Halo vest fixation effectively maintains cervical alignment through intraoperative repositioning in patients with cervical spine instability
Introduction: The objective of this study was to examine if halo vest fixation provides sufficient stabilization of cervical spine alignment to endorse its use through intraoperative positional changes in patients with cervical spine instability. Methods: The subjects of this study were 14 patients...
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| Language: | English |
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Elsevier
2024-03-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844024039835 |
| _version_ | 1797224121177735168 |
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| author | Takafumi Arita Osamu Kawano Hiroaki Sakai Yuichiro Morishita Muneaki Masuda Tetsuo Hayashi Kensuke Kubota Takeshi Maeda Yasuharu Nakashima Kazuya Yokota |
| author_facet | Takafumi Arita Osamu Kawano Hiroaki Sakai Yuichiro Morishita Muneaki Masuda Tetsuo Hayashi Kensuke Kubota Takeshi Maeda Yasuharu Nakashima Kazuya Yokota |
| author_sort | Takafumi Arita |
| collection | DOAJ |
| description | Introduction: The objective of this study was to examine if halo vest fixation provides sufficient stabilization of cervical spine alignment to endorse its use through intraoperative positional changes in patients with cervical spine instability. Methods: The subjects of this study were 14 patients with cervical spine instability who were immobilized in halo vests until they underwent subsequent internal fixation surgery. After induction of anesthesia, the patients in halo vests were repositioned from the supine position to the prone position. The halo ring was fixed to the surgical table and the dorsal struts and vest were removed for surgery. Radiographs obtained in the preoperative sitting position and intraoperative prone position were compared for the following measures of cervical alignment: O–C2 angle, C2–C6 angle, pharyngeal inlet angle (PIA), atlantodental interval (ADI), Redlund-Johnell (R–J) value as a measure of O–C2 length, O–C6 length, and O–C2 length/O–C6 length (%). Results: There were no significant differences in O–C2 angle, C2–C6 angle, PIA, ADI, or O–C2 length/O–C6 length (%). However, the R–J value and O–C6 length were significantly higher in the intraoperative prone position than in the preoperative sitting position. None of the patients presented with any complications, including dysphagia or neurological deterioration. Conclusions: Our results suggest that when patients are repositioned to the prone position while immobilized in halo vests, the cervical spine is distracted in the cephalocaudal direction across all cervical segments but the cervical alignment is sufficiently maintained. Halo vests are a highly effective external fixation method for patients with cervical spine instability, allowing for a safe repositioning to the prone position for surgery while preserving cervical alignment and preventing neurological deterioration. |
| first_indexed | 2024-04-24T13:48:05Z |
| format | Article |
| id | doaj.art-4328370883774e0d86c3594c1cbcba5b |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-04-24T13:48:05Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-4328370883774e0d86c3594c1cbcba5b2024-04-04T05:06:26ZengElsevierHeliyon2405-84402024-03-01106e27952Halo vest fixation effectively maintains cervical alignment through intraoperative repositioning in patients with cervical spine instabilityTakafumi Arita0Osamu Kawano1Hiroaki Sakai2Yuichiro Morishita3Muneaki Masuda4Tetsuo Hayashi5Kensuke Kubota6Takeshi Maeda7Yasuharu Nakashima8Kazuya Yokota9Department of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, 820-0053, JapanDepartment of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, 820-0053, JapanDepartment of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, 820-0053, JapanDepartment of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, 820-0053, JapanDepartment of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, 820-0053, JapanDepartment of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, 820-0053, JapanDepartment of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, 820-0053, JapanDepartment of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, 820-0053, JapanDepartments of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka, 812-8582, JapanDepartment of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, 820-0053, Japan; Departments of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka, 812-8582, Japan; Corresponding author. Department of Orthopaedic Surgery, Japan Labor Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka, 820-0053, Japan.Introduction: The objective of this study was to examine if halo vest fixation provides sufficient stabilization of cervical spine alignment to endorse its use through intraoperative positional changes in patients with cervical spine instability. Methods: The subjects of this study were 14 patients with cervical spine instability who were immobilized in halo vests until they underwent subsequent internal fixation surgery. After induction of anesthesia, the patients in halo vests were repositioned from the supine position to the prone position. The halo ring was fixed to the surgical table and the dorsal struts and vest were removed for surgery. Radiographs obtained in the preoperative sitting position and intraoperative prone position were compared for the following measures of cervical alignment: O–C2 angle, C2–C6 angle, pharyngeal inlet angle (PIA), atlantodental interval (ADI), Redlund-Johnell (R–J) value as a measure of O–C2 length, O–C6 length, and O–C2 length/O–C6 length (%). Results: There were no significant differences in O–C2 angle, C2–C6 angle, PIA, ADI, or O–C2 length/O–C6 length (%). However, the R–J value and O–C6 length were significantly higher in the intraoperative prone position than in the preoperative sitting position. None of the patients presented with any complications, including dysphagia or neurological deterioration. Conclusions: Our results suggest that when patients are repositioned to the prone position while immobilized in halo vests, the cervical spine is distracted in the cephalocaudal direction across all cervical segments but the cervical alignment is sufficiently maintained. Halo vests are a highly effective external fixation method for patients with cervical spine instability, allowing for a safe repositioning to the prone position for surgery while preserving cervical alignment and preventing neurological deterioration.http://www.sciencedirect.com/science/article/pii/S2405844024039835Upper cervical spine instabilityHalo vestExternal fixationPositional changeCervical alignment |
| spellingShingle | Takafumi Arita Osamu Kawano Hiroaki Sakai Yuichiro Morishita Muneaki Masuda Tetsuo Hayashi Kensuke Kubota Takeshi Maeda Yasuharu Nakashima Kazuya Yokota Halo vest fixation effectively maintains cervical alignment through intraoperative repositioning in patients with cervical spine instability Heliyon Upper cervical spine instability Halo vest External fixation Positional change Cervical alignment |
| title | Halo vest fixation effectively maintains cervical alignment through intraoperative repositioning in patients with cervical spine instability |
| title_full | Halo vest fixation effectively maintains cervical alignment through intraoperative repositioning in patients with cervical spine instability |
| title_fullStr | Halo vest fixation effectively maintains cervical alignment through intraoperative repositioning in patients with cervical spine instability |
| title_full_unstemmed | Halo vest fixation effectively maintains cervical alignment through intraoperative repositioning in patients with cervical spine instability |
| title_short | Halo vest fixation effectively maintains cervical alignment through intraoperative repositioning in patients with cervical spine instability |
| title_sort | halo vest fixation effectively maintains cervical alignment through intraoperative repositioning in patients with cervical spine instability |
| topic | Upper cervical spine instability Halo vest External fixation Positional change Cervical alignment |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024039835 |
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