Discharge Instructions: Using a Halo Ring and Vest Brace

You are going home with a halo ring and vest brace in place. This device is used to keep your head and neck from moving after a neck fracture or surgery. It has three parts:

• A vest that you wear on your chest

• A lightweight metal ring, or halo, that is fastened to your head with four pins

• Four rods that extend from the vest and attach to the ring

The halo does for your neck what a cast does for a broken arm. Wearing a halo ring and vest brace means that you can go home to heal and move about. You don't need to stay in bed or in the hospital while your neck heals. Getting used to the halo ring and vest brace takes time. But you'll adjust. You will be wearing the device for about 12 weeks. Here's what you need to know about home care.

Skin and hair care

• The skin around the pins needs to be cleaned once or twice a day. Soak a cotton swab or cotton ball with soap and water to clean around the pin, or use the cleaning solution advised by your health care provider. Use a clean swab each time. Avoid re-dipping into cleaning solutions.

• Don’t use creams, lotions, or antiseptics unless your provider says it’s okay.

• Check the skin under the vest brace daily for possible skin breaks or pressure sores (ulcers). These pressure sores are more likely to occur on the top of the shoulders. This is often done by having someone pass their hand under the vest while you are lying down. Don’t use soap, lotion, or powder under the vest. These items can irritate your skin.

• Ask a friend or family member to help you wash your hair. Use mild soap.

• Don’t dye your hair or use hair sprays.

The vest

• Bathe in a bathtub. But keep the water below the level of your vest. Don’t get the vest brace wet.

• Wear a cotton T-shirt under the vest to prevent irritation.

• Over the halo, wear shirts that button up the front. They should be one or two sizes larger than you normally wear. Then they can fit over the vest.

Activity

• Be active, but use good judgment. Don’t ride a bike or skateboard. Your balance will be off.

• It is very important that, as long as you wear a halo, you avoid falling because a fall might dislodge the cranial screws and injure your neck.

• Bend over a bit when entering doorways.

• Turn your back toward the seat and lower yourself carefully to get into cars. Small cars will be hard for you to get in and out of.

• Don’t jump, run, or lift anything heavier than 10 pounds (5 pounds for children).

• Stay away from crowds or places where you might bump into others or be shoved.

• Stop any activity that makes your neck hurt.

• Sleep in any position that feels okay.

• Remember to be careful when you get out of bed. Log-roll to the edge of the bed. Drop your legs to the floor and use your arm to raise your upper body slowly.

• Ask your health care provider when you can go back to work. You may not be able to work while you are wearing your halo ring and vest brace.

Follow-up care

Follow up with your health care provider as advised. 

When to contact your health care provider

Contact your provider or seek medical care right away if:

• You have new neck pain.

• You have pain, redness, swelling, or green or yellow drainage at the pin sites.

• Your pins move or shift, or your skin opens around the pin sites.

• Your halo or halo parts are loose, or you hear clicking noises coming from the device.

• You can nod or excessively move your head.

• You have severe back or neck pain.

• You think you have a pressure ulcer.

• You have bruising and swelling on your neck or back.

• You have tingling or numbness in your arms or legs.

• You have trouble controlling your bowels or bladder.

• You lose feeling or movement in arms or legs.

• You have a fever above 100.4°F (38°C) or higher, or as advised by your provider.

• You have shaking chills.