Much like a fiberglass cast holds a broken arm or leg in place, a "halo" with vest
holds a child's head and neck in place after a spinal injury so that spinal bones,
or vertebrae, can heal.
This brace lets children who have been injured or are recovering from spinal surgery
walk, move around, and participate in many regular activities instead of being confined
to bed rest while they recover.
What's a Halo?
The halo gets its name from the metal ring that surrounds the head, which looks
like an angel halo. The ring — which keeps the head fixed in a level, forward-facing
position — is attached to the head with small pins that hold it in place. To
keep the halo from moving in any direction, vertical rods connect it to a person's
shoulders, where it's fastened to a vest. The vest (usually made of plastic or plaster,
like a cast), wraps around the neck, over the shoulders, and down to the belly button.
It's lined with soft material to make it more comfortable and prevent skin irritations.
When properly fitted, a halo brace keeps a child's head and neck completely still,
even during movement.
Is a Halo Painful?
While the brace may look painful, it should not cause any pain to the head, neck,
or shoulders. Some kids do experience a little forehead pain or a headache, particularly
while eating, but this usually goes away soon after a child has gotten used to wearing
If the pain continues or gets more severe, the pins that secure the halo might
need to be adjusted. Never attempt to adjust the pins or rods on your own, or to remove
the vest. If your child is experiencing pain or discomfort, call the doctor right
away. Also seek medical care if the area around the pins (or anywhere else) becomes
red, swollen, or irritated.
How Long Is a Brace Worn?
Depending on the severity of a child's injury and the duration of recovery, the
brace may be worn for a couple of months. Your doctor can tell you how long your child
needs to wear a halo brace.
Are Some Activities Off Limits?
Many kids with halos can continue their everyday activities, like going to school,
doing schoolwork, and participating in extracurricular clubs, as long as they're feeling
up to it and the doctor says it's OK.
Your child's doctor will tell you what activities your child should avoid while
in a halo brace. Sports will have to be put on hold for a while, and running —
which can increase the chance of a fall — will have to be avoided, as well.
Other activities to limit:
any sort of quick or jerky movements, like jumping or dancing
pulling or tugging on the halo or attached bars
bumping the halo into other objects (when avoidable)
getting the vest or vest liner wet
Since kids with a halo cannot look down while walking, it's important for them
to take precautions while walking and moving about. Clear the floor of anything that
might cause your child to trip or fall, and offer assistive devices, if needed. For
example, a cane or walker might give your child the confidence to get around on his
or her own, rather than relying on you, a family member, or friend to help with walking.
How Will My Child Sleep at Night?
Let your child sleep in whatever position feels most comfortable. Usually, this
is the position used prior to getting the halo brace. Kids with halo braces can sleep
on their backs, stomachs, or sides. Some prefer to sleep on a slight incline, with
pillows supporting the brace from underneath. You also can use pillows to support
the back, stomach, or side as your child finds a comfortable sleeping position.
Can My Child Take a Shower?
No. Showers are not permitted because water can damage the halo or vest. But kids
can take a bath as long as there's a shallow amount of water in the tub and it does
not wet the vest. However, since it can be difficult to get kids in and out of the
tub safely, most parents opt to manually bathe their child with a damp towel.
During bathing, have your child sit in a chair while you cleanse the arms, legs,
hands, head/neck, and feet using a mild soap and damp towel. Avoid using sponges that
trap water and can easily leak onto the halo brace. Protect the edges of the vest
with a dry towel or plastic bag (which can also be worn over the vest; cut a slit
for your child's head and arms).
To shampoo hair, lay your child's head over the edge of the tub or sink. Small
kids can lie on the kitchen counter with their head over the sink. Wash and dry as
usual, protecting the vest and liner from any moisture. If you prefer, a dry or powder
shampoo (that requires no water at all) also can be used to cleanse and condition
If, at any time, the skin beneath the vest becomes wet, dry it with a hairdryer
set on "cool."
Caring for a Halo
Besides keeping the halo vest free of any moisture, it's also important to keep
the site of the pins clean to avoid infection. Your doctor will give you specific
instructions for cleaning the pin areas, including what type of cleaning solution
to use. Run a cotton swab along the pin and surrounding area, and be sure to use a
new swab for each pin to avoid spreading any germs. If you notice that any pins have
come loose, call the doctor right away.
Caring for the Vest
Some vests come with removable liners that are washable. Buying more than one liner
means you can wash one while your child wears the other. If you only have one liner
or if it is not washable, use a cornstarch-based baby powder around the edges of the
vest to keep your child and the liner cool, dry, and comfortable.
To clean a non-washable vest liner, try using a long piece of surgical gauze dipped
in witch hazel. Wring out the gauze so that it is barely damp. Then, feed the gauze
under the edge of the vest and liner and, with one end in each hand, slide back and
forth. This can also be done in case your child's skin becomes itchy.
The liner should always be worn against the skin, with the vest immediately over
it. Regular clothes can be worn over the vest, although they may need to be adapted
to fit over the halo rods.
You will be instructed on how to switch the liner.
Helping Your Child Cope
Managing any sort of physical challenge, however temporary, is difficult for anyone
— especially a child or teen who is dealing with the pressures of growing up
and fitting in with peers. Kids who have to wear a halo brace may feel angry, frustrated,
and even depressed, especially if they're no longer participating in activities with
In the meantime, find ways to maintain normalcy in your child's life. Many kids
can continue going to school with a halo and, if not, they can do schoolwork at home
or with a tutor. If your child does go back to school, 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
If you're worried about your child going out with friends, encourage them to come
over to your house so that you can supervise.
In time, your child can return to his or her favorite activities. But if your child
continues to feel angry or depressed during recovery, consider talking to a school
psychologist or counselor, who may be able to help your child cope and look ahead
to better days./p>