A halo vest is a specialized medical device used to immobilize and stabilize the head and neck. Its primary purpose is to restrict movement of the cervical spine, the seven vertebrae that make up the neck, to allow for healing after injury or surgery. This external brace ensures the head and upper body move as a single unit, providing a stable environment for the delicate spinal structures.
Understanding the Halo Vest
A halo vest is typically used for severe neck and upper spine injuries, such as fractures or dislocations of the cervical vertebrae. Conditions like fractures at the base of the skull, dislocation between the skull and spine, and fractures of the first and second neck vertebrae necessitate its application. While less severe neck injuries might be managed with a cervical collar, the halo vest offers superior immobilization, restricting atlantoaxial joint movement by approximately 75% compared to 45% with conventional orthoses. Most individuals wear a halo vest for a period ranging from 8 to 16 weeks, depending on the injury and healing progress.
Anatomy and Function
The halo vest system comprises three main components: the halo ring, the pins, and the vest. The halo is a lightweight metal ring that encircles the head, secured to the skull by pins. Four pins, typically one above each eyebrow and one behind each ear, secure the halo to the skull. These pins provide a rigid attachment point for the halo.
Metal rods connect the halo ring to a specialized vest worn on the torso. The vest is made of a hard plastic shell and lined with a soft material for comfort. The combination of the halo, pins, rods, and vest creates a rigid, three-point fixation system that immobilizes the head and neck relative to the torso.
Living with a Halo Vest
Care Routines
Living with a halo vest requires specific care routines. Pin sites require daily cleaning to prevent infection, using solutions like saline or soap and water with cotton swabs; inspect for signs of infection (redness, swelling, discharge, pain). Daily skin checks under the vest are important for redness, sores, or blisters. Keep the vest lining dry; if wet, dry with a hairdryer on a cool setting. Avoid lotions or powders under the vest to prevent skin irritation.
Daily Activities
Showering is not possible with a halo vest; sponge baths are recommended, keeping the vest dry. Hair washing requires assistance, leaning the head over a sink or tub while protecting the vest from water. For sleeping, individuals find comfort lying on their back with pillows or in a reclining chair. When getting out of bed, roll onto one side and use arms to push up, avoiding bending at the waist to prevent stress on pins. Eating requires cutting food into smaller pieces and taking small bites due to limited head movement, and loose-fitting clothing that buttons or zips up the front is easier to wear over the vest.
Removal and Aftercare
Halo vest removal is performed by medical professionals in a clinic setting. Nuts on the vest are loosened, followed by the halo ring pins. Once loosened, the ring is carefully lifted from the head. While not generally painful, increased pressure may be felt during ring removal.
After removal, small open pin sites remain, typically scabbing within 24 to 48 hours. Keep these sites clean; scars may remain but fade over time. A cervical collar is often fitted immediately after removal for continued support, as neck muscles may feel weak from disuse. Physical therapy may be recommended to strengthen neck muscles and regain full range of motion. Adherence to medical advice for rehabilitation is important.