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KMID : 1189320130070020091
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Asian Spine Journal
2013 Volume.7 No. 2 p.91 ~ p.95
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Reduction of Halo Pin Site Morbidity with a New Pin Care Regimen
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Kazi Hussain Anthony
De Matas Marcus
Pillay Robin
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Abstract
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Study Design: A retrospective analysis of halo device associated morbidity over a 4-year period.
Purpose: To assess the impact of a new pin care regimen on halo pin site related morbidity.
Overview of Literature: Halo orthosis treatment still has a role in cervical spine pathology, despite increasing possibilities of open surgical treatment. Published figures for pin site infection range from 12% to 22% with pin loosening from 7% to 50%.
Methods: We assessed the outcome of a new pin care regimen on morbidity associated with halo spinal orthoses, using a retrospective cohort study from 2001 to 2004. In the last two years, our pin care regimen was changed. This involved pin site care using chlorhexidene & regular torque checking as part of a standard protocol. Previously, povidone iodine was used as skin preparation in theatre, followed by regular sterile saline cleansing when pin sites became encrusted with blood.
Results: There were 37 patients in the series, the median age was 49 (range, 22-83) and 20 patients were male. The overall infection rate prior to the new pin care protocol was 30% (n=6) and after the introduction, it dropped to 5.9% (n=1). This difference was statistically significant (p<0.05). Pin loosening occurred in one patient in the group prior to the formal pin care protocol (3%) and none thereafter.
Conclusions: Reduced morbidity from halo use can be achieved with a modified pin cleansing and tightening regimen.
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KEYWORD
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Cervical spine, Trauma, Tumour, Spinal injury, Orthosis
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