The study center was not able to implement the contract parameters to our satisfaction. In particular, the number of patients recruited was far below the number agreed in the PMCF study protocol.

In accordance with the European Medical Device Regulation MDR 2017/745/EU, the legal manufacturers of medical devices are obliged to evaluate medical devices with regard to their clinical performance and safety.

The VERTICALE® Cervical System is intended for immobilization and stabilization of spinal segments of the craniocervical junction (occipital-C2), subaxial cervical spine (C3-C7) and upper thoracic spine (T1-T3).

Primary Objective:

To assess the functional outcome and clinical benefit of the VERTICALE® Cervical System for the patient using the NDI (Neck Disability Index) questionnaire.

Primary endpoint hypothesis:

The investigators hypothesize that NDI improves by at least 10% or 5 points at 12 months FU (Follow-Up) compared with preoperatively.

In accordance with the European Medical Device Regulation MDR 2017/745/EU, the legal manufacturers of medical devices are obliged to evaluate medical devices with regard to their clinical performance and safety.

The VERTICALE® Cervical System is intended for immobilization and stabilization of spinal segments of the craniocervical junction (occipital-C2), subaxial cervical spine (C3-C7) and upper thoracic spine (T1-T3).

The investigators interest is the continuous improvement of the surgical procedure in the context of degenerative cervical spine diseases. Patient satisfaction, as well as the avoidance of possible complications, are the main focus here. In addition, CE-certified medical devices must be evaluated for long-term performance and safety in clinical practice in accordance with the Medical Devices Act. The VERTICALE® Cervical System is a rod-screw system for immobilization (= immobilization) and stabilization of the affected segments, in the area between the occiput, the cervical spine and the upper thoracic spine (up to the 3rd thoracic vertebral body). Surgical intervention with the VERTICALE® Cervical System is performed from behind (posteriorly) and usually serves to stiffen the affected areas.

The goals of surgical intervention depend on the exact clinical picture and the associated symptoms, but usually consist of surgical relief of the affected structures of the nervous apparatus and/or spinal cord, stabilization of the bony structures to restore and/or maintain function, and relief of pain.

Inclusion Criteria:

Ability to read, understand and speak the local language fluently to ensure understanding of Informed consent and protocol specific investigations

• The surgical indication must be one or a combination of the following
• Degenerative disc disease (DDD)
• Instabilities
• Trauma
• Deformities
• Mono-, bi- and multisegmental restoration (occipital T3)
• Age: ≥ 18 years
• The subject must give written informed consent before inclusion into the PMCF study.

Exclusion Criteria:

Relative and absolute contraindications according to IFU (Instruction for Use):

Under certain circumstances, implantation is prohibited or associated with substantial risks, even though there may be an indication for it.

These include in particular:

• Anticipated or documented allergy or intolerance to the materials (e.g., titanium or cobalt chromium).
• Active systemic infection or an infection localized to the site of the proposed implantation
• Any case in which the chosen implants would be too large or too small to achieve a successful result.
• Any patient for whom the use of the implant would conflict with anatomical structures.
• Missing bony structures, which would render solid anchoring of the implant impossible (e.g., in the case of fractures, tumors, or osteoporosis). In addition, the patient's occupation or activity level or mental capacity may be relative contraindications to this surgery. Specifically, patients who because of their occupation or lifestyle, drug abuse, may place undue stresses on the implant during bony healing and may be at higher risk for implant failure.

Patients (minimum 18 years old) who undergo surgery with the VERTICALE® Cervical System due to one or a combination of the above mentioned indications and give their written consent to participate.