AESCULAP® Ennovate® Cervical

This first multicenter study demonstrates that fully percutaneous cervical pedicle screw‑rod fixation using 3D navigation is both feasible and safe. Across three centers, 89.7% of screws were placed accurately, with no permanent neurological deficits or wound complications. Accuracy improved over time, indicating a learning curve. Mid‑cervical levels (C3–C6) showed lower accuracy and require particular attention.

The study evaluates the feasibility and accuracy of navigated percutaneous cervical pedicle screw instrumentation compared with a matched cohort treated using a conventional open midline approach. The results demonstrate comparable screw placement accuracy between both techniques, while the percutaneous group showed significantly shorter preparation times. Postoperative imaging revealed no relevant differences in paraspinal muscle atrophy between the groups. However, due to the retrospective study design, reliable follow-up imaging was available for only 35–40% of patients, which limits the strength of conclusions regarding muscle preservation. To assess the true benefits of minimally invasive surgery, prospective studies are required. Overall, the findings indicate that the percutaneous approach is a safe and versatile alternative suitable for a broad range of clinical indications.

The study compares open versus percutaneous navigated cervical pedicle screw placement for traumatic subaxial cervical spine injuries and shows that both techniques achieve similar accuracy in screw positioning. Percutaneous surgery demonstrated clear advantages, including a significantly shorter operative time (101 min vs. 148 min) and a notably lower intraoperative blood loss (166 mL vs. 342 mL). Further studies are needed to evaluate long-term clinical outcomes.

This anatomical feasibility study investigates the accuracy of navigated percutaneous cervical pedicle screw placement in the subaxial cervical spine. In a cadaveric setting, all subaxial cervical pedicles were instrumented using a standardized, navigation‑supported minimally invasive procedure. The results demonstrate that navigated percutaneous cervical pedicle screw placement can be performed with a high level of accuracy under the described conditions, supporting the technical feasibility of this approach.

A new minimally invasive cervical pedicle screw (CPS) fixation system using intra‑operative computed tomography‑guided navigation This pilot study reports on workflow, feasibility, and accuracy of a minimally invasive surgical (MIS) approach for cervical pedicle screw placement using intra‑operative CT‑guided navigation. A series of ten patients undergoing dorsal MIS cervical instrumentation was retrospectively analysed. Screw placement accuracy and procedure‑related events were assessed using established classification criteria. The results indicate that MIS cervical pedicle screw placement using CT‑based navigation can be performed with acceptable accuracy and appears feasible and safe in selected cases when performed by experienced surgeons.

This retrospective case series included patients with cervical instabilities treated by minimally invasive, percutaneous cervical and upper thoracic spine pedicle screw and rod insertion using Ennovate® Cervical. The results of this study indicate that minimally invasive percutaneous implantation of a pedicle screw-rod system is feasible.

Similar to the thoracic and lumbar spine, minimally invasive surgery (MIS) techniques in the cervical spine aim to achieve outcomes comparable to conventional procedures with regard to target surgery, while at the same time offering the benefits of less traumatic access surgery. In contrast to the thoracic and lumbar regions, however, MIS techniques in the cervical spine are predominantly applied via posterior approaches.