ACIS Anterior Cervical Interbody Spacer
|
|
- Coral Sims
- 5 years ago
- Views:
Transcription
1 Implants and Instruments for Interbody Fusion ACIS Anterior Cervical Interbody Spacer Surgical Technique
2 Image intensifier control This description alone does not provide sufficient background for direct use of DePuy Synthes products. Instruction by a surgeon experienced in handling these products is highly recommended. Processing, Reprocessing, Care and Maintenance For general guidelines, function control and dismantling of multi-part instruments, as well as processing guidelines for implants, please contact your local sales representative or refer to: For general information about reprocessing, care and maintenance of Synthes reusable devices, instrument trays and cases, as well as processing of Synthes non-sterile implants, please consult the Important Information leaflet (SE_023827) or refer to:
3 Table of Contents Introduction ACIS Anterior Cervical Interbody Spacer 2 AO Spine Principles 4 Indications and Contraindications 5 Surgical Technique Preparation 6 Patient Positioning 7 Exposure and Discectomy 8 Segment Distraction 9 Endplate Preparation 10 Implant Size and Shape Determination 11 Implant Insertion 14 Supplemental Fixation 22 Implant Removal 23 Product Information Implants 24 Instruments 28 Sets 31 Additionally Available 32 Also Available from Synthes: chronos Putty Spine 33 Bibliography 35 ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 1
4 ACIS Anterior Cervical Interbody Spacer. Implants and Instruments for Interbody Fusion. The ACIS implant is designed to meet the specific demands of anterior cervical interbody fusion procedures. The implant features a large central canal and is available in three footprints, multiple heights and three sagittal profiles to accommodate various patient anatomies. Implant-Instrument interface Stable interface designed for fast and effective connection/release with the insertion device Pyramidal teeth Designed to provide resistance to implant migration Large central canal Accommodates autogenous bone graft or bone graft substitute to allow fusion to occur through the implant Midline markers Facilitate implant positioning/alignment in multilevel procedures Anatomic shapes Multiple implant variations offered to suit individual anatomical conditions Lateral windows Windows on the lateral walls of the cage to allow for fusion Material Biocompatible radiolucent polymer (PEEK*) allows clear assessment of bony fusion *Polyetheretherketone 2 DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
5 Trial Implants Preassembled trials for improved handling Double-sided trials for fast height comparison Color coded by sagittal profile Insertion Device Rigid interface for secure implant placement Slim implant interface for enhanced visibility during insertion Multiple shaft options with and without depth stop designed to accommodate surgeon preference Implant Holder Alternative implant insertion option designed for enhanced precision control Quick implant engagement and disengagement with one click squeeze-lock mechanism Allows for enhanced visibility ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 3
6 AO Spine Principles The four principles to be considered as the foundation for proper spine patient management underpin the design and delivery of the Curriculum: Stability Alignment Biology Function. 1,2 Stability Stabilization to achieve a specific therapeutic outcome axial sagittal coronal Alignment Balancing the spine in three dimensions Biology Etiology, pathogenesis, neural protection, and tissue healing Function Preservations and restoration of function to prevent disability Copyright 2012 by AOSpine 1 Aebi et al (1998) 2 Aebi et al (2007) 1 DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
7 Indications and Contraindications Intended Use The Synthes ACIS system is intended to replace cervical intervertebral discs and to fuse adjacent vertebral bodies at vertebral levels C2 C7 following anterior cervical discectomy for reduction and stabilization of the cervical spine. The use of autologous bone or bone graft substitute is recommended. Indications Cervical pathologies for which segmental arthrodesis is indicated: Degenerative disc diseases and instabilities Ruptured and herniated discs Pseudarthrosis or failed spondylodesis For multisegmental fusions with the ACIS system supplemental fixation is recommended. Contraindications Osteoporosis Severe instabilities Vertebral body fractures Spinal tumors Infections ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 5
8 Preparation 1. Preparation Required set ACIS Standard Set in Vario Case Optional sets Cervical Retractors and Distractors Have all necessary imaging studies readily available to plan implant placement and visualize individual patient anatomy. Have all necessary sets readily available prior to surgery. 2. Assemble insertion device Instrument ACIS Insertion Device 1 Assemble the insertion device prior to use according to the assembling instruction shown here or refer to DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
9 Patient Positioning Position the patient in a supine position on a radiolucent operating table. Ensure that the neck of the patient is in a sagittally neutral position and supported by a cushion. When treating C6 C7 make sure that the shoulders do not limit the x-ray monitoring. For all cases, both vertebrae should be completely visible. ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 7
