Abstract
The effectiveness of the halo vest in the treatment of cervical spinal lesions was investigated in 40 RA patients who underwent spinal fusion with the help of the apparatus. Preoperative application of the vest was quite useful in obtaining neurological recovery in all of the 11 patients with ‘upper’ cervical lesions including irreducible subluxation, in 15 of the 16 with reducible subaxial subluxation and in 2 of the 4 with irreducible subaxial subluxation.
Cervical spinal fusion without decompression of the spinal cord was then performed on those cases who had demonstrated favorable neurological recovery with the vest. In order to obtain solid bone fusion, the vest was kept on for three more months post-operatively. Solid union was demonstrated radiographically in 18 of 21 patients with ‘upper’ cervical spinal lesions and all 15 patients with subaxial lesions. Posterior spinal fusion was performed on all of them. In 6 patients with subaxial subluxation who underwent anterior spinal fusion, collapse of the grafted bone was observed. Pseudoarthroses developed in 2 of them, with the recurrence of preoperative neurological symptoms.
