Halo Brace

What Is a Halo Brace?

A halo brace holds the head and neck in place so that the bones of the spine (vertebrae) can heal from an injury or surgery. Kids who have a halo brace can move around and do many of their regular activities while healing.

What Are the Parts of the Halo Brace?

The parts of a halo brace include:

• a halo (a metal ring that surrounds the head)
• pins that attach the halo to the head
• a vest made of plastic or plaster (like a cast)
• a liner that goes under the vest to make it more comfortable and prevent skin irritation
• rods that go from the halo to the person's shoulders, where they fasten to the vest

Is a Halo Brace Painful?

No, the halo brace should not cause pain. Some kids get headaches, especially while eating, but this usually goes away after the child gets used to the brace.

If the pain continues or gets worse, the surgeon may adjust the pins to make the child more comfortable. Don't try to adjust the halo brace at home.

How Long Is a Halo Brace Worn?

To decide how long someone needs to wear the halo brace, the medical care team considers: 

• how severe the injury was
• which surgery was done
• how long it will take the bones to heal

Typically, kids wear a halo brace for a couple of months.

Which Activities Are OK?

Many kids with a halo brace can continue their everyday activities — like walking, going to school, studying, and spending time with friends — as long as they feel up to it and the care team says it's OK. Encourage gentle activities like drawing, puzzles, and board games.

What Activities Should Be Avoided?

Kids who wear a halo brace must avoid activities that could lead to bumping the halo, pulling on the rods, falling, or getting the vest or vest liner wet. These include:

• lifting anything heavier than 10 pounds, including a backpack
• all sports
• running
• swimming
• riding a bike
• jumping
• dancing
• rough play

Your care team will go over in detail what activities your child should avoid.

How Do I Care For My Child at Home?

Your child will need your help at home. Here are some tips to help.

Getting Around the House

Kids with a halo can't look down while walking, so make sure floors are clear of anything that might cause a trip or fall. Your child may want to use a cane or walker to get around without your help.

Sleeping

Let your child sleep in whatever position feels most comfortable. Kids with halo braces can sleep on their backs, stomachs, or sides. Some prefer to sleep with their head slightly raised with pillows under the brace. Help your child try different positions and use pillows for support to find a comfortable sleeping position.

Bathing

The most important thing to remember when your child bathes is that the vest and liner can't get wet. Your child should not take a shower.

Your child can:

• Take a bath with only a little water in the tub, being very careful not to splash the vest.

Or use a damp washcloth to get clean:

• Have your child sit in a chair.
• Protect the vest from getting wet by putting a plastic bag or dry towel over the vest and tucking it under the vest.
• Put a little bit of mild soap on the damp washcloth and clean the parts of the body not covered by the vest.
• Unbuckle the vest to loosen it. Do not take the vest or liner off. Use the damp washcloth to clean under the areas of the vest and liner that you can easily reach. Dry the skin with a clean dry towel and then buckle the vest again.
• Don't use a sponge because it can trap water and leak onto the halo brace.

Washing the Hair

To wash your child's hair:

• Protect the vest from getting wet by putting a plastic bag or dry towel over the vest and tucking it under the vest.
• Small children can lie on their back on the kitchen counter with their head over the sink.
• Bigger kids can lean over the sink or tub.
• Use a faucet sprayer or plastic bottle sprayer to wet the hair, shampoo, and rinse.
• Be careful not to splash or spray the vest.

Your child also can use a dry or powder shampoo that doesn't need water to clean the hair.

What Should We Do if the Vest Gets Wet?

If a little of the vest or liner gets a damp, use a hair dryer set on cool to dry it. If a large part of the vest gets wet, call your care team to see if your child needs a new one.

How Do I Care for the Halo?

Caring for the Pins

Clean the pins regularly to help prevent infection. Clean them once a day unless your care team gives you other instructions. Your care team will teach you how to clean the pins.

Caring for the Vest

Clean your child's vest as your care team showed you:

If your child has a vest with a removable liner, take it out and wash it. You will need two liners so that your child has one to wear while the other is being washed. Your care team will explain how to take out the liner and put it back on. Follow the manufacturer's instructions on how to wash the liner.

To clean a liner that is not removable:

1. Dip a long piece of surgical gauze in witch hazel and wring it out so that it is barely damp.
2. Feed the gauze under the edge of the vest and liner and, with one end in each hand, slide it back and forth.

Some other tips:

• To keep your child dry and comfortable, sprinkle a cornstarch-based baby powder around the edges of the vest about once a day.
• Have your child wear regular, loose-fitting clothes cut to fit around the halo brace.
• For itching, you can use surgical gauze lightly dampened with witch hazel that you slide under the vest and liner (as described above for cleaning a vest without a removable liner).
• Don't use any creams or lotions under the vest.
• Don't remove the vest.

When Should I Call the Care Team?

Call your care team right away if:

• Your child has pain at the pin sites.
• Your child has a fever.
• A pin becomes loose.
• The area around the pins is red, swollen, or irritated.
• Your child gets a rash or redness under the vest.

How Can Parents Help?

Wearing a halo brace can be tough for kids and their families. Your child may feel sad, frustrated, or angry that life has to change, even if it is only for a few months. To support your child:

• Help your child continue with as many regular activities as possible. Going to school, seeing friends outside of school, and continuing the regular routine at home can help your child stay positive and connected.
• A nurse or social worker from the doctor's office may be able to visit your child's classroom to talk about the halo. This might make your child feel more comfortable about wearing the brace in school.
• To keep up with schoolwork if your child can't go to school, arrange for a tutor at home.
• If your child is angry or sad during recovery, encourage talking to a school counselor or school psychologist.