Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 9:10:1129809.
doi: 10.3389/fsurg.2023.1129809. eCollection 2023.

Comparative study of halo-vest reduction and skull traction reduction in the treatment of cervical fracture dislocation in patients with ankylosing spondylitis

Liang Wang #  1   2 , Haibin Wang #  2 , Can Wang #  3 , Bangke Zhang  2 , Haisong Yang  2 , Xuhua Lu  1   2
Affiliations

Comparative study of halo-vest reduction and skull traction reduction in the treatment of cervical fracture dislocation in patients with ankylosing spondylitis

Liang Wang et al. Front Surg. .

Abstract

Background: This study aimed to investigate the safety and efficacy of the halo-vest in the treatment of cervical fracture in patients with ankylosing spondylitis (AS) and kyphosis.

Methods: From May 2017 to May 2021, 36 patients with cervical fractures with AS and thoracic kyphosis were included in this study. The patients with cervical spine fractures with AS underwent preoperative reduction by halo-vest or skull tractions. Instrumentation internal fixation and fusion surgery were then performed. The level of cervical fractures, the operative duration, blood loss, and treatment outcomes were investigated preoperatively and postoperatively.

Results: A total of 25 cases were included in the halo-vest group and 11 cases were included in the skull tractions group. The intraoperative blood loss and the surgery duration were significantly less in the halo-vest group than in the skull traction group. A comparison of American Spinal Injury Association scores at admission and final follow-up showed that the neurological function of patients improved in both groups. All patients had reached solid bony fusion during the follow-up.

Conclusion: This study presented a unique approach to use halo-vest treatment fixation of unstable cervical fracture in patients with AS. The patient should also have early surgical stabilization with a halo-vest to correct spinal deformity and avoid worsening of neurological status.

Keywords: American Spinal Injury Association (ASIA) impairment scale; ankylosing spondylitis (AS); cervical spine trauma; cervical traction; halo-vest immobilization; skull traction.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
A 57-year-old man with AS and thoracic kyphosis and was diagnosed as fracture dislocation at C5/6. (A) Lateral radiography reveal a severe dislocated fracture at C5–6 levels with significant widen at C5–6 intervertebral space and so-called bamboo spine resulting from ankylosing spondylitis. (B) Sagittal CT showing fracture dislocation at C5/6. (C) MRI demonstrating increased signal segmentally at the level of the fracture indicate total segmental disruption. AS, ankylosing spondylitis; MRI, magnetic resonance imaging.
Figure 2
Figure 2
Reduction of cervical fractures in patients with AS from the perspective of a C-arm radiograph system. AS, ankylosing spondylitis.
Figure 3
Figure 3
Nasotracheal intubation and sitting position with halo-vest.
Figure 4
Figure 4
Postoperative plain radiography (A,B).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Colterjohn NR, Bednar DA. Identifiable risk factors for secondary neurologic deterioration in the cervical spine-injured patient. Spine. (1995) 20(21):2293–7. 10.1097/00007632-199511000-00006 - DOI - PubMed
    1. Boonen A, van der Linden SM. The burden of ankylosing spondylitis. J Rheumatol Suppl. (2006) 78:4–11. - PubMed
    1. Yang B, Lu T, Li H. Single-session combined anterior-posterior approach for treatment of ankylosing spondylitis with obvious displaced lower cervical spine fractures and dislocations. Biomed Res Int. (2017) 2017:9205834. 10.1155/2017/9205834 - DOI - PMC - PubMed
    1. Einsiedel T, Schmelz A, Arand M, Wilke HJ, Gebhard F, Hartwig E, et al. Injuries of the cervical spine in patients with ankylosing spondylitis: experience at two trauma centers. J Neurosurg Spine. (2006) 5(1):33–45. 10.3171/spi.2006.5.1.33 - DOI - PubMed
    1. An SB, Kim KN, Chin DK, Kim KS, Cho YE, Kuh SU. Surgical outcomes after traumatic vertebral fractures in patients with ankylosing spondylitis. J Korean Neurosurg Soc. (2014) 56(2):108–13. 10.3340/jkns.2014.56.2.108 - DOI - PMC - PubMed