The Journal of Bone and Joint Surgery, Vol 70, Issue 3 357-360, Copyright © 1988 by Journal of Bone and Joint Surgery, Inc
The effect of halo-vest length on stability of the cervical spine. A study in normal subjects
GJ Wang, JT Moskal, T Albert, C Pritts, CM Schuch and WG Stamp
Department of Orthopaedics and Rehabilitation, University of Virginia Medical Center, Charlottesville 22908.
In order to study how the efficiency of the halo vest is affected by
different lengths of the vest, an experimental headband was devised that
allowed the head of a normal person to be held securely in the halo
attachment. The vest was then modified to allow it to be adjusted to three
different lengths (Fig. 2): a full vest extended to the iliac crests, a
short vest extended to the twelfth ribs, and a half vest extended to the
level of the nipples. Twenty normal, healthy adult men participated in the
study. For each vest length, radiographs were made of each subject
demonstrating rotation, flexion-extension, and lateral bending of the
cervical spine. There was no rotation of the cervical spine, regardless of
the length of the vest. There was a variable degree of motion in flexion or
extension of the upper part of the cervical spine with all vest lengths,
but this was not statistically significant. There was definite increase of
motion caudad to the level of the fifth cervical vertebra regardless of the
length of the vest. We concluded that a lesion of the upper part of the
cervical spine can be treated effectively by halo traction with a half
vest. This will improve the comfort and care of the patient and avoid the
necessity of removing the vest if emergency cardiovascular resuscitation is
needed. In the treatment of lesions of the lower part of the cervical spine
(caudad to the level of the fourth cervical vertebra), the use of a halo
vest that extends caudad to the level of the twelfth ribs does provide
additional stability.