The Halo Vest Immobilization for Craniocervical Junction Tuberculosis: A Comparison of Treatment Options
ABSTRACT Objective The treatment of tuberculosis at the craniovertebral junction (CVJ) remains challenging, with significant debate surrounding therapeutic approaches. Halo vest (HV) therapy provides a non‐invasive immobilization alternative, while occipitocervical fusion (OCF) offers a surgical opt...
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| Format: | Article |
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Wiley
2025-06-01
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| Series: | Orthopaedic Surgery |
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| Online Access: | https://doi.org/10.1111/os.70047 |
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| author | Yunfeng Wu Xiyou Yang Long Yu Ning Liu Shangjie Yang Xu Cui |
| author_facet | Yunfeng Wu Xiyou Yang Long Yu Ning Liu Shangjie Yang Xu Cui |
| author_sort | Yunfeng Wu |
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| description | ABSTRACT Objective The treatment of tuberculosis at the craniovertebral junction (CVJ) remains challenging, with significant debate surrounding therapeutic approaches. Halo vest (HV) therapy provides a non‐invasive immobilization alternative, while occipitocervical fusion (OCF) offers a surgical option. However, limited evidence exists comparing the efficacy of HV therapy with OCF for CVJ tuberculosis. This study aimed to evaluate the clinical outcomes and safety of HV immobilization in treating CVJ tuberculosis, compared with OCF. Methods This retrospective cohort study was conducted from January 2012 to December 2022 and included 43 patients diagnosed with CVJ tuberculosis. Radiographic and treatment data were meticulously analyzed to compare outcomes between patients treated with HV immobilization (Group H, n = 22) and those undergoing OCF (Group O, n = 21). Interventions comprised at least 28 weeks of HV immobilization for Group H and OCF supplemented with postoperative external fixation for Group O. Outcomes were evaluated using the Visual Analog Scale (VAS‐neck), erythrocyte sedimentation rate (ESR), and radiographic stability (assessed via X‐ray and CT). Statistical analyses included the Student's t‐test (parametric data), Mann–Whitney U test (nonparametric data), and chi‐square test (categorical variables), with a significance level set at p < 0.05. Results Over a 24‐month follow‐up, all patients exhibited successful healing of tuberculosis lesions. Group H demonstrated greater improvements in cervical flexion‐extension and rotation function compared with Group O. Both groups showed statistically significant decreases in Visual Analog Scale (VAS‐neck) and Neck Disability Index (NDI) scores, as well as in ESR and C‐reactive protein (CRP) values from pre‐surgery levels (p < 0.01). Notably, differences in VAS‐neck (1 month) and NDI (24 months) between the groups were statistically significant (p < 0.05), while no significant differences were observed in other follow‐up periods (p > 0.05). Additionally, there were no significant differences in ESR and CRP values at any time point between the treatment groups (p > 0.05). Conclusions The study yielded satisfactory outcomes for all patients. Short‐term differences in pain relief did not significantly impact the healing of CVJ tuberculosis. Patients receiving HV treatment showed greater improvement in neck function compared with those undergoing occipitocervical fusion. Given the substantial costs and risks associated with open surgery, we advocate for conservative treatment utilizing HV. |
| format | Article |
| id | doaj-art-f12b8ed3783e4e128fe90f6403ffb3fb |
| institution | Kabale University |
| issn | 1757-7853 1757-7861 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
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| series | Orthopaedic Surgery |
