[Conservative fracture treatment of the cervical spine with halo fixation]

A differentiated therapeutic approach is necessary in discoligamentous or osseous lesions of the cervical spine. Whereas lesions with neurological disturbances are stabilised by operation almost in all cases--and extensive lesions of the lower cervical spine (C3 to C7) quite frequently--, conservative treatment is the order of the day in sequels to trauma at the upper cervical spine (C1 and C2) as well as in mild lesions of all sections of the cervical vertebral column. Fractures of the dens of Types II and III (after Anderson and d'Alonzo) are the exception, since they are now being stabilized by surgery on a large scale. The advantages of the halo-fixateur therapy compared against extension and immobilization in Minerva gypsum are that secondary correction of positioning is possible; that functionally disturbing and extended spondylodeses are avoided; that care of the polytraumatized patient is facilitated; that X-ray films are easy to assess; and that the period of hospitalization is greatly reduced. Successful treatment is possible only of the possible complications are known. Failures are possible if the head screws become loose, if there are pin-trac infections, if dislocations and fractures are redislocated, and if there are points of pressure beneath the jacket.