10 Exposure and Discectomy 1. Access Optional set Cervical Retractors and Distractors Locate the correct operative level under radiographic control and incise. Expose the intervertebral disc and the adjacent vertebral bodies through a standard anterior approach to the cervical spine. Warning: Careful positioning of the retractor is required to reduce soft tissue damage. 2. Discectomy Prepare the fusion site following the appropriate technique for the given indication. 8 DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
11 Segment Distraction Optional set Cervical Retractors and Distractors Perform segmental distraction. Note: Distraction of the segment is essential for restoring disc height and for providing good access to the intervertebral space. ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 9
12 Endplate Preparation Optional instrument Endplate Rasp When the discectomy is complete, remove the superficial cartilaginous layers of the endplates to expose bleeding bone. Warnings: Adequate cleaning of the endplates is important for vascular supply of the autologous bone graft or bone graft substitute. Excessive cleaning, however, may result in removal of bone underlying the cartilaginous layers and weaken the endplates. The removal of any osteophytes is crucial for achieving complete decompression of the neural structures and for reducing the risk of partial compression after implant insertion. Note: The endplate rasp is double sided with a standard depth on one side and a large depth on the other side. These are indicated by one (standard) and two (large) white bands on the shaft as well as etchings on the rear side of the rasp. The depth is limited by a stop. Depths are 14 mm for the standard and 16 mm for the large. The width is 8 mm and the height is 4 mm. height 4 mm depth 14 mm: standard 16 mm: large width 8 mm 11 DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
13 Implant Size and Shape Determination Instruments ACIS Trial Implant, standard, lordotic, heights 5 12 mm, double-sided, blue ACIS Trial Implant, standard, parallel, heights 5 12 mm, double-sided, purple ACIS Trial Implant, standard, convex, heights 5 12 mm, double-sided, yellow ACIS Trial Implant, large, lordotic, heights 5 12 mm, double-sided, blue ACIS Trial Implant, large, parallel, heights 5 12 mm, double-sided, purple ACIS Trial Implant, large, convex, heights 5 12 mm, double-sided, yellow ACIS Trial Implant, small, lordotic, heights 5 12 mm, double-sided, blue ACIS Trial Implant, small, parallel, heights 5 12 mm, double-sided, purple ACIS Trial Implant, small, convex, heights 5 12 mm, double-sided, yellow Optional instrument Mallet For a complete overview of trial implants please refer to page 28. ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 11
14 Implant Size and Shape Determination The selection of the trial implant depends on the height, width and depth of the intervertebral space, the preparation technique and the patient s anatomy. Choose a standard, large or small footprint trial implant with convex, lordotic or parallel sagittal shape of the appropriate height. Notes: The trial implants are double sided with different heights on either side. Colored bands on the shaft indicate which side is of lesser (one band) or greater (two bands) height. In addition, heights are etched on the cranial and caudal surfaces of the trial implants. Trial implants are color coded by sagittal shape: yellow, blue and purple bands on the shaft indicate that a trial implant is convex, lordotic or parallel. Furthermore, the following etchings on the cranial and caudal surfaces indicate the sagittal shape: C for convex, L for lordotic, and P for parallel. The footprint is indicated by the etchings Small, Standard and Large on the cranial and caudal surfaces of the trial implants. yellow convex blue lordotic purple parallel greater height lesser height lordotic convex parallel Before carefully inserting the trial implant, ensure that the orientation of the trial implant is correct. Each convex trial implant is etched with an arrow pointing cranially on the lateral walls to indicate the correct cranial/ caudal alignment. The lordotic and parallel trial implants do not have a dedicated cranial or caudal surface. They can be inserted into the intervertebral disc space with either surface pointing cranially. Warning: Ensure that all disc material has been removed from the insertion path to avoid dislocation into the spinal canal. 11 DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
15 If necessary, controlled and light hammering with the mallet can be used to help advance the trial implant into the intervertebral disc space. Precautions: Excessive impaction force during trial implant insertion must be avoided. The trial implants do not have a depth limiter; an image intensifier should be used to check the position during insertion. Use image intensifier to confirm the fit of the trial implant. If the trial implant appears too loose or too tight, try the next larger or smaller size height until the most secure fit is achieved. Warnings: The height of the trial implants is undersized by 0.5 mm compared to the implant, to ensure a tight fit for final implant insertion. With the segment fully distracted, the trial implant must fit tightly and accurately between the endplates. To reduce potential increased risk to the patient, it is recommended to first trial with smaller height trial implants before trialing with taller trial implants. Trial implants are not for implantation and must be removed before insertion of the ACIS implant. The mallet can be used for trial implant removal. While holding the trial implant slide the mallet over the upper part of the trial implant s shaft and apply an upward force. Repeat this process until the trial implant has been removed. ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 11
