Document Detail


Neck motion due to the halo-vest in prone and supine positions.
MedLine Citation:
PMID:  20118835     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: An in vitro biomechanical study of the effectiveness of halo-vest fixation. OBJECTIVE: The objective was to evaluate motion of the injured cervical spine with normal halo-vest application and vest loose in the prone and supine positions. SUMMARY OF BACKGROUND DATA: Snaking motion of the neck is defined as rotation in opposing directions throughout the cervical spine. Previous clinical studies have suggested snaking neck motion due to the halo-vest may lead to inadequate healing or nonunion. METHODS: The halo-vest was applied to a Human Model of the Neck, which consisted of a cervical spine specimen mounted to the torso of an anthropometric test dummy and carrying a surrogate head. The model was transitioned from prone, to upright, to supine with the halo-vest applied normally and with the vest loose. Average peak spinal motions were computed in the prone and supine positions and contrasted with the physiologic rotation range, obtained from the intact flexibility test, and statistically compared (P < 0.05) between normal halo-vest application and vest loose. RESULTS: Snaking motion of the neck was observed in the prone and supine positions, consisting of extension at head/C1 and C1/2 and flexion at the inferior spinal levels. The intervertebral rotation peaks generally exceeded the physiologic range throughout the cervical spine due to the loose vest in the prone position. Significant increases in the extension peaks at head/C1 (16.9 degrees vs. 5.7 degrees) and flexion peaks at C4/5 (6.9 degrees vs. 3.6 degrees) and C7-T1 (5.2 degrees vs. 0.7 degrees) were observed in the prone position due to the loose vest, as compared to normal halo-vest application. Axial neck separation was consistently observed in the prone and supine positions. CONCLUSION: The present results, which document snaking motion of the cervical spine due to the halo-vest, indicate that an inadequately fitting or loose vest may significantly diminish its immobilization capacity leading to delayed healing or nonunion.
Authors:
Paul C Ivancic; Connor J Telles
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Spine     Volume:  35     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-30     Completed Date:  2010-08-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E400-6     Citation Subset:  IM    
Affiliation:
Department of Orthopaedics and Rehabilitation, Biomechanics Research Laboratory, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA. paul.ivancic@yale.edu
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MeSH Terms
Descriptor/Qualifier:
Aged, 80 and over
Biomechanics / physiology
Cadaver
Cervical Vertebrae / anatomy & histology,  physiology*
External Fixators / standards*
Female
Fracture Fixation / methods*
Head Movements / physiology
Humans
Joint Instability / etiology,  physiopathology,  therapy*
Male
Models, Anatomic
Posture / physiology
Prone Position / physiology
Range of Motion, Articular / physiology*
Spinal Fractures / physiopathology,  therapy*
Supine Position / physiology
Weight-Bearing / physiology
Zygapophyseal Joint / anatomy & histology,  physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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