gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Clinical assessment of different systems for dorsal instrumentation of the cervical spine

Klinische Untersuchung der Eigenschaften verschiedener Systeme zur dorsalen Instrumentation der Halswirbelsäule

Meeting Abstract

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  • corresponding author K.-M. Scheufler - Abteilung Allgemeine Neurochirurgie, Universitätsklinikum Freiburg
  • V. I. Vougioukas - Abteilung Allgemeine Neurochirurgie, Universitätsklinikum Freiburg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP085

The electronic version of this article is the complete one and can be found online at:

Published: May 4, 2005

© 2005 Scheufler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




To evaluate the handling properties and surgical safety of three systems (Neon, PEAK/MossMini, Oasys) devised for dorsal instrumentation of the cervical spine.


In 75 patients, 408 pedicle screws, 132 lateral mass screws and 34 C1/C2 transarticular screws were inserted using anatomic landmarks and fluoroscopic guidance during surgical interventions addressing craniocervial (35), cervical (24) and cervicothoracic (15) instabilities. The ease and security of screw path preparation, screw insertion, screw-rod connection, occipital-plate fixation as well as neurological and vascular complications and early fixation failure were assessed retrospectively for a minimum observation period of 6 months.


Pedicle and transarticular screw insertion appeared safest with the cannulated self-tapping screws and percutaneous trocars of the Neon system, whereas screw-rod connection and overall assembly, especially during occipitocervical instrumentations, was more quickly achieved with the polyaxial PEAK/MossMini and Oasys systems. The most variable occipital plate-rod connection is offered by the PEAK/MossMini system. Lateral pedicle screw misplacement despite correct primary drilling trajectory (6) and occipital plate fracture (2) were observed exclusively with the Oasys system (p<0.01). Vertebral artery injury occurred once. Occipital neuralgia due to preparation of the C1/C2-joint was observed in 2 cases, and cervical nerve-root dysfunction was noted in 5 cases (4 of them transiently).


Percutaneous placement of cannulated self-tapping screws (Neon) greatly facilitates cervical transpedicular/transarticular instrumentation and appears to reduce the risk of vascular and neurological complications, especially in the upper and mid-cervical spine. Screw-rod connection is more quickly achieved with polyaxial PEAK/MossMini and Oasys polyaxial screws, whereas the Neon screw-rod connectors allow for easy transition from lateral mass to pedicle screws. Placement of cervical pedicle screws using the Oasys system should be avoided until the functionality of its screwdriver has been improved.