gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Anterior-posterior cervical intrumentation – the need and benefits in multilevel corpectomy and cervico-thoracic pathology

Meeting Abstract

  • Murat Yavuz - Klinik für Neurochirurgie, Universitätsklinikum Münster, Münster, Deutschland
  • Mark Klingenhöfer - Zentrum für Wirbelsäulentherapie, Städtisches Klinikum Dresden-Friedrichstadt, Dresden, Deutschland
  • Swenja Lüthge - Klinik für Neurochirurgie, Universitätsklinikum Münster, Münster, Deutschland
  • Nils Warneke - Klinik für Neurochirurgie, Universitätsklinikum Münster, Münster, Deutschland
  • Michael Schwake - Klinik für Neurochirurgie, Universitätsklinikum Münster, Münster, Deutschland
  • Walter Stummer - Klinik für Neurochirurgie, Universitätsklinikum Münster, Münster, Deutschland
  • Christian Ewelt - Klinik für Neurochirurgie, Universitätsklinikum Münster, Münster, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.25.08

doi: 10.3205/17dgnc330, urn:nbn:de:0183-17dgnc3306

Published: June 9, 2017

© 2017 Yavuz et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: Postoperative stability of the cervical spine is affected by the increasing number of decompressed levels and also depending on the underlying disease. Considering the stability alone the anterior-posterior instrumentation seems to be the best choice. However, in multimorbid elderly patients the combined approach could be disproportionately risky. Therefore it is a balancing act between the extent of surgery for postoperative stability and patient safety. We report on our experience in anterior-posterior cervical instrumentation in complex spine reconstruction and the postoperative results.

Methods: We retrospectively identified 38 patients aged between 38 and 85 years (64±10 years, 20 female vs. 17 male) over the last six years. The inclusion criteria were anterior-posterior instrumentation either including cervico-thoracic junction or multilevel (≥2) cervical corpectomy. Reasons for surgery were pathologic and traumatic fractures, advanced degeneration or purulent diseases of the cervical spine. All patients received postoperative computed tomography and follow- ups (8±7 months, range 1–28 months).

Results: Patients were assigned into two groups, the larger group 1 (87%, n=33) received anterior-posterior cervical instrumentation in a one-stage approach, including 2 patients (5%) who were initially scheduled for unilateral instrumentation (anterior or dorsal) – in which early instability of the instrumentation during current hospital stay forced to immediate conversion to the combined (anterior and dorsal) approach. Group 2 (13%, n=5) in retrospect was treated in a two-stage procedure. Initial unilateral instrumentation led to instability in the course after a mean time of 11 months (range 1–28 months). None of the group 1 patients showed secondary instrumentation failure after the combined one-stage approach.

No patient died after the treatment and none showed lasting deterioration in the neurological outcome. Eight patients were unchanged (21%) and thirty patients improved (79%) in terms of sensorimotor function, pain level and / or spasticity.

Seven patients of group 1 (21%) developed complications like wound healing disturbances (6%, n=2), pleura effusion, urinary tract infection, Horner’s syndrome, paralysis of the recurrent nerve and pneumonia (each 3% / n=1). Three patients (60%) of group 2 showed wound healing disturbances (40%, n=2) and pneumonia (20%).

Conclusion: Considering the lower morbidity and missing instability in the course, the anterior-posterior cervical instrumentation in multilevel corpectomy and cervico-thoracic junction pathology seems to be unrivaled at the moment – especially in regard of missing adequate alternatives.