Name of the Procedure:

Halo Procedure, Cervical Halo Incorporated into Jacket Vest (L0810)

• Common Name: Halo vest application
• Technical/Medical Term: Cervical halo-vest orthosis application

Summary

The halo procedure involves attaching a metal ring (halo) to the skull, which is then secured to a jacket-like vest. This apparatus immobilizes the neck and head to allow for healing after a severe neck injury.

Purpose

• Medical Conditions: The procedure is mainly used to treat cervical spine fractures, spinal instability, and severe neck injuries.
• Goals: To immobilize the cervical spine, promote healing, prevent further injury, and maintain proper spinal alignment.

Indications

• Fractures or dislocations in the cervical spine
• Post-operative immobilization after cervical spinal surgery
• Severe neck trauma needing stabilization

Preparation

• Pre-Procedure Instructions: Patients may be advised to avoid eating or drinking a few hours before the procedure. Medication adjustments, such as stopping blood thinners, might be necessary.
• Diagnostic Tests: X-rays, CT scans, or MRIs are usually required to assess the injury before the procedure.

Procedure Description

1. Patient Positioning: The patient is positioned upright.
2. Local Anesthesia: Local anesthetic is administered to numb the areas where pins will be inserted.
3. Halo Ring Attachment: The halo ring is placed around the patient’s head and secured using four or more pins that are gently screwed into the outer layer of the skull.
4. Vest Assembly: The halo is connected to a vest worn by the patient, keeping the head and neck immobile.
5. Adjustments: Final adjustments ensure that the spine is properly aligned.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The halo procedure is generally performed in a hospital setting, either in an operating room or a specialized treatment area.

Personnel

• Orthopedic surgeon or neurosurgeon
• Nursing staff
• Anesthesiologist or nurse anesthetist (if anesthesia is used)

Risks and Complications

• Common Risks: Skin irritation, discomfort at pin sites, pressure sores
• Rare Risks: Infection at pin sites, pin loosening, nerve injury, skull fracture
• Management: Regular cleaning of pin sites, monitoring for signs of infection, and follow-up visits for adjustments

Benefits

• Stabilizes the cervical spine to promote healing
• Prevents further spinal injury
• Allows for early mobilization of the patient in many cases

Recovery

• Post-Procedure Care: Regular cleaning of pin sites, follow-up visits for adjustments
• Recovery Time: The halo vest is typically worn for 3 to 4 months.
• Restrictions: Limited neck movement, gradual return to normal activities under medical guidance
• Follow-Up: Periodic X-rays or imaging studies to monitor healing

Alternatives

• Treatment Options: Cervical collars, surgical stabilization if appropriate
• Pros and Cons: Collars provide less immobilization and might prolong healing time. Surgical interventions come with their own risks and recovery times.

Patient Experience

• During the Procedure: Patients might feel pressure during pin insertion, but local anesthesia minimizes pain.
• After the Procedure: Initially, there may be discomfort at the pin sites and adjusting to the halo vest can be challenging. Pain management will be provided. Regular cleaning and care of pin sites is critical to avoid complications. The healthcare team will offer guidelines for sleeping, daily activities, and hygiene.