11.3\ Spine Stabilization

and Fusion

11.3.1\ Halo and Traction Devices

11.3.1.1\ Discussion

A variety of surgically affixed devices are available for immobilization and traction of unstable cervical spine fractures and dislocations, including halo vests and Gardner-Wells tongs (Figs. 11.22 and 11.23). Halo vests comprise a metallic ring secured to the skull via screws. The ring is attached

to a padded fiberglass or plastic thoracic cast by metal struts. The Gardner-Wells device consists of two screws attached to both sides of the skull that support the tongs to which traction is applied. Both types of devices provide excellent long-term cervical spine fixation. Pullout of the screws is a rare, but potentially devastating complication. In addition to pullout, screw site infection or screw breaking through the inner cortex of the skull is a rare complication. In general, devices composed of aluminum or graphite-carbon composites and plastic joints are MRI compatible.