Discharge Instructions: Using a Halo Ring and Vest Brace

You are going home with a halo ring and vest brace in place. This device is used to keep your head and neck from moving after a neck fracture or surgery. It has 3 parts:

  • A vest that you wear on your chest

  • A lightweight metal ring, or halo, that is fastened to your head with 4 pins

  • Four rods that extend from the vest and attach to the ring

The halo does for your neck what a cast does for a broken arm. Wearing a halo ring and vest brace means that you can go home to heal and move about. You don't need to stay in bed or in the hospital while your neck heals. Getting used to the halo ring and vest brace takes time. But you'll adjust. You will be wearing the device for about 12 weeks. Here's what you need to know about home care.

Skin and hair care

  • Clean the skin around the pins twice a day. Soak a cotton swab or cotton ball with soap and water to clean around the pin, or use the cleaning solution advised by your healthcare provider. Use a clean swab each time avoiding re-dipping into cleaning solutions.

  • Don’t use creams, lotions, or antiseptics unless the healthcare provider says it’s OK.

  • Check the skin under the vest brace daily for possible skin breaks or pressure sores (ulcers). These pressure sores are more likely to occur on the top of the shoulders. This is often done by having someone pass their hand under the vest while you are lying down. Don’t use soap, lotion, or powder under the vest. These items can irritate your skin.

  • Ask a friend or family member to help you wash your hair. Use mild soap.

  • Don’t dye your hair or use hair sprays.

The vest

  • Bathe in a bathtub. But keep the water below the level of your vest. Don’t get the vest brace wet.

  • Wear a cotton T-shirt under the vest to prevent irritation. You will need to cut or stretch the T-shirt so that it will fit over the halo.

  • Wear shirts that button up the front. They should be one or two sizes larger than you normally wear. Then they can fit over the vest.


  • Be active, but use good judgment. Don’t ride a bike or skateboard. Your balance will be off.

  • Bend over a bit when entering doorways.

  • Turn your back toward the seat and lower yourself carefully to get into cars. Small cars will be hard for you to get in and out of.

  • Don’t jump, run, or lift anything heavier than 10 pounds (5 pounds for children).

  • Stay away from crowds or places where you might be shoved or bump into others.

  • Stop any activity that makes your neck hurt.

  • Sleep in any position that feels OK.

  • Remember to be careful when you get out of bed. Log-roll to the edge of the bed. Drop your legs to the floor and use your arm to raise your upper body slowly.

  • Ask your healthcare provider when you can go back to work. You may not be able to work while you are wearing your halo ring and vest brace.

Follow-up care

Follow up with your healthcare provider as advised. 

When to call your healthcare provider

Call your healthcare provider right away if any of these occur:

  • New neck pain

  • Pain, redness, swelling, or green or yellow drainage at the pin sites

  • Pins that move or shift, or open skin around the pin sites

  • Loose halo or halo parts, or clicking noises coming from the device

  • Ability to nod or excessively move your head

  • Severe back or neck pain

  • If you think you have a pressure ulcer

  • Bruising and swelling on your neck or back

  • Tingling or numbness in your arms or legs

  • Trouble controlling your bowels or bladder

  • Loss of feeling and movement in arms or legs

  • Fever above 100.4°F (38°C) or higher, or as advised by your provider

  • Shaking chills

© 2000-2024 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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