Length dependence of a halo orthosis on cervical immobilization

This study was designed to observe the length dependence of a well-molded fiberglass body cast attached to a halo on motion restriction in an unstable cadaveric cervical spine. Also, by using this technique, comparison between the immobilization provided by a body cast and that provided by a standard premolded polyethylene halo vest could be made. Extreme cervical instability was created on adult cadavers. A halo ring was applied and then attached to a fiberglass body cast or to a polyethylene halo vest. Sequential lateral cervical radiographs were obtained during maximum flexion as the body cast was shortened from the level of the iliac crests to the level of the xiphoid process. Radiographic motion was also assessed within the polyethylene halo vest. Results revealed minimal motion difference as the fiberglass body cast was sequentially shortened. In contrast, motions within the polyethylene halo vest were variable. These results suggest that cervical immobilization may be relatively independent of support structure length and that immobilization can be maintained by a well-fitting halo vest extending to the level of the xiphoid process.