In children, anterior pin loosening also is predominant, occurring in up to 87% of cases. In adults, loosening is slightly more common with anterior pins than with posterior pins. Pin loosening: This is the most prevalent complication in adults, occurring in as many as 36% of patients. We briefly reviewed the halo complications and classified them based on the etiology (pin, vest, underlying pathology, etc.) of complications. It has a complication rate of 0%-100% because of its rigid ring that attaches to the outer cortex of the cranium. The halo vest is a rigid orthosis with a ring and four pins attached to the outer cortex of the cranium. Finally, the extracted papers were reviewed and critically analyzed. using the keywords of “halo vest orthosis”, “unstable cervical spine fracture”, “halo vest complications”, “halo vest immobilization”, “pin-site-related complications”, and “vest-related complications”.
We retrieved all relevant articles from Google Scholar, Medline, PubMed, etc. To provide up-to-date information on the complications of the halo vest, we briefly reviewed its complications in related articles. This article is a narrative study about the halo vest complications. This narrative study aims to evaluate and search the rate and type of complications of halo vest orthosis. To prevent these problems, physicians must consider pin-site problems for early detection and treatment. Because of the many complications and high failure rate of halo vest immobilization, the clinicians must rethink before applying halo. Pin-site problems are the most prevalent complications of halo. Overall, the halo vest has a failure rate of 39.1%, with complications in 60.9% of patients and an intolerability rate of 68.4%. The fracture healing rates with halo vest in the cervical spine are about 67% to 93.9%. Complications of halo vest are relatively high and include pin loosening, migration, penetration, scalp infection, skull fracture, cerebral hemorrhage, paresthesia, and pressure sores. Also, restriction of halo vest for three months is not tolerable for some patients. Still, because of incomplete immobilization, there is a chance of progressive deformity that may result in surgical treatment for spinal instability.
Halo vest can protect against neurological damage in posttraumatic cervical spine instability. We conducted this study to evaluate the associated complications of halo vest immobilization. So for the usage of the halo vest in these conditions, we must consider these disadvantages. However, the halo vest has some complications (with a relatively high rate). In many centers, the halo vest is the first choice for nonsurgical treatment and external fixation. We can use different orthoses such as halo vest, Minerva, CTLSO (cervicothoracic lumbosacral orthosis), etc., for nonoperative treatment of cervical spine fractures. About 60% of spinal injuries occur in the cervical spine, and 20% of its fractures occur in the upper cervical spine.
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