16 Implant Insertion Option A. Insertion device 1. Attach implant to insertion device Instruments ACIS Insertion Device and Inner Shaft, small, with Stop, for No or Inner Shaft, standard/large, without Stop, for No or Inner Shaft, standard/large, with Stop, for No or Inner Shaft, small, without Stop, for No Optional instruments Impactor, flat Mallet Select the ACIS implant that corresponds to the footprint, shape and height determined using the trial implant. Refer to page 6 for ACIS insertion device assembly. If desired, the insertion device can be combined with an inner shaft with stop. It has a depth limiter that will contact the anterior edge of the vertebral body when the ACIS implant is inserted approximately 1 mm beyond the anterior edge of the vertebral body. Attach the implant to the ACIS insertion device by aligning the recessed grooves located on the side walls of the implant with the prolonged tabs of the instrument tip and engaging those. Turn the knob clockwise to secure the implant. Ensure that the implant is held flush against the insertion device and securely in the tabs. 11 DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
17 2. Pack implant with autologous bone graft or bone graft substitute Optional instruments Cancellous Bone Impactor Packing Block It is recommended to pack the ACIS implant with autologous bone or bone graft substitute. Place the ACIS implant into the packing block. Small and standard footprint implants fit into the cavity marked Standard while large footprint implants fit into the cavity marked Large. The cancellous bone impactor can be used to firmly pack the autologous or bone graft substitute into the implant cavity. Precaution: Excessive impaction of the implant with the cancellous bone impactor should be avoided to prevent possible implant damage. Notes: To ensure contact with the vertebral endplates, it is important to fill the implant until the autologous bone or bone graft substitute protrudes from the openings of the implant. A table on page 27 shows the approximate graft volume that the ACIS implants hold, depending on the footprint, height and sagittal profile. ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 11
18 Implant Insertion 3. Insert implant Confirm the implant is securely attached. Carefully insert the implant into the distracted segment, ensuring that the orientation of the implant is correct. Each convex implant is etched with an arrow pointing cranially on the left lateral wall to indicate the correct cranial/caudal alignment. The lordotic and parallel implants have a symmetrical sagittal profile and therefore do not require specific orientation. If necessary, controlled and light hammering with the mallet can be used to help advance the implant into the intervertebral disc space. Turn the knob in a counterclockwise direction to release the implant from the insertion device. Remove the insertion device and if required use the flat impactor to seat the implant into its final position. 11 DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
19 Use image intensifier to confirm the position of the implant. Precautions: If an inner shaft without stop is used then an image intensifier should be used to check the position during insertion. Excessive impaction must be avoided to prevent implant damage or too deep insertion. Excessive tilting of the insertion device must be avoided to prevent implant separation or damage. Warning: Verify final implant position relative to the vertebral bodies in the AP and lateral direction with the help of an intraoperative x-ray. The ACIS implant has three x-ray markers incorporated in the implant to enable accurate intraoperative radiographic assessment of the implant position. Notes: B 1.0 mm TAV pins as x-ray markers. The distance between pins and the anterior and posterior walls of the implant is approx. 1.0 mm. The posterior pin is centered. ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 11
20 Implant Insertion Option B. Implant holder 1. Attach implant to implant holder Instrument ACIS Implant Holder Optional instruments Impactor, flat Mallet Select the ACIS implant that corresponds to the footprint, shape and height determined using the trial implant. Attach the implant to the ACIS implant holder by aligning the recessed grooves located on the side walls of the implant with the prolonged tabs of the instrument tip. Engage the squeeze-lock by applying slight pressure on the arms of the implant holder. 11 DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
