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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Dorsal instrumentation of the cervical spine with the "Neon® occipito-cervical system

Dorsale Instrumentierung der HWS mittels Neon®

Meeting Abstract

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  • corresponding author Florian Ringel - Department of Neurosurgery, Friedrich-Wilhelms-University, Bonn
  • M. Behr - Department of Neurosurgery, Friedrich-Wilhelms-University, Bonn
  • M. Stoffel - Department of Neurosurgery, Friedrich-Wilhelms-University, Bonn
  • L. Rößeler - Department of Neurosurgery, Friedrich-Wilhelms-University, Bonn
  • C. Stüer - Department of Neurosurgery, Friedrich-Wilhelms-University, Bonn
  • J. Schramm - Department of Neurosurgery, Friedrich-Wilhelms-University, Bonn
  • B. Meyer - Department of Neurosurgery, Friedrich-Wilhelms-University, Bonn

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.13.06

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0130.shtml

Published: April 23, 2004

© 2004 Ringel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

To study the suitability of the Neon® occipito-cervical system for dorsal spondylodesis of the cervical and upper thoracic spine in neoplastic, degenerative, or traumatic diseases. Neon® (Ulrich GmbH, Ulm, Germany) is a novel polyaxial system that allows screw implantation into the occipital bone, transarticular, transpedicular, or through the lateral masses and stabilisation via a rod system.

Methods

53 consecutive patients (m=31, f=22, median age=63) with degenerative (n=26), traumatic (n=8), infectious (n=2), or neoplastic (n=17) diseases of the cervical and upper thoracic spine (C0-Th4) have been treated within 29 months. Primary dorsal as well as secondary dorsal approaches after ventral instrumentation have been used. Pre-/postoperative ct-scans/radiographs and clinical/radiographic follow-ups in pre-defined time intervals have been prospectively acquired using standard scales.

Results

A median of 3 segments (range: 1-6) have been bridged without significant intraoperative complications (median time of operation: 155 min). 10 of 261 implanted screws were defined as suboptimal (post-op. ct) leading to operative revision in 2 cases. 1 temporary and 1 permanent neurologic deterioration were observed postoperatively. In the last follow-up (2-25 months, mean: 7.5 months) patients showed improved mobility (median Karnofsky 60 (pre) to 80 (post)) with less subjective pain (median VAS 40 (pre) to 10 (post)). 20 (38%) patients showed a neurologic improvement (Nurick scale). No breaks or dislocation of the implanted hardware have been observed.

Conclusions

The Neon® occipito-cervical system has proven a convenient and extraordinary versatile system for dorsal spondylodesis along the cervical and upper thoracic spine. Especially in high-risk patients, for whom the anterior instrumentation poses an unreasonable risk due to perioperative morbidity, the Neon® system serves as an adequate alternative for cervical stabilisation. Above that, improved stability can be achieved by dorsal spondylodesis after extended ventral approaches.