Functional and patient-reported outcomes after halo-vest immobilisation for C2 fractures: A retrospective analysis of prospectively collected data
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Published on: November 8, 2024
Surya Teja Dunga1, Tharun Teja Aduri1, Aditya Gupta1
1Department of Orthopaedic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Background:
Halo-vest immobilisation remains an established non-operative treatment option for selected cervical spine injuries, particularly in patients with reducible fractures or high surgical risk. However, contemporary evidence evaluating functional recovery and patient-reported outcomes following halo treatment remains limited.
Methods:
Prospectively maintained institutional data of patients treated with halo-vest immobilisation between January, 2021 and December 2024 were retrospectively analysed. Forty-seven consecutive patients (mean age 43.1 ± 3.6 years) with odontoid Type II/III or stable C2 body fractures managed with halo-vest immobilisation were prospectively enrolled between January 2021 and August 2024. Predefined clinical and institutional criteria guided treatment selection. Outcomes included radiological union, range of motion (ROM), pain, and validated patient-reported outcome measures (PROMs): Neck Disability Index (NDI), Visual Analogue Scale (VAS), and Short-Form 12 (SF-12). Statistical comparisons were made between baseline and 12-month follow-up values.
Results:
Radiological union was achieved in 69% (31/47) of patients, consistent with prior literature (67-94%). Union rates were highest in odontoid Type II fractures (75%). The mean NDI improved from 42 ± 11 to 22 ± 10, and VAS decreased from 6.1 ± 1.3 to 2.4 ± 1.0, both exceeding established Minimal Clinically Important Difference thresholds (7.5 and 1.5, respectively). The SF-12 Physical Component Score increased by 8.4 points (p < 0.001) and the Mental Component Score by 3.6 points (p = 0.04). Complications were infrequent, with one pin-site infection (2.1%) and one minor skin irritation (2.1%).
Conclusion:
Halo-vest immobilisation achieved satisfactory union and clinically meaningful improvements in pain, function, and quality of life when applied in carefully selected patients under structured follow-up. The findings support the continued, selective role of halo-vest immobilisation as a feasible, motion-preserving option for upper cervical fractures, particularly in patients unfit for surgery or in resource-limited settings.
