Comparison of initial injury features in cervical spine trauma of C3-C7 : Predictive outcome with halo-vest management

The purpose of this retrospective study was to examine specific patient variables and fracture morphologies to further elucidate the predictors of successful halo-vest treatment for cervical spine fractures (C3-C7). Eighty-seven cases of acute cervical spine injuries treated with halo-vest management were reviewed to assess initial injury features and radiographic outcomes by measuring (a) subluxation and direction, (b) angulation, (c) facet abnormalities, and (d) vertebral body fracture patterns on plain radiographs and computed tomography scans. The cases were divided into three groups: facet subluxations with fractures, facet subluxation without fractures, and fractures with no subluxation. Patients with facet subluxation and advance-staged compression-flexion fractures (stages 4 or 5) were a distinct group when treated conservatively with a halo. Despite anatomic reduction, facet subluxations associated with advance-staged compression-flexion fractures (stages 4-5), might be best treated surgically. Risk factors for late halo failure should include subluxations with advance-staged compression-flexion fractures when treated conservatively.