Document Detail

Pneumocranium secondary to halo vest pin penetration through an enlarged frontal sinus.
MedLine Citation:
PMID:  19390875     Owner:  NLM     Status:  MEDLINE    
We present a case report of a patient with pneumocranium secondary to halo vest pin penetration and a review of literature. The objectives of this study are to report a rare complication of halo vest pin insertion and to discuss methods of prevention of this complication. Halo vest orthosis is a commonly used and well-tolerated upper cervical spinal stabilizing device. Reports of complications related to pin penetration is rare and from our review, there has been no reports of pneumocranium occurring from insertion of pins following standard anatomical landmarks. A 57-year-old male sustained a type 1 traumatic spondylolisthesis of C2/C3 following a motor vehicle accident. During application of the halo vest, penetration of the left anterior pin through the abnormally enlarged frontal sinus occurred. The patient developed headache, vomiting and CSF rhinorrhoea over his left nostril. He was treated with intravenous Ceftriaxone for 1 week. This resulted in resolution of his symptoms as well as the pneumocranium. In conclusion, complications of halo vest pin penetration are rare and need immediate recognition. Despite the use of anatomical landmarks, pin penetration is still possible due to aberrant anatomy. All patients should have a skull X-ray with a radio-opaque marker done prior to placement of the halo vest pins and halo vest pins have to be inserted by experienced personnel to enable early detection of pin penetration.
Min Lee Cheong; Chris Yin Wei Chan; Lim Beng Saw; Mun Keong Kwan
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Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2009-04-24
Journal Detail:
Title:  European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society     Volume:  18 Suppl 2     ISSN:  1432-0932     ISO Abbreviation:  Eur Spine J     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-21     Completed Date:  2009-11-17     Revised Date:  2010-09-27    
Medline Journal Info:
Nlm Unique ID:  9301980     Medline TA:  Eur Spine J     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  269-71     Citation Subset:  IM    
Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Lembah Pantai, Kuala Lumpur, Malaysia.
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MeSH Terms
Accidents, Traffic
Anti-Bacterial Agents / therapeutic use
Bone Nails / adverse effects*
Ceftriaxone / therapeutic use
Cerebrospinal Fluid Rhinorrhea / drug therapy,  etiology*
Cervical Vertebrae / injuries
Frontal Sinus / injuries*
Middle Aged
Spondylolisthesis / surgery
Traction / adverse effects*,  instrumentation
Treatment Outcome
Reg. No./Substance:
0/Anti-Bacterial Agents; 73384-59-5/Ceftriaxone

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

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