Incidence of complications associated with reconditioned halo-vest immobilization at Siriraj Hospital-Thailand’s largest National Tertiary referral center

Abstract

© JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND| 2019 Background: Halo-vest is an effective and high-cost immobilization modality in patients that experience trauma of the cervical spine. To make this device available to more patients that may not be able to afford this modality, the authors refitted used halo-vests to create what has been termed reconditioned halo-vest (RHV). The rate of complications associated with the use of the RHV is not known. Objective: To investigate the incidence of complications associated with RHV immobilization at Siriraj Hospital-Thailand’s largest national tertiary referral center. Materials and Methods: Cervical trauma patients treated with RHV immobilization at the Siriraj Spinal Unit during the February 1995 to December 2016 study period were included. A standardized chart and radiographic review protocol was developed to identify complications associated with the use of the RHV. Radiographs and patient records were retrospectively reviewed and analyzed. Results: Seventy-one patients (52 men and 19 women) with an average age of 45 years (range: 16 to 86) were included. RHV immobilization was used as a definite treatment in 49 (69.0%) patients, and in conjunction with surgical intervention in 22 (31.0%) patients. The average period of RHV use was 69.8 days. No major complications (death or pneumonia) were observed in any study patient. Fourteen (19.7%) minor complications developed, including pin site loosening in 5 (7.0%) patients, infection in 5 (7.0%) patients, stress/depression in 2 (2.8%) patients, pressure sore under the body vest in 1 (1.4%) patient, and prolonged pin site pain in 1 (1.4%) patient. Conclusion: RHV immobilization was shown to be a viable treatment modality in selected patients. Of the 71 patients that were treated with RHV immobilization for cervical trauma, there were no major complications and 14 minor complications, including pin site loosening and infection. The observed rate of complications in this study was low compared to the rates reported from many other studies.