Pneumocranium secondary to halo vest pin penetration through an enlarged frontal sinus.

Cheong, M.L. and Chan, C.Y.W. and Saw, L.B. and Kwan, M.K. (2009) Pneumocranium secondary to halo vest pin penetration through an enlarged frontal sinus. European Spine Journal, 18 Sup. pp. 269-71. ISSN 1432-0932, DOI 19390875.

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We present a case report of a patient with pneumocranium secondary to halo vest pin penetration and a review of literature. The objectives of this study are to report a rare complication of halo vest pin insertion and to discuss methods of prevention of this complication. Halo vest orthosis is a commonly used and well-tolerated upper cervical spinal stabilizing device. Reports of complications related to pin penetration is rare and from our review, there has been no reports of pneumocranium occurring from insertion of pins following standard anatomical landmarks. A 57-year-old male sustained a type 1 traumatic spondylolisthesis of C2/C3 following a motor vehicle accident. During application of the halo vest, penetration of the left anterior pin through the abnormally enlarged frontal sinus occurred. The patient developed headache, vomiting and CSF rhinorrhoea over his left nostril. He was treated with intravenous Ceftriaxone for 1 week. This resulted in resolution of his symptoms as well as the pneumocranium. In conclusion, complications of halo vest pin penetration are rare and need immediate recognition. Despite the use of anatomical landmarks, pin penetration is still possible due to aberrant anatomy. All patients should have a skull X-ray with a radio-opaque marker done prior to placement of the halo vest pins and halo vest pins have to be inserted by experienced personnel to enable early detection of pin penetration.

Item Type: Article
Additional Information: Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Lembah Pantai, Kuala Lumpur, Malaysia.
Uncontrolled Keywords: Accidents, Traffic; Anti-Bacterial Agents/therapeutic use
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine
Depositing User: Mr. Faizal Hamzah
Date Deposited: 27 Apr 2011 04:51
Last Modified: 13 Mar 2013 09:03

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