{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T04:10:02Z","timestamp":1749442202287,"version":"3.41.0"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81972079"],"award-info":[{"award-number":["81972079"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The treatment of tuberculosis at the craniovertebral junction (CVJ) remains challenging, with significant debate surrounding therapeutic approaches. Halo vest (HV) therapy provides a non\u2010invasive immobilization alternative, while occipitocervical fusion (OCF) offers a surgical option. However, limited evidence exists comparing the efficacy of HV therapy with OCF for CVJ tuberculosis. This study aimed to evaluate the clinical outcomes and safety of HV immobilization in treating CVJ tuberculosis, compared with OCF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study was conducted from January 2012 to December 2022 and included 43 patients diagnosed with CVJ tuberculosis. Radiographic and treatment data were meticulously analyzed to compare outcomes between patients treated with HV immobilization (Group H, <jats:italic>n<\/jats:italic>\u2009=\u200922) and those undergoing OCF (Group O, <jats:italic>n<\/jats:italic>\u2009=\u200921). Interventions comprised at least 28\u2009weeks of HV immobilization for Group H and OCF supplemented with postoperative external fixation for Group O. Outcomes were evaluated using the Visual Analog Scale (VAS\u2010neck), erythrocyte sedimentation rate (ESR), and radiographic stability (assessed via X\u2010ray and CT). Statistical analyses included the Student's <jats:italic>t<\/jats:italic>\u2010test (parametric data), Mann\u2013Whitney <jats:italic>U<\/jats:italic> test (nonparametric data), and chi\u2010square test (categorical variables), with a significance level set at <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over a 24\u2010month follow\u2010up, all patients exhibited successful healing of tuberculosis lesions. Group H demonstrated greater improvements in cervical flexion\u2010extension and rotation function compared with Group O. Both groups showed statistically significant decreases in Visual Analog Scale (VAS\u2010neck) and Neck Disability Index (NDI) scores, as well as in ESR and C\u2010reactive protein (CRP) values from pre\u2010surgery levels (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Notably, differences in VAS\u2010neck (1\u2009month) and NDI (24\u2009months) between the groups were statistically significant (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), while no significant differences were observed in other follow\u2010up periods (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). Additionally, there were no significant differences in ESR and CRP values at any time point between the treatment groups (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The study yielded satisfactory outcomes for all patients. Short\u2010term differences in pain relief did not significantly impact the healing of CVJ tuberculosis. Patients receiving HV treatment showed greater improvement in neck function compared with those undergoing occipitocervical fusion. Given the substantial costs and risks associated with open surgery, we advocate for conservative treatment utilizing HV.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.70047","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T12:23:25Z","timestamp":1746188605000},"page":"1732-1741","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Halo Vest Immobilization for Craniocervical Junction Tuberculosis: A Comparison of Treatment Options"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8475-7876","authenticated-orcid":false,"given":"Yunfeng","family":"Wu","sequence":"first","affiliation":[{"name":"College of Medicine Southwest Jiaotong University  Chengdu Sichuan Province China"},{"name":"Department of Orthopedics, The Eighth Medical Centre Chinese PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiyou","family":"Yang","sequence":"additional","affiliation":[{"name":"College of Medicine Southwest Jiaotong University  Chengdu Sichuan Province China"},{"name":"Department of Orthopedics, The Eighth Medical Centre Chinese PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Long","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Eighth Medical Centre Chinese PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Eighth Medical Centre Chinese PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shangjie","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, The Eighth Medical Centre Chinese PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"Cui","sequence":"additional","affiliation":[{"name":"College of Medicine Southwest Jiaotong University  Chengdu Sichuan Province China"},{"name":"Department of Orthopedics, The Eighth Medical Centre Chinese PLA General Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2024.109858"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1995.83.2.0243"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-013-2850-1"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-024-04582-6"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.CC.22.00053"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.CC.24.00266"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620x.80b6.8911"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000366109.85796.42"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2019.05.002"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.09.073"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-8237.188418"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2022.107453"},{"issue":"2","key":"e_1_2_10_14_1","first-page":"79","article-title":"Surgical Treatment of Tuberculous Spondylodiscitis","volume":"16","author":"Pola E.","year":"2012","journal-title":"European Review for Medical and Pharmacological Sciences"},{"issue":"2","key":"e_1_2_10_15_1","first-page":"166","article-title":"Outcome in Neurologically Impaired Patients With Craniovertebral Junction Tuberculosis: Results of Combined Anteroposterior Surgery","volume":"97","author":"Arunkumar M. J.","year":"2002","journal-title":"Journal of Neurosurgery"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-006-0071-6"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-012-2497-3"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/jcvjs.JCVJS_30_20"},{"issue":"1","key":"e_1_2_10_19_1","first-page":"37","article-title":"Total Cervicalspine Fusion for Neck Paralysis","volume":"41","author":"Perry J.","year":"1959","journal-title":"Journal of Bone and Joint Surgery. American Volume"},{"issue":"3","key":"e_1_2_10_20_1","first-page":"320","article-title":"Complications in the Use of the Halo Fixation Device","volume":"68","author":"Garfin S. R.","year":"1986","journal-title":"Journal of Bone and Joint Surgery. American Volume"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-198807000-00015"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.3171\/2010.3.SPINE08143"},{"issue":"1","key":"e_1_2_10_23_1","article-title":"Unexpected Neurological Deterioration Following Occipitocervical Fusion Surgery: A Case Report","volume":"17","author":"Nakagawa T.","year":"2025","journal-title":"Cureus"},{"issue":"8","key":"e_1_2_10_24_1","article-title":"Early Occipitocervical Fusion Surgery in a Rare Clinical Encounter of Non\u2010Traumatic Atlantooccipital Subluxation (AOS) in Down Syndrome (Trisomy 21)","volume":"16","author":"Ng L. H.","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/10790268.2003.11753681"},{"issue":"7","key":"e_1_2_10_26_1","first-page":"409","article-title":"The Neck Disability Index: A Study of Reliability and Validity","volume":"14","author":"Vernon H.","year":"1991","journal-title":"Journal of Manipulative and Physiological Therapeutics"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sjpain.2016.06.012"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.3171\/2019.9.SPINE19331"},{"issue":"1","key":"e_1_2_10_29_1","first-page":"40","article-title":"Spinal Infections. Diagnosis and Treatment","volume":"59","author":"Weisz R. D.","year":"2000","journal-title":"Bulletin of the Hospital for Joint Diseases"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tube.2015.01.003"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy253"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-023-05509-6"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.3171\/CASE22290"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-5898(20)32199-4"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-005-0555-x"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199110001-00003"},{"key":"e_1_2_10_37_1","first-page":"1","article-title":"Upper Cerebral Vertebrae. Regional Morphology, Pathology and Traumatology, Practical x\u2010Ray Atlas and Taxonomy","volume":"101","author":"Torklus D.","year":"1975","journal-title":"Fortschritte auf dem Gebiete der R\u00f6ntgenstrahlen und der Nuklearmedizin. Erg\u00e4nzungsband"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197410000-00023"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.230137"},{"issue":"5","key":"e_1_2_10_40_1","first-page":"481","article-title":"Atlantoaxial Tuberculosis: Three Cases","volume":"67","author":"Allali F.","year":"2000","journal-title":"Joint, Bone, Spine"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000043930.28934.FE"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-019-02236-5"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e318074d41e"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00634"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200105000-00012"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T03:39:39Z","timestamp":1749440379000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.70047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":44,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1111\/os.70047"],"URL":"https:\/\/doi.org\/10.1111\/os.70047","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"type":"print","value":"1757-7853"},{"type":"electronic","value":"1757-7861"}],"subject":[],"published":{"date-parts":[[2025,5]]},"assertion":[{"value":"2024-10-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}