Acute pulmonary edema following removal of a spinal orthosis: an unusual complication of a halo vest.

The halo vest is a commonly used spinal orthosis that provides stability to the cervical spine. Known complications include loss of spinal reduction, local pin tract infection, skin breakdown over the scapulae, and, rarely, brachial plexus and cranial nerve palsies. The use of the halo vest has not been associated with significant respiratory compromise. Cardiopulmonary complications associated with halo vests have not been reported. We report a case of pulmonary edema associated with removal of a halo vest in a patient with occult mitral stenosis. We speculate that removal of the orthosis resulted in rapid redistribution of peripheral blood volume sufficient in magnitude to provide the hemodynamic substrate for acute pulmonary edema.