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Using A Halo Brace After Spinal Cord Injury


A halo brace is a brace used to prevent your neck and head from moving. It keeps your neck in the correct position. This allows your injured spinal column and the ligaments to heal. It also helps support your neck muscles. This brace keeps your neck from moving forward, bending backward, and your head from turning. Staying in bed may cause many pressure sores, blood clots, and other health problems. The halo brace lets you get out of bed and start moving sooner after your injury. The halo brace consists of:
  • A metal ring that circles your head without touching your skull.
  • Pins that go through the metal ring and are screwed into your skull.
  • A movable frame that connects the metal ring to a plastic vest.
  • A plastic vest that supports the frame.
  • A washable liner that goes inside the plastic vest to protect your skin.



  • Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  • Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.

Ask your caregiver when to return for a follow-up visit.

Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Do's and do nots of having a halo brace:

  • Do lie flat if the vest needs to be opened for any reason.
  • Do close and secure the vest after opening it in front before turning over to open the back. Always have someone check the vest and the tightness of the pins before getting out of bed.
  • Do keep your hair short around the pin sites.
  • Do wear the liner under the vest without anything else between the vest and your skin.
  • Do tell your caregiver if you have neck pain or a headache. Also tell them if you can move your head even a little bit. Stay flat in bed until your caregiver checks the halo.
  • Do not allow anyone to move you by holding onto the frame of the halo.
  • Do not open the vest unless you have help from someone who has been trained to help you.
  • Do not allow anyone to adjust the halo unless they are trained to adjust it.

Caring for the halo brace:

Taking care of your halo brace includes cleaning and checking the pin sites and the skin under the vest. It also includes checking the pin and bolt adjustments.

Checklist for pin site care:

Check the site where the pins enter the skull. Do this twice each day. Tell your caregiver if the pin sites are red, swollen, painful, or draining. Tell your caregiver if you can move your head because the brace may need to be adjusted. Clean each pin site two times each day with half-strength hydrogen peroxide and cotton tipped swabs. To clean your pin sites, follow these steps:

  • 1. Gather the needed supplies. These usually include hydrogen peroxide, sterile (clean) normal saline (salt water), cotton tipped swabs, and two small clean bowls. Ask caregivers where to find these supplies. Keep the bottle of peroxide out of the light.
  • 2. Wash your hands.
  • 3. Make half strength hydrogen peroxide by pouring a small amount (such as one-half of a cup) of the hydrogen peroxide into one of the bowls. Add the same amount of the saline into the bowl.
  • 4. Pour a small amount of saline into a second bowl.
  • 5. Dip a cotton tipped swab into the half strength peroxide and clean around each pin in a circular motion. Gently press the skin down so that you can clean the part of the pin under the surface of the skin. You may need to use several clean cotton tipped swabs to clean the drainage around each pin. Use each cotton swab only once. Do not use the same swab for more than one pin site, or when the swab looks dirty.
  • 6. Clean and rinse each pin site.
  • 7. Throw the dirty cotton tipped swabs into the trash. Dump the half strength peroxide and the saline down the drain when you are done. Wash and dry both containers and finish by washing your hands.

Checklist for good skin care:

  • 1. Have a caregiver check your skin every morning and evening.
  • 2. Lie flat on the bed before having your caregiver open your vest. Your caregiver may want to use a flashlight to look under the vest. If so, it may not need to be completely removed.
  • 3. To bathe, leave the vest on. Your caregiver will change the liner of the vest after you bathe. Sit up after replacing the liner to make sure that it is not bunched or wrinkled.
  • 4. Wash the liner that you remove. Make sure it is completely dry before using it. Let it air dry by lying it flat. Once it is dry, you may reuse it.
  • 5. Notify your caregiver if you notice any red, sore, or open areas on your skin.

Safety measures with a halo brace:

It is very important to make sure that the pins and bolts on your halo frame and in your skull are secure. If they are loose, the frame may not be lined up correctly. This could cause serious problems. Your caregiver will check the pin sites, nuts, and bolts regularly. Tell them if you notice any loose pieces so that your caregiver can tighten them as soon as possible.

For support and encouragement:

  • Having a spinal cord injury is life changing for you and your family. Accepting that you have a spinal cord injury is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Let them help you. Your caregiver can help your family better understand how to support a person with a spinal cord injury.
  • You may want to join a support group. This is a group of people who also have spinal cord injuries. Ask your caregiver for the names and numbers of support groups in your town. For more information, you may contact any of the following:
  • Paralyzed Veterans of America
    801 Eighteenth Street NW
    Washington, DC , 20006
    Phone: 1- 800 - 424-8200
    Web Address:
  • National Spinal Cord Injury Association
    6701 Democracy Blvd, Ste 300-9
    Bethesda , MD 20817
    Phone: 1- 800 - 962-9629
    Web Address:
  • American Spinal Cord Association
    2020 Peachtree Road, NW
    Atlanta, Georgia , 30309-1402
    Phone: 1- 404 - 355-9772
    Web Address:


  • You notice any signs of infection, such as redness, swelling, pain, or drainage around the pin sites.
  • You have neck pain or a headache.
  • You have signs of a pressure sore under the vest. These signs include red, painful, and open areas of skin.


  • You can move your head or neck. Lie down flat after contacting your caregiver. Your caregiver will need to check your halo and pin sites.
  • You see or feel any loose pins, nuts, or bolts.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Learn more about Using A Halo Brace After Spinal Cord Injury (Discharge Care)

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