{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T08:57:16Z","timestamp":1785574636439,"version":"3.56.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>An 82-year-old woman sustained an Anderson Type II odontoid fracture after a fall and underwent halo vest fixation. Eight weeks later, she developed eyelid edema and altered consciousness. Computed tomography revealed intracranial pin penetration, cerebrospinal fluid (CSF) leakage, and pneumocephalus. The halo vest was removed, and subsequent conservative treatment with bed rest and antibiotics led to full neurological recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This rare case of intracranial pin penetration and CSF leakage following halo vest fixation emphasizes the importance of close monitoring and early imaging in patients presenting with neurological symptoms during prolonged immobilization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.26.00103","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T18:10:22Z","timestamp":1784225422000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Impaired Consciousness Following Cerebrospinal Fluid Leakage After Halo Vest Fixation for Odontoid Fracture"],"prefix":"10.2106","volume":"16","author":[{"given":"Taisuke","family":"Kurokawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1682-2749","authenticated-orcid":false,"given":"Shunsuke","family":"Katsumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2825-1819","authenticated-orcid":false,"given":"Akira","family":"Shinohara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2582-165X","authenticated-orcid":false,"given":"Daigo","family":"Arimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Obata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1653-4309","authenticated-orcid":false,"given":"Mitsuru","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7]]},"reference":[{"issue":"8","key":"bib1-20260801","doi-asserted-by":"crossref","first-page":"742","DOI":"10.2490\/jjrmc.57.742","article-title":"Upper cervical spine injury: treatment strategy","volume":"57","author":"Watanabe","year":"2020","journal-title":"Jpn J Rehabil Med."},{"issue":"10","key":"bib2-20260801","first-page":"e21.00129","article-title":"Cervical myelopathy caused by posttraumatic osteophytes resulting from long-standing neglected posterior atlanto-occipital dislocation more than 30 years: a case report","volume":"5","author":"Chang","year":"2021","journal-title":"J Am Acad Orthop Surg Glob Res Rev."},{"key":"bib3-20260801","first-page":"905","article-title":"Clinical characteristics and treatment results of odontoid fracture","volume":"12","author":"Gondo","year":"2021","journal-title":"J Spine Res."},{"issue":"1","key":"bib4-20260801","doi-asserted-by":"crossref","first-page":"37","DOI":"10.2106\/00004623-195941010-00006","article-title":"Total cervical-spine fusion for neck paralysis","volume":"41-A","author":"Perry","year":"1959","journal-title":"J Bone Joint Surg Am."},{"issue":"5","key":"bib5-20260801","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1177\/2192568218808293","article-title":"Outcomes of halo immobilization for cervical spine fractures","volume":"9","author":"Isidro","year":"2019","journal-title":"Glob Spine J."},{"key":"bib6-20260801","first-page":"413","article-title":"Complications of halo vest treatment","volume":"34","author":"Takahashi","year":"2022","journal-title":"J East Jpn Soc Orthopaedic Trauma Surg."},{"issue":"1","key":"bib7-20260801","doi-asserted-by":"crossref","first-page":"46","DOI":"10.3171\/spi.2006.5.1.46","article-title":"Complications of halo fixation in the elderly","volume":"5","author":"Horn","year":"2006","journal-title":"J Neurosurg Spine."},{"issue":"2 Suppl","key":"bib8-20260801","doi-asserted-by":"crossref","first-page":"12S","DOI":"10.1177\/2192568218768227","article-title":"Treatment of odontoid fractures: recommendation of the spine section of the German society for orthopaedics and trauma (DGOU)","volume":"8","author":"Gonschorek","year":"2018","journal-title":"Glob Spine J."},{"issue":"6","key":"bib9-20260801","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1093\/neuros\/nyw168","article-title":"Morbidity and mortality associated with surgery of traumatic C2 fractures in octogenarians","volume":"80","author":"Dhall","year":"2017","journal-title":"Neurosurgery."},{"issue":"2","key":"bib10-20260801","doi-asserted-by":"crossref","first-page":"196","DOI":"10.3171\/2023.3.SPINE221001","article-title":"Outcomes following anterior odontoid screw versus posterior arthrodesis for odontoid fractures: a systematic review and meta-analysis","volume":"39","author":"Texakalidis","year":"2023","journal-title":"J Neurosurg Spine."},{"issue":"3","key":"bib11-20260801","first-page":"553","article-title":"Treatment results of anterior fixation for odontoid fractures","volume":"68","author":"Hara","year":"2019","journal-title":"Orthop Disaster Surg."},{"issue":"6","key":"bib12-20260801","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1227\/neu.0000000000003529","article-title":"Masseter sarcopenia and mortality after type II odontoid fractures in the elderly: a 5-Year Follow-Up study","volume":"97","author":"Nassar","year":"2025","journal-title":"Neurosurgery."},{"key":"bib13-20260801","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.jocn.2021.08.027","article-title":"Too frail is to fail: frailty portends poor outcomes in the elderly with type II odontoid fractures independent of management strategy","volume":"93","author":"Carlstrom","year":"2021","journal-title":"J Clin Neurosci."},{"key":"bib14-20260801","doi-asserted-by":"crossref","first-page":"45","DOI":"10.3171\/2023.6.SPINE22920","article-title":"Nonoperative versus operative management of type II odontoid fracture in older adults: a systematic review and meta-analysis","volume":"40","author":"Mauricio","year":"2024","journal-title":"J Neurosurg Spine."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.26.00103","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T08:00:16Z","timestamp":1785571216000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.26.00103"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":14,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.26.00103","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}