65 years (mean 75,4 years). The diagnosis among all patients were the following: 9 atlas fractures, 11 odontoid fractures, 9 axis fractures, 4 hangman`s fractures. 6 patients had a combination of C1- and C2-fractures. All patients had regular clinical and radiological examinations. The halo vest was removed after bony healing of the injured vertebrae.

Results

Most of the patients had good acceptance of the halo vest. A complete bony healing of the fractured vertebrae occured in 25 patients after a mean time of 14,3 weeks (8,9-19,7 weeks) without any difference among the patients younger and older than 65 years. 4 patients (2 patients younger and 2 patients older than 65 years) developed a pseudarthrosis and were operated on by a dorsal approach with stabilization procedure. Other complications were 7 superficial pin infections, 2 screw loosenings, and 1 decubitus under the halo vest. Revision surgery was performed by 3 new positioning of screws, 2 screw removals, and 1 plastic covering of a decubitus. There were no differences in the clinical and radiological results, the complication and revision surgery rate, and the acceptance of the halo vest among the patients in dependence of their age.

Conclusions

If the indication for conservative treatment of injuries of the upper cervical spine with the halo vest is correct, then the clinical and radiological results are good and similar in the patients independent of their age. Patients older than 65 years had no more complications or revision surgeries than the younger patients and they tolerate the halo apparatus very well.