Halo Immobilization Superior to Fusion for C2 Fractures

Fusion tied to greater complication rates, increased length of stay, greater resource utilization

FRIDAY, Oct. 14 (HealthDay News) -- For patients with C2 fractures, treatment with fusion is associated with increased overall complication rates, increased length of stay, and greater resource utilization compared to halo-vest immobilization, but mortality rates are similar for the two procedures, according to a study published online Sept. 30 in Spine.

Maxwell Boakye, M.D., from the University of Louisville in Kentucky, and colleagues investigated early complication rates and associated risk factors in patients aged 18 years or older with C2 fractures without spinal cord injury who underwent fusion or halo-vest immobilization. In a propensity score matched sample, complication rates, hospital length of stay, and costs were compared. Predictors of in-hospital complications were identified using multivariate analysis.

The investigators found that fusion was correlated with significantly increased overall complication rates, length of stay, and higher charges. Fusion was also associated with a significantly lower rate of non-routine discharge. No difference was seen between the fusion and halo groups with respect to mortality. In both groups, age, injury score, and comorbidity raised the complication rates to a similar extent. Compared to patients younger than 60, those aged 80 years and older were found to be 3.5 times more likely to have a complication.

"Given the similar mortality rate between the fusion and halo group and the higher cost and complication rate in the fusion group, our study supports the use of halo-vest immobilization in patients where operative therapy is contraindicated," the authors write.

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