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 patien t variables and fracture morphologies to further elucidate the predict ors 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 fractu re patterns on plain radiographs and computed tomography scans. The ca ses were divided into three groups: facet subluxations with fractures, facet subluxation without fractures, and fractures with no subluxatio n. Patients with facet subluxation and advance-staged compression-flex ion fractures (stages 4 or 5) were a distinct group when treated conse rvatively 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 fail ure should include subluxations with advance-staged compression-flexio n fractures when treated conservatively.