Halo Fixator and Halo Traction – Value for the Treatment of Spinal Disorders in Childhood

Abstract

The application of the Halo fixateur in case of spinal pathologies in childhood is a standardized technique. The halo fixateur may be used for treatment of injuries of the cervical spine, for additional stabilization following extended surgery at the cervical spine and their transitional regions as well as to achieve preoperative reduction in case of severe and rigid deformity. These indications are, referred to the early age, rare. However, the successful use of the Halo fixateur presumes a certain familiarity with the device and experiences regarding the underlying diseases to minimize related risks and to avoid possible complications. In this article the use and specific features regarding the application of the halo fixateur in childhood based on presented cases and the literature will be discussed.

Key words

halo fixateur - halo traction - spine - children

Publikationsverlauf

Artikel online veröffentlicht:
27. November 2019

• References/Literatur

• 1 Perry J, Nickel VL. Total cervical spine fusion for neck paralysis. J Bone Joint Surg Am 1959; 41-A: 37-60
• 2 Bono CM. The Halo Fixator. J Am Acad Orthop Surg 2007; 15: 728-737
• 3 Schrödel M, Hertlein H. Halswirbelsäulenverletzungen im Kindes- und Jugendalter. Unfallchirurg 2013; 116: 1054-1061
• 4 Skaggs DL, Lerman LD, Albrektson J. et al. Use of noninvasive halo in children. Spine (Phila Pa 1976) 2008; 33: 1650-1654
• 5 Strohm PC, Müller CA, Köstler W. et al. Halo-Fixateur – Indikationen und Komplikationen. Zentralbl Chir 2007; 132: 54-59
• 6 Brown RL, Brunn MA, Garcia VF. Cervical spine injury in children: a review of 102 patients treated consecutively at a level 1 pediatric trauma center. J Pediatr Surg 2001; 36: 1107-1114
• 7 Jarvers JS, Völker A, von der Höh N. et al. Verletzungen der Halswirbelsäule im Kindes- und Jugendalter. Die Wirbelsäule 2017; 1: 171-182
• 8 Arkader A, Hosalkar HS, Drummond DS. et al. Analysis of halo-orthoses application in children less than three years old. J Child Orthop 2007; 1: 337-344
• 9 Tomaszewski R, Pyzińska M. Treatment of cervical spine fractures with halo vest method in children and young people. Orthop Traumatol Rehabil 2014; 5: 449-454
• 10 Knox JB, Schneider JE, Cage JM. et al. Spine trauma in very young children: a retrospective study of 206 patients presenting to a level 1 pediatric center. J Pediatr Orthop 2014; 34: 698-702
• 11 Ramrattan NN, Oner FC, Boczczyk BM. et al. Cervical spine injury in the young child. Eur Spine J 2012; 21: 2205-2211
• 12 Kawabata S, Watanabe K, Hosogane N. et al. Surgical correction of severe cervical kyphosis in patients with neurofibromatosis Type 1. J Neurosurg Spine 2013; 18: 274-279
• 13 Helenius IJ, Sponseller PD, Mackenzie W. et al. Outcome of spinal fusion for cervical kyphosis in children with neurofibromatosis. J Bone Joint Surg Am 2016; 98: e95
• 14 Stagnara P. Traction cranienne par le “Halo” de Rancho Los Amigos. Rev Chir Orthop Reparatrice Appar Mot 1971; 57: 287-300
• 15 Koller H, Zenner J, Gajic V. et al. The impact of halo-gravity traction on curve rigidity and pulmonary function in the treatment of severe and rigid scoliosis and kyphoscoliosis: a clinical study and narrative review of the literature. Eur Spine J 2012; 21: 514-529
• 16 Seller K, Haas S, Raab P. et al. Die präoperative Halo-Extension bei hochgradiger Lähmungsskoliose. Z Orthop Ihre Grenzgeb 2005; 143: 539-543
• 17 Lewis SJ, Zamorano JJ, Goldstein CL. Treatment of severe pediatric spinal deformities. J Pediatr Orthop 2014; 34 (Suppl. 01) S1-S5
• 18 Sponseller PD, Takenaga RK, Newton P. et al. The use of traction in the treatment of severe spinal deformity. Spine (Phila Pa 1976) 2008; 33: 2305-2309
• 19 Johnston CE II. Delaying Tactics: Traction, Casting and Bracing. In: Yazici M. ed. Non-idiopathic Spine Deformities in young Children. Heidelberg, Dordrecht, London, New York: Springer; 2011: 109-120
• 20 Johnston CE II. Halo Gravity Traction. In: Akbarnia BA, Yazici M, Thompson GH. Eds. The growing Spine. Heidelberg, Dordrecht, London, New York: Springer; 2011: 383-391
• 21 Neal KM, Siegall E. Strategies for surgical management of large, stiff spinal deformities in children. J Am Acad Orthop Surg 2017; 25: e70-e78
• 22 Park DK, Braaksma B, Hammerberg KW. et al. The efficacy of preoperative halo-gravity traction in pediatric spinal deformity the effect of traction duration. J Spinal Disord Tech 2013; 26: 146-154
• 23 Bauer R. Skoliose: Haloextensionstechniken. In: Bauer R, Kerschbaumer F, Poisel S. Hrsg. Orthopädische Operationslehre: Wirbelsäule. Stuttgart: Thieme; 1991: 74-79
• 24 Schmolke S, Gossé F. Der Halo-Fixateur. Oper Orthop Traumatol 2008; 20: 3-12
• 25 Rinella A, Lenke L, Whitaker C. et al. Perioperative halo-gravity traction in the treatment of severe scoliosis and kyphosis. Spine (Phila Pa 1976) 2005; 30: 475-482
• 26 Limpaphayom N, Skaggs DL, McComb G. et al. Complication of halo use in children. Spine (Phila Pa 1976) 2009; 34: 779-784
• 27 Godfried DH, Amory DW, Lubicky JP. The halo-Milwaukee brace. Case series of a revived technique. Spine (Phila Pa 1976) 1999; 24: 2273-2277
• 28 Mehlman CT, Al-Sayyad MJ, Crawford AH. Effectiveness of spinal release and halo-femoral traction in the management of severe spinal deformity. J Pediatr Orthop 2004; 24: 667-673
• 29 Bogunovic L, Lenke LG, Bridwell KH. et al. Preoperative halo-gravity traction for severe pediatric spinal deformity: complications, radiographic corrections and changes in pulmonary function. Spine Deform 2013; 1: 33-39
• 30 Iyer S, Duah HO, Wulff I. et al. The use of halo gravity traction in the treatment of severe early onset spinal deformity. Spine (Phila Pa 1976) 2019; 44: E841-E845
• 31 Roye BD, Campell ML, Matsumoto H. et al. Establishing consensus on the best practice guidelines for the use of halo gravity traction for pediatric spinal deformity. J Pediatr Orthop 2019; DOI: 10.1097/BPO.0000000000001379.
• 32 Nepple JJ, Lenke LG. Severe idiopathic scoliosis with respiratory insufficiency treated with preoperative traction and staged anteroposterior spinal fusion with a 2-level apical vertebrectomy. Spine J 2009; 9: e9-e13
• 33 LaMont LE, Jo CH, Molinari S. et al. Radiographic, pulmonary, and clinical outcomes with halo gravity traction. Spine Deform 2019; 7: 40-46