gms | German Medical Science

Objective: Lately there has been a remarkable alteration in surgical techniques for spinal instrumentation by the development of less and less invasive accesses. For instance, mono- or bisegmental percutaneous instrumentation is already in good clinical practice for stabilizing spine trauma patients. Unfortunately, also multilevel procedures may be necessary depending on the degree of the underlying disease – tumor, trauma, infection, degenerative. Since September 2008 there is a new system available on the German market which fulfills these demands: CD Horizon Longitude™, Medtronic. We prospectively evaluated the field of application in patients with spinal metastases. In these patients the procedure had to fulfill the aim of sufficient benefit at the cost of minimal stress to preserve maximum quality of life.

Methods: Since September 2008 we prospectively operated on 4 consecutive patients who had to undergo spinal tumor decompression and stabilization within a palliative concept. The operation was performed in percutaneous multilevel technique with intraoperative X-ray control using antero-posterior and lateral paths of rays. In the postoperative course the patients were clinically and radiologically (CT) evaluated.

Results: Blood loss was less than 200ml in each procedure. OR time was reduced by up to 15% after the initial operations, even though the learning curve took its toll. Up two now 24 screws were implanted through minimally invasive approach. Postoperative CT control showed no screw displacement. Clinically, no neurological alterations were to be observed.

Conclusions: Inserting screws percutaneously in a multilevel procedure using CD Horizon Longitude™ is a safe and feasible technique and advances the surgical options in the aforementioned tumor patients.