Long term results of halo-vest fixation for upper cervical spine fractures

We underwent this retrospective study to evaluate effectiveness, complaints, long term results and prognostic factors of Halo-Vest Fixation (HVF) for upper cervical spine fractures. Clinical and radiographs records were reviewed for 33 of the 40 patients treated with HVF for C1 and/or C2 fractures between 1995 and 2004 in our Center. Follow-up studies included imaging, a satisfaction survey and clinical evaluation with measurement of cervical ROM, successively confronted with a normal control group. Mean follow-up was 57 months, with all patients having a greater than 1-year follow-up. Bony radiographically fusion rate was 93.9%. After 12 weeks the fusion rate was 33.3%, after 18-20 weeks was 90.9%. Complications occurred in 36.4% of patients (usually minor). Type of fracture (p = 0.713), diagnostic delay (p = 0.507), age (p = 0.856), and gender (p = 0.397) were not prognostic factor for healing rate. C1-C2 associated fractures was the only negative prognostic factor for healing time (p = 0.006). The long term results showed reduction of cervical ROM versus the normal control group. Type of fracture and age were prognostic factor for outcome cervical ROM. Patients were satisfied in 90.6%.