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Region A
1%
44/5338
Region B
18%
980/5338
Region C
3%
145/5338
Region D
75%
4013/5338
Region E
2%
122/5338
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The safe zone for anterior pin insertion with halo immobilization is an approximately 1-cm region just above the lateral one third of the orbit (eyebrow) at or below the equator of the skull. More lateral pin insertion risks penetration of the thin temporal bone. More medial positioning risks injury to the supraorbital and supratrochlear nerves (see Illustration A). An injury to the supraorbital nerve may lead to pain and numbness over the medial one third of the eyebrow. The supratrochlear nerve supplies sensation medial and inferior to the supraorbital sensory distribution. Regions A, B, and C are all above the equator of the skull and would not be ideal from a biomechanical perspective. The review article by Bono explains the history, indications, proper placement, and complications of halo immobilization.
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