Question
I was in a halo for three months (after a C1 fracture==no surgery).  I am now in a soft collar.  Typically, how long should one wear it? Will I always be in danger of another fracture?

Answer
Dear Patricia,

The first thing you want to do is get out of that soft collar as soon as possible and begin rehab for increased mobility in the neck, muscular strength, and functional capacity.

Concerning a time frame for getting out of the collar, you really need to ask the orthopedist or neuro-surgeon who was your consult/treating physician for the halo.  They need to evaluate how well the fracture has healed...that is the limiting factor.  If the fracture is fully healed as I would suspect, then you should be fine to start activity without the collar.  Mild activity.

I would recommend starting off slowly with mild range of motion exercises in the neck about 10 minutes at a time, three times a day without the collar, and I would recommend that you not wear it while sleeping. The biggest problem here is that your neck is very weak at this point and also stiff.  You should really be going through an in office  physical therapy program 3-4 times a week for the next 4-6 weeks.

Concerning another fracture, as long as the atlas (C1) has healed without any deformity, it should be very strong, but any compressive trauma to the head would be bad news. You need to be particularly careful for the next 2-3 months, but after that time frame, and after completing rehab for the neck, I don't see any reason why you would not be able to live life normally.  Please check in with your treating physicians, and get in a structured rehab program.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net