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Introducing.. Lerman Non-Invasive Halo Introducing.. Lerman Non-Invasive Halo

Introducing.. Lerman Non-Invasive Halo - PowerPoint Presentation

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Introducing.. Lerman Non-Invasive Halo - PPT Presentation

Lerman NonInvasive Halo NIH Designed to address and overcome to complications associated with the use of the Traditional Invasive Halo Lerman NIH Padded carbon composite ID: 806720

halo nih lerman invasive nih halo invasive lerman cervical spine patients fractures retrospective complications traditional loosening occipital spinal outcomes

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Presentation Transcript

Slide1

Introducing..

Lerman Non-Invasive Halo

Slide2

Lerman Non-Invasive Halo ( NIH )

Designed to address and overcome to complications associated with the use of the Traditional Invasive Halo

Slide3

Lerman NIH

Padded carbon composite

chest plate

2 posts for attaching plateto HaloFacemask ( halo ) with Silicone padding

Posterior occipital support

Padded criss cross straps

posteriorly

Slide4

Traditional Invasive Cervical Halo

( CH )

Used since 1959

Regarded as ‘the’ standard for external stabilisation for injury to cervical spineConsists of a 4 pin skull fixation halo and vestStudies have shown that this system fails to immobilise the unstable cervical spine as much as originally thought

There are a number of complications associated with this Invasive Halo

Slide5

Complications associated with Traditional Invasive Halo

Pin and Ring loosening – 36% - 60% of patients

Pin Infection in 20% of cases

Dysphagia – 4%Pressure Ulcers – 11%Facial scarring

Skull and Dural penetration

Rare but real risk of further neurological deficit during application

Suitability of the noninvasive halo for cervical spine injuries: a retrospective analysis of outcomes. Sawers, DiPaolo, Rechtine, The Spinal Journal, 2009

Slide6

Study

Suitability of the noninvasive halo for cervical spine injuries: a retrospective analysis of outcomes.

The Spinal Journal. 2009; 216 – 220.

Sawers, DiPaola, Rechtine

Slide7

Retrospective study

17 Patients. 8 Female: 9 Male

All sustained cervical spine injury

All fitted with NIH by Certified Orthotist at discretion of ConsultantAt least 6 months follow up data available on allAverage age 52.5 yearsTime spent in NIH; 36 – 150 days - Average 79 days

Types of fractures: C1-C2 lateral fracture; Rotary subluxation; facet fractures; hangman and odontoid fractures

Slide8

Outcomes…

All fractures healed successfully and in allignment

No additional loss of neurological function

Most reported the orthosis as feeling comfortable and secureNo-ones course of treatment reverted to use of an Invasive haloOne patient had surgery prior to applicationComplications

One Occipital Ulcer

2 Cases of non compliance. 1 due to Dementia Both loosening and removing orthosis

Slide9

Comparisons...

Lerman NIH

12% ( 2 )non compliance where patient loosened and / or removed NIH.

No incidence of Infection

No Dysphagia

6% ( 1 ) reported ulcer

No scarring

Invasive HaloPin and Ring loosening – 36% - 60% of patientsPin Infection in 20% of casesDysphagia – 4%Pressure Ulcers – 11%Facial scarringSkull and Dural penetration Suitability of the noninvasive halo for cervical spine injuries: a retrospective analysis of outcomes. Sawers, DiPaolo, Rechtine, The Spinal Journal, 2009

Slide10

Other comparisons…

Advantages

Lerman NIH can be applied in supine position

Anterior plate of Lerman NIH can be removed quickly if rapid access to thorax requiredFloating occipital pad reduces pressure over the occiput Costs associated with Lerman NIH 40% less the that of Invasive CHDisadvantages

Lerman NIH can be loosened by the patient

Male patients would have difficulty shaving

May not suit obese patients with short chins

Slide11

Conclusion

Clinical efficacy of the Lerman NIH has been demonstrated.

Further studies are warranted

Has potential to eliminate complications associated with use of traditional Invasive methodsCost effective – No theatre slot required And…..

Slide12

Long hair not a problem!!