gms | German Medical Science

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

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

Dorsale Instrumentierung der HWS mittels Neon®

Meeting Abstract

  • 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

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0130.shtml

Veröffentlicht: 23. April 2004

© 2004 Ringel et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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.