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Infectious pin complication rates in halo vest fixators using ceramic versus metallic pins
Paul Kraemer1, Michael B Lee, Hillary Englehardt
1Harborview Medical Center, Seattle, WA, USA. pkraemer@indianaspinegroup.com
Journal of Spinal Disorders & Techniques
|October 5, 2010
Summary
Ceramic halo pins show a higher complication rate, including infections and loosening, compared to traditional metallic pins in cervical spine trauma patients. This emerging technology may not yet meet the performance standards of metallic pins.
Area of Science:
- Orthopedics
- Neurosurgery
- Biomaterials
Background:
- Halo/vest fixators are crucial for cervical spine trauma but often cause pin-related complications.
- Ceramic pins were developed to potentially reduce infections, MRI artifact, and overheating compared to metallic pins.
Purpose of the Study:
- To compare infectious pin complication rates between ceramic and metallic pins used in halo vests for cervical spine trauma.
Main Methods:
- Retrospective review of a prospectively collected patient data set.
- Comparison of a 14-month cohort using ceramic pins against a 10-year historic control group using metallic pins.
- Investigation of aseptic loosening and infections using a novel 3-tier grading system.
Main Results:
- Overall pin complications were higher in the ceramic group (40.9%) versus the metallic group (21.7%).
- Pin site infections were significantly higher in the ceramic group (27.3%) compared to the metallic group (13.3%).
- Ceramic pins were associated with a higher incidence of adverse events and complications than metallic pins.
Conclusions:
- The newer ceramic pin technology demonstrated a trend toward higher failure rates compared to established metallic pins.
- Limitations in mechanical properties of MRI-compatible materials may contribute to the increased failure rate of ceramic pins.
