Where should the anterior pins for a HALO be placed?

The correct placement of the anterior pins for a HALO device is crucial for effective immobilization and stabilization of the cervical spine. Placing the pins 10mm superior to the eyebrow, specifically in the lateral 1/3 of the eyebrow, allows for optimal fixation while avoiding critical structures in the forehead area and ensuring that the device is centered on the skull.

This positioning ensures that the pins engage the denser bone of the frontal region, providing a solid foundation for the HALO structure, which is essential for maintaining alignment and preventing movement of the cervical spine during the healing process. The lateral aspect of the eyebrow also helps in distributing the forces exerted on the skull and minimizes the risk of complications such as pin site infections or skin necrosis due to pressure points.

In contrast, placements at the level of the eyebrow or directly on the eyebrow could risk damaging the periosteum or cause discomfort to the patient. Moreover, positioning the pins in the center of the forehead may not provide adequate security for stabilization, as it does not make effective use of the anatomical structure of the skull in providing a solid grip. Hence, the recommended placement at 10mm superior to the eyebrow, in the lateral 1/3, optimizes both safety and effectiveness of