Posterior instrumentation of the cervical spine using the neon occipito-cervical system. Part 2: cervical and cervicothoracic instrumentation.

OBJECTIVE

Posterior cervical and cervicothoracic stabilization, if necessary, in combination with posterior spondylodesis, after closed or open reduction as well as with or without neural decompression as clinically indicated.

INDICATIONS: Instabilities and deformities of rheumatoid, traumatic, neoplastic, infectious, iatrogenic or congenital origin. Multilevel cervical spinal stenosis with degenerative instability or kyphosis of the affected spinal segment. Corrective spondylodesis for posttraumatic or postinfectious kyphosis.

CONTRAINDICATIONS: Infection in the operative field. Inability to undergo anesthesia.

SURGICAL TECHNIQUE: Prone position, rigid head fixation, e. g., with Mayfield tongs. If appropriate, closed reduction under lateral image intensification. Midline posterior surgical approach at the level of the segment to be instrumented. If necessary, open reduction. Insertion of the cervical/upper thoracic screws. If necessary, posterior decompression. Instrumentation with prebent longitudinal rods. If a fusion is to be obtained, decortication of the posterior bone elements with a burr and onlay of cancellous bone.

RESULTS

44 patients, 13 women and 31 men, with an average age of 57 years were operated on between August 2000 and August 2003. All patients underwent a follow-up examination 4-39 months (average 15.7 months) after the initial surgery. Fusion was achieved in all patients who had undergone a posterior spondylodesis: no implant failure, no implant removal or reoperation. The preoperatively planned instrumentation could be implemented intraoperatively in all patients.