The "halo" traction apparatus. A method of external splinting of the cervical spine after injury.

External fixation of the cervical spine is usually obtained by means of a “ Minerva” plaster-of-Paris jacket, a device by no means always satisfactory. The patient usually finds it heavy, and frequently hot and uncomfortable. Even the best fitting “ Minerva “ plaster allows more cervical movement than the surgeon may desire, and though immobilisation may be improved by the incorporation of a skull caliper in the plaster, as suggested by Blockey and Purser (1956), the caliper may work loose after a few weeks. Radiographic examination ofthe cervical spine through a plaster-of-Parisjacket is difficult, and adjustment ofthe position of the head or neck is impossible once such a plaster is applied. If an unstable spine is to be exposed at operation, a “ window “ in a “ Minerva “ plaster gives all too little room, especially in the depths of a fat neck, and such explorations have usually to be performed without the safety of rigid fixation of the neck during anaesthesia and operative manipulation. It follows that a method which overcomes any or all of these difficulties is of value. Perry and Nickel (1959) devised and described the use of a device for cervical fixation which they called the “ halo “ traction apparatus. They used it for control of the unstable paralysed neck and upper thoracic spine, but did not suggest its use in other circumstances. James ( 1960) reported a single case of fracture-dislocation of the cervical spine treated by means of a “ halo “ splint somewhat modified from the original design. The “ halo “ traction apparatus has now been in use in this department for nearly two years. The following is a description of the apparatus and its method of application, together with a record of eleven patients who have been treated in it.