gms | German Medical Science

61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010
Joint Meeting mit der Brasilianischen Gesellschaft für Neurochirurgie am 20. September 2010

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21. - 25.09.2010, Mannheim

A prospective multicenter non-interventional study of rigid polyaxial pedicle screw fixation of the lumbar and thoracic spine for degenerative, metastatic, infectious and traumatic instability using the tangoRS spinal instrumentation system

Meeting Abstract

Suche in Medline nach

  • Marc-Eric Halatsch - Ruprecht-Karls-Universität, Neurochirurgische Klinik und Poliklinik Heidelberg, Deutschland; Neurochirurgische Universitätsklinik, Ulm, Deutschland
  • Berk Orakcioglu - Ruprecht-Karls-Universität, Neurochirurgische Klinik und Poliklinik Heidelberg, Deutschland
  • Andreas Unterberg - Ruprecht-Karls-Universität, Neurochirurgische Klinik und Poliklinik Heidelberg, Deutschland
  • tangoRS Study Group

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1605

DOI: 10.3205/10dgnc079, URN: urn:nbn:de:0183-10dgnc0794

Veröffentlicht: 16. September 2010

© 2010 Halatsch 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 vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Rigid dorsal instrumentation continues to represent a mainstay of treating spinal instability caused by various pathological conditions. In this prospective multicenter study of rigid polyaxial pedicle screw fixation of the lumbar and thoracic spine using the tangoRS spinal instrumentation system, epidemiology, surgical characteristics and clinical outcomes were compared for four disease categories commonly associated with spinal instability.

Methods: In 17 study centers in Belgium, Germany and Italy, a total of 433 patients were prospectively recruited and followed for 24 months postoperatively between May 2005 and March 2009 with intermittent visits at 6 and 12 months. The Visual Analog Scale (VAS) for pain was used as primary outcome measure.

Results: Rigid polyaxial pedicle screw fixation was performed for degenerative spondylosis, vertebral metastasis, spondylodiscitis and traumatic vertebral fracture in 50%, 12%, 13% and 25% of cases, respectively, and supplemented with indication-specific surgical measures (i.e., decompression, vertebral body replacement) via an traditional open (85%) or less invasive transmuscular approach (15%). Surgical times ranged from 48 to 720 minutes depending on the number of instrumented levels and additional surgical actions taken. For all indications, VAS for pain scores continuously dropped during the postoperative follow-up period (median, from 7.8 preoperatively to 2.1 at 24 months postoperatively), with the most pronounced improvement being observed for spondylodiscitis (median, from 8.1 preoperatively to 1.6 at 24 months postoperatively). For degenerative spondylosis and vertebral metastasis, the length of postoperative hospitalization generally increased with the number of instrumented spinal segments (median, 9 days for ≤ 2 segments to 20 days for ≥5 segments). This association was less clear for spondylodiscitis and traumatic fractures, probably due to the variable severity of the concomitant pathological state (e.g., sepsis, polytraumatization). Overall, implant-related complications occurred in 4.8% (n=21). Five of these patients required revision surgery.

Conclusions: In conjunction with disease-adapted surgical steps, rigid polyaxial pedicle screw fixation of the lumbar and thoracic spine using the tangoRS system provides excellent symptom relief for a variety of indications at low surgical morbidity and can be safely applied via alternative approaches.

The first two authors contributed equally to this study.