| spelling | doaj-art-f12b8ed3783e4e128fe90f6403ffb3fb2025-08-20T03:45:47ZengWileyOrthopaedic Surgery1757-78531757-78612025-06-011761732174110.1111/os.70047The Halo Vest Immobilization for Craniocervical Junction Tuberculosis: A Comparison of Treatment OptionsYunfeng Wu0Xiyou Yang1Long Yu2Ning Liu3Shangjie Yang4Xu Cui5College of Medicine Southwest Jiaotong University Chengdu Sichuan Province ChinaCollege of Medicine Southwest Jiaotong University Chengdu Sichuan Province ChinaDepartment of Orthopedics, The Eighth Medical Centre Chinese PLA General Hospital Beijing ChinaDepartment of Orthopedics, The Eighth Medical Centre Chinese PLA General Hospital Beijing ChinaDepartment of Orthopedics, The Eighth Medical Centre Chinese PLA General Hospital Beijing ChinaCollege of Medicine Southwest Jiaotong University Chengdu Sichuan Province ChinaABSTRACT Objective The treatment of tuberculosis at the craniovertebral junction (CVJ) remains challenging, with significant debate surrounding therapeutic approaches. Halo vest (HV) therapy provides a non‐invasive immobilization alternative, while occipitocervical fusion (OCF) offers a surgical option. However, limited evidence exists comparing the efficacy of HV therapy with OCF for CVJ tuberculosis. This study aimed to evaluate the clinical outcomes and safety of HV immobilization in treating CVJ tuberculosis, compared with OCF. Methods This retrospective cohort study was conducted from January 2012 to December 2022 and included 43 patients diagnosed with CVJ tuberculosis. Radiographic and treatment data were meticulously analyzed to compare outcomes between patients treated with HV immobilization (Group H, n = 22) and those undergoing OCF (Group O, n = 21). Interventions comprised at least 28 weeks of HV immobilization for Group H and OCF supplemented with postoperative external fixation for Group O. Outcomes were evaluated using the Visual Analog Scale (VAS‐neck), erythrocyte sedimentation rate (ESR), and radiographic stability (assessed via X‐ray and CT). Statistical analyses included the Student's t‐test (parametric data), Mann–Whitney U test (nonparametric data), and chi‐square test (categorical variables), with a significance level set at p < 0.05. Results Over a 24‐month follow‐up, all patients exhibited successful healing of tuberculosis lesions. Group H demonstrated greater improvements in cervical flexion‐extension and rotation function compared with Group O. Both groups showed statistically significant decreases in Visual Analog Scale (VAS‐neck) and Neck Disability Index (NDI) scores, as well as in ESR and C‐reactive protein (CRP) values from pre‐surgery levels (p < 0.01). Notably, differences in VAS‐neck (1 month) and NDI (24 months) between the groups were statistically significant (p < 0.05), while no significant differences were observed in other follow‐up periods (p > 0.05). Additionally, there were no significant differences in ESR and CRP values at any time point between the treatment groups (p > 0.05). Conclusions The study yielded satisfactory outcomes for all patients. Short‐term differences in pain relief did not significantly impact the healing of CVJ tuberculosis. Patients receiving HV treatment showed greater improvement in neck function compared with those undergoing occipitocervical fusion. Given the substantial costs and risks associated with open surgery, we advocate for conservative treatment utilizing HV.https://doi.org/10.1111/os.70047craniocervical junctionhalo vestnonsurgical managementoccipitocervical fusiontuberculosis |
| spellingShingle | Yunfeng Wu Xiyou Yang Long Yu Ning Liu Shangjie Yang Xu Cui The Halo Vest Immobilization for Craniocervical Junction Tuberculosis: A Comparison of Treatment Options Orthopaedic Surgery craniocervical junction halo vest nonsurgical management occipitocervical fusion tuberculosis |
| title | The Halo Vest Immobilization for Craniocervical Junction Tuberculosis: A Comparison of Treatment Options |
| title_full | The Halo Vest Immobilization for Craniocervical Junction Tuberculosis: A Comparison of Treatment Options |
| title_fullStr | The Halo Vest Immobilization for Craniocervical Junction Tuberculosis: A Comparison of Treatment Options |
| title_full_unstemmed | The Halo Vest Immobilization for Craniocervical Junction Tuberculosis: A Comparison of Treatment Options |
| title_short | The Halo Vest Immobilization for Craniocervical Junction Tuberculosis: A Comparison of Treatment Options |
| title_sort | halo vest immobilization for craniocervical junction tuberculosis a comparison of treatment options |
| topic | craniocervical junction halo vest nonsurgical management occipitocervical fusion tuberculosis |
| url | https://doi.org/10.1111/os.70047 |
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