Younis Kamal1, M S Ortho1, Hayat Ahmad Khan2, Naseemul Gani3, Ansar Ul Haq4, Snobar Gul5, Dara Singh6. 1. Senior Resident, Postgraduate Department of Orthopaedics GMC SRINAGAR, Email kdryounis@gmail.com. 2. DNB ortho, Senior Resident, Postgraduate Department of Orthopaedics, GMC SRINAGAR, Email drhayatkhan@gmail.com. 3. Assistant Professor, Postgraduate Department of Orthopaedics, GMC SRINAGAR. 4. Resident, Postgraduate Department of Orthopaedics, GMC, Jammu. 5. PGDMCH Scholar, GMC Srinagar, Email snobaryounis@gmail.com. 6. Professor, Postgraduate Department of Orthopaedics, GMC, Jammu.
Abstract
BACKGROUND: The literature regarding the different patterns of atlas and axis injuries and their appropriate management and the progressive development in the management of these injuries is scarce from our world, so we presenting here our experience of management of these injuries by applying Halovest. MATERIALS AND METHODS: Thirty patients (22 males, 8 females) with atlas and axis injuries were treated and then followed-up for an average of 24 months. The data was analysed with respect to type of injury and use of Halovest in the treatment of these injuries. The patients with neuro defecit were scored as per ASIA grading scale (from Grade A to Grade E). RESULTS: The halo-vest immobilization was used for a mean period of 12 ± 3weeks (range 9 to 15 weeks) for atlas and axis injuries. Four patients had neurodeficit. Two patients recovered from ASIA Grade C to ASIA Grade D. One patient improved from ASIA grade D to ASIA grade E while as one patient with neurodeficit was lost to follow up. No death or worsening of the neurodeficit was observed during the follow up period. CONCLUSION: The clinical as well as radiological outcome of these injuries is mostly satisfactory with the conservative management using Halovest. More studies should be conducted to form the guidelines regarding patient selection for conservative management using halovest.
BACKGROUND: The literature regarding the different patterns of atlas and axis injuries and their appropriate management and the progressive development in the management of these injuries is scarce from our world, so we presenting here our experience of management of these injuries by applying Halovest. MATERIALS AND METHODS: Thirty patients (22 males, 8 females) with atlas and axis injuries were treated and then followed-up for an average of 24 months. The data was analysed with respect to type of injury and use of Halovest in the treatment of these injuries. The patients with neuro defecit were scored as per ASIA grading scale (from Grade A to Grade E). RESULTS: The halo-vest immobilization was used for a mean period of 12 ± 3weeks (range 9 to 15 weeks) for atlas and axis injuries. Four patients had neurodeficit. Two patients recovered from ASIA Grade C to ASIA Grade D. One patient improved from ASIA grade D to ASIA grade E while as one patient with neurodeficit was lost to follow up. No death or worsening of the neurodeficit was observed during the follow up period. CONCLUSION: The clinical as well as radiological outcome of these injuries is mostly satisfactory with the conservative management using Halovest. More studies should be conducted to form the guidelines regarding patient selection for conservative management using halovest.
Authors: Richard J Bransford; David W Stevens; Staci Uyeji; Carlo Bellabarba; Jens R Chapman Journal: Spine (Phila Pa 1976) Date: 2009-07-01 Impact factor: 3.468