Background: In patients with unstable cervical spine injuries initially managed with in-line traction, there is some risk of loss of cervical alignment and of new neurologic deficit when the halo vest is applied. This report outlines a simple technique which facilitates halo application in these patients.
Methods: The back of the halo vest is "prepositioned" before traction is instituted. Once alignment is optimized, halo vest application is easily completed without lifting the patient or discontinuing cervical traction.
Results: The authors have used this technique in four patients without complication.
Conclusions: In patients with unstable cervical spine injuries who require an initial period of in-line traction, halo vest application is made easier and safer by "prepositioning" the back of the vest.