Richard Bransford, Maarten Spruit
SYMPHONY OCT System—Compartment 2 Occipital-Cervical-Thoracic (OCT) Systems have been developed to provide posterior correction and stabilization of spinal segments as an adjunct to fusion from the occiput to the thoracic spine. The current generation of OCT systems address the clinical needs for open posterior approach for numerous pathologies to include degenerative conditions, trauma, tumors, deformities, and infections. The SYMPHONY™ OCT System is an enhanced set of instruments and implants for posterior fixation of the occipital-cervical junction, subaxial spine, and cervico-thoracic junction. Compartment 1 of the SYMPHONY OCT system was launched in November 2019, and was described in the 2019 issue of the Innovations magazine (Innovations magazine; 2019). A complex cervical case was presented in the 2020 issue of the Innovations magazine demonstrating the utility of Compartment 1 (Innovations magazine; 2020). SYMPHONY Compartment 1 has recently been supplemented by enhanced and innovative elements (Compartment 2) to further address surgical needs and avoid pitfalls in a complex cervical surgery. Launched in early 2021, the Compartment 2 components include MULTIPOINT SECURE™ to augment lateral mass screws, reduction screws, advanced connector and various rod designs, a short drill guide, and polydriver. This additional feature builds on the advanced features already found in Compartment 1, which took the best of Synthes Synapse and DePuy Mountaineer.
Fixation By optimizing and improving instruments and implants for posterior cervical fusion (PCF) following FATE principle (fixation, alignment, targeting, and extension), Compartment 2 further addresses surgical and technical concerns in an aging population with suboptimal bone quality and in patients who may require stronger constructs meeting the indications for spinal fusion [1–3]. There is also an increasing number of patients requiring extensions from prior posterior instrumented fusions. Screw fixation failure is another frequently reported issue (up to 5.2%) in PCF, and patients with suboptimal bone quality may be at a greater risk [3, 4]. More robust fixation of lateral mass screws (C3-C7) is now provided with MULTIPOINT SECURE (Fig 1). A significant potential complication associated with lateral mass screws is loss of fixation. Market research reveals that 95% of surgeons have observed a lateral mass screw pullout or screw loosening [5]. The supplemental use of MULTIPOINT SECURE adds additional points of fixation, as the load can be shared across additional points of fixation via a locking plate. Reinforcing a lateral mass screw with MULTIPOINT SECURE with additional screws, increases the resistance to screw pullout by an average of 48.2% compared with standalone lateral mass screws [5].
Fig 1 MULTIPOINT SECURE adapter with a two-screw fixation. It has variable angle locking technology. Screw tips are self-drilling. The adapter allows up to 25° cone of angulation.
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Innovations 2021
