h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

My wife was just injured a week ago with a C2 fracture and was fitted with a halo in the trauma ER. I don't think it fits properly as it does not come close to contacting her shoulders. We've been back to the ER and the neurosurgeon dismissed it as, "The neck is in alignment." She has to lift up on the front of the vest to keep the weight of the halo and vest from pulling her head down.

It causes her great pain when she stands and her head is facing 1 o'clock instead of straight ahead, which affects her walking.

We are going to get a second opinion but I need as much information as possible. I'm all about being informed and an active participant in care.

Thanks for the good info on the pages!

Hello. Sorry to hear that your wife was injured. I can understand your desire to get as many opinions and data points as possible. Your question's a difficult one to answer, but I'll give it a shot. First let me say that I had exactly the same concerns - pretty much throughout the period in my halo. My head was tipped forward, and definitely off at a slight angle, and my shoulders were askew -- these things caused us concern, mostly because we didn't want long term problems with neck pain after the healing had completed. It seemed hit and miss at the beginning - they fixed the halo, didn't like the bone/fracture alignment in the x-rays, and then sat me up in bed and made some arbitary adjustments. Then, just as you said, the orthopedic surgeon said that the bone alignment was very good, and showed little interest in my concerns about the symmetry of the halo. The outcome in my case was good bone healing, and no surprise -- I did have a side/forwards neck tilt afterwards which we're still working on through physio-therapy. Actually the tilting itself hasn't caused my any major problems in the year since the halo came off (ref my previous posting on the rehab phase). It does seem that from the advice I received and my outcomes, it's the fracture alignment that matters most by far.

I also remember all these concerns being magnified during the first month when the pain was most acute, and the fragility of the fracture was at the forefront of my mind. Guess over time it hurt less, and it feels good when you start to see the little bone bridges forming on the scans, and I started to trust the halo more.

I do remember being told that the halo was heavy deliberately, as it has a traction effect.

However, this is all just from my particular experience, and there is such a huge spectrum of fracture types and severities, and clearly no two halo fittings are the same. I have heard some cases of the halo not being fitted correctly, so of course I'm not saying definitively "don't worry it'll be fine". If you've access to a second opinion, then you may wish to get one. Or if you trust your doctor and can push him to put your mind at rest, then by all means do so at your next consultation. I do advocate being fairly stubborn and demanding of doctors - we are just another patient to them, but for us it's a very scary and a first-time experience.

We found it very helpful to walk into the consultations with a written list of questions which we worked our way through with the doctor, so that we could go home having covered everything and with our minds at ease.

So, all the best to you and wife for her recovery, and if I can answer any other questions at all, then do let me know. Actually it would be better to email me on [email protected] as I never get notifications from this website -- hence the delayed responses.

Rachel

Her NP says she'lll have to wear the collar for at least six weeks without taking it off for anything but a shower and even then she cannot move her head. Sounds like she's being a witch again.

No account of halo wearing and removal on the internet I can find says you can't take the collar off and was wondering if you were told not to or just felt better knowing you were supported?

Frankly, my wife is slowly going stir crazy despite my attempts to get her out at least every other day to visit and shop. She almost nightly begs me to remove it.

My suggestion would be to consult your orthopedic consultant on this point i.e. the doctor that assesses your final scans. If your neck has healed and is in a stable state, then they will take off the Halo. What you then experience is a weakness and stiffness that should not be underestimated. I could bearly turn my head, not even a centimetre, and I could not hold the weight of my head without the new 'soft collar' neck support. In fact I remember for some time (until I reached a personal level of strength and confidence) I was pretty much wearing the collar in the shower. This is a key point in terms of psychology also. When the halo is removed, there is great deal of rehabilitation ahead of you. For me, during the first few days it was hard to feel the euphoria that I expected due to the weakness and stiffness I've described. However, it's the bone healing that really matters, and the muscle strength and movement WILL come back over time. Weekly physio/physical therapy really helped, and in fact was probably essential, with this recovery.