Your surgeon will determine the amount of time your child will be in the halo based on X-rays. This can range from several weeks to several months. The type of surgery, individual health considerations and postoperative course all play a part in the length of time spent in a halo brace.
Once the doctor determines the need for a halo brace, the next step is the application. A halo brace is applied in a controlled setting, such as an operating room. Your child will be given an anesthetic for the procedure so that he/she won’t feel pain.
The X-rays used to determine the child’s need for a halo are reviewed in the operating room. They will be available to the doctor during the halo placement.
The halo stays steady with pins that are threaded through the ring and anchored to the head (unless the physician is using a pinless halo). The halo and its jacket and rods hold the head still, so that the bones can heal. The pins in the halo are secured to the skull, which prevents any motion in the neck. The pins are inserted using a special tool and then tightened securely.
The vest is fitted based on body size and attached to the halo with the supporting bars. In some cases, the vest will be premeasured or customized before the day of placement.
Pain and Safety
Your child may have pain at the pin sites or at the surgical incisions after waking up in the recovery room with the halo brace. Pain medication will be dispensed while your child is still in the hospital, based on the doctor’s orders and individual needs. Pills and liquid pain medication will also be provided at discharge. After a week or two, there should be a noticeable decrease in pain and in the need for pain medication.
A halo should not hurt, and the vest should not rub. If this occurs, contact your health provider.
After surgery, you will be given a special screwdriver and wrench. They must be attached to the halo uprights at all times, as they will be used when removing the halo. In case of emergency, it is essential that these tools be available for prompt removal of the halo.
Possible Complications for a Patient in a Halo
- Pin-site infections
- Pin loosening
- Social isolation
- Eating and sleep disturbances
- Loss of intervertebral alignment
- Forehead scarring
- Pin penetration into the head
- Pressure sores under the vest
- Pin penetration into the dura, causing a cerebrospinal fluid (CSF) leak
- Scarring once the skin has healed at the pin insertion site
Other risks are associated with spinal surgery or spinal cord injury:
It is important to speak with your doctor about potential complications and their treatment. Some problems can be avoided with proper postoperative care at home.
During postoperative visits, new X-rays will be taken to assist in measuring how much healing has taken place since the last visit. Your child’s surgeon will look at these X-rays during your office visit and discuss care plans with you and your family. These plans may change unexpectedly, but this should not be cause for alarm.