Houston Methodist. Leading Medicine

Neck FAQ

Question:

Mother fell down the stairs and broke her neck right at the top of the spine. Because she has diabetes and other health complications, they put her in a halo vest instead of attempting to do surgery to fuse the spine. What are her chances for recovery? She's not that old (63) but she seems more fragile now than she used to.

Answer:

Upper cervical spine fractures (C1-C2) are treated using a halo vest when surgery isn't an option or when the patient wants to avoid surgery. Many patients seem to do quite well with this treatment and have good results. There is some thought that older adults take longer to heal and have more complications. But a recent study from Germany reported no real difference between patients older than 65 and younger than 65. However, the patient's health status (such as having diabetes or being a smoker) can affect the outcome. Special care must be taken to avoid infections at the pin sites. Getting proper hydration (fluids), nutrition, and sleep are essential during the healing period. If she is having trouble making meals for herself, you can help by arranging for meals on wheels (if available in her area). If not, a few friends or volunteer groups from churches might be able to help out with meals for a few weeks at least until she gets settled at home. A consultation visit with a nutrition expert might be a good idea, too. Just having someone review the importance of good food choices and a healthy diet can help keep your mother on track with managing her diabetes. That will be a key element in her healing and recovery process. Getting enough rest and especially good sleep can be a problem. Sleeping positions are somewhat limited with a halo device. It may be worth the money to purchase the thickest, most comfortable memory foam and mattress topper possible. A bed with adjustable firmness/softness works well, too. If she has private insurance, they may cover this as a medical expense with a physician's letter of justification. Some people have gone to using a lower daybed because it's easier to get in and out of. Others rent an adjustable hospital bed for the necessary time. Over time, it will be easier for your mother to maneuver herself in and out of bed. But at first, she is probably going to need some help. Find (or make) her a small, very soft pillow (or use a covered piece of memory foam) to place between the halo bar and her face for sidelying. It gives a little pillow support without affecting the frame in any way. Halo vests are put on under a local anesthesia. Most patients are able to go home the same day or soon after. For some older adults, having someone there to help the first few days to weeks may be essential. If family members cannot provide this type of help, there are visiting nurse services, home health aids, private personal care attendants, or even volunteer friends who can help. Dorothea Daentzer, MD, and Thilo Flörkemeier, MD. Conservative Treatment of Upper Cervical Spine Injuries with the Halo Vest: An Appropriate Option for All Patients Independent of Their Age? In Journal of Neurosurgery: Spine. June 2009. Vol. 10. No. 6. Pp. 543-550.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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