Prospective Analysis of Complication Rate Using Two Types of Adult Halo Skull Pins

Abstract

In Brief The halo vest is used successfully to address clinical situations requiring cervical spine immobilization. Several studies have addressed the topic of complications associated with halo immobilization, and the strategies to improve them. Skull pin loosening is the most common complication. Complications of pin loosening include infection, periorbital cellulitits, loss of anatomic stability, halo dislodgement, and possible perforation of the inner table of the skull with abscess and disfiguring scars. Two study groups were utilized to test two different types of halo pins, the standard halo skull pin and the new trochar-style HIFix™ pin (DePuy AcroMed, Raynham, MA). The standard pin is designed with a sharp conical tip that flares into a rounded shoulder. The HIFix pin is designed with a cylindrical tip and a cutting edge. Forty patients treated with a halo-vest were prospectively monitored for complications. Half received the standard pins and half received the HIFix pins. Data were collected on the basis of a clinical evaluation of the patient as well as a questionnaire that addressed the patient's subjective experiences while immobilized in the halo-vest. The use of the HIFix halo pins produced a clinical improvement with respect to pin loosening. Results showed that the HIFix pin was clinically superior, with an incidence of 30% loosening as compared with 60% with the standard pins and this correlated with decrease in the number of halo-vest complications. The halo vest is used successfully to address clinical situations requiring cervical spine immobilization. Several studies have addressed the topic of complications associated with halo immobilization, and many have been described as well as the strategies to improve them. Skull pin loosening is the most common complication. Two study groups were used to test two different types of halo pins, the standard halo skull pin, and the new trochar-style HIFix™pin.. Forty patients treated with a halo-vest were prospectively monitored for complications. Results showed that the HIFix pin was clinically superior, with an incidence of 30% loosening as compared with 60% with the standard pins and this correlated with decrease in the number of halo-vest complications.