21 2. Pack implant with autologous bone graft or bone graft substitute Optional instruments Cancellous Bone Impactor Packing Block It is recommended to pack the ACIS implant with autologous bone or bone graft substitute. Place the ACIS implant into the packing block. Small and standard footprint implants fit into the cavity marked Standard while large footprint implants fit into the cavity marked Large. The cancellous bone impactor can be used to firmly pack the autologous or bone graft substitute into the implant cavity. Precaution: Excessive impaction of the implant with the cancellous bone impactor should be avoided to prevent possible implant damage. Notes: To ensure contact with the vertebral endplates, it is important to fill the implant until the autologous bone or bone graft substitute protrudes from the openings of the implant. A table on page 27 shows the approximate graft volume that the ACIS implants hold, depending on the footprint, height and sagittal profile. ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 11
22 Implant Insertion 3. Insert implant Confirm the implant is securely attached, carefully insert the implant into the distracted segment, ensuring that the orientation of the implant is correct. Each convex implant is etched with an arrow pointing cranially on the left lateral wall to indicate the correct cranial/caudal alignment. The lordotic and parallel implants have a symmetrical sagittal profile and therefore do not require specific orientation. Release the implant holder by applying slight pressure on the arms of the implant holder and disengaging the squeeze-lock. Remove the holder and if required use the flat impactor to seat the implant into its final position. Use image intensifier to confirm the position of the implant. Precautions: The implant holder does not feature a depth stop. Image intensifier control should be used to check the position during insertion. Excessive tilting of the implant holder must be avoided to prevent implant separation or damage. Warning: Excessive impaction must be avoided to prevent implant damage or too deep insertion. 22 DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
23 Warning: Verify final implant position relative to the vertebral bodies in the AP and lateral direction with the help of an intraoperative x-ray. The ACIS implant has three x-ray markers incorporated into the implant to enable accurate intra operative radiographic assessment of the implant position. Notes: B 1.0 mm TAV pins as x-ray markers. The distance between pins and the anterior and posterior walls of the implant is approx. 1.0 mm. The posterior pin is centered. ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 22
24 Supplemental Fixation Optional Sets Cervical Spine Locking Plates with variable angle in Vario Case Cervical Spine Locking Plates 4.0/4.35 (Pure Titanium) in Vario Case Vectra in Vario Case For multi-segmental instrumentation, ACIS is intended to be used with Synthes supplemental fixation, e.g. CSLP or Vectra. Complete the procedure by following the steps indicated in the respective surgical technique. 22 DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
25 Implant Removal Instrument ACIS Insertion Device Optional instrument Mallet Attach the ACIS insertion device to the implant in the disc space by aligning the pronged tabs of the instrument tip to the recessed grooves located on the side walls of the implant. Tighten the knob clockwise until the implant has a rigid connection. Ensure that the implant is held flush against the insertion device and securely in the tabs. Remove the implant from the disc space. Warning: Take care not to push the implant towards the posterior elements. Precautions: Excessive tilting of the insertion device must be avoided to prevent implant separation or damage. In case of visible damages on the implant it should not be reused. The mallet can be used for implant removal. While holding the insertion device, slide the mallet over the shaft of the insertion device and apply an upward force. Repeat this process until the implant has been removed. ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 22
26 Implants ACIS implants Supplied sterile Implant material: PEEK with Titanium alloy (Ti-6Al-4V) radiographic marker pins Three radiographic marker pins Enable visualization of the implant position B 1.0 mm TAV pins Distance between pins and the anterior and posterior walls of the implant is approx. 1.0 mm Posterior pins are centered Distance between anterior pins and lateral walls of the implant varies between the different footprint sizes: Small 3.0 mm Standard 4.0 mm Large 5.0 mm 1 mm 1 mm 22 DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
27 3 footprints: Small (11.5 mm 12.5 mm) Standard (13 mm 14 mm) Large (15 mm 16 mm) 11.5 mm Small Standard Large 13 mm 15 mm 12.5 mm 14 mm 16 mm 3 sagittal shapes: Lordotic Parallel Convex Lordotic Parallel Convex 8 heights ranging from 5 mm to 12 mm (in 1 mm increments) Height Height Height ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 22
28 Implants Lordotic Parallel Convex Height Implant Footprint depth width Small S S S 5 mm 11.5 mm 12.5 mm S S S 6 mm 11.5 mm 12.5 mm S S S 7 mm 11.5 mm 12.5 mm S S S 8 mm 11.5 mm 12.5 mm S S S 9 mm 11.5 mm 12.5 mm S S S 10 mm 11.5 mm 12.5 mm S S S 11 mm 11.5 mm 12.5 mm S S S 12 mm 11.5 mm 12.5 mm Standard S S S 5 mm 13 mm 14 mm S S S 6 mm 13 mm 14 mm S S S 7 mm 13 mm 14 mm S S S 8 mm 13 mm 14 mm S S S 9 mm 13 mm 14 mm S S S 10 mm 13 mm 14 mm S S S 11 mm 13 mm 14 mm S S S 12 mm 13 mm 14 mm Large S S S 5 mm 15 mm 16 mm S S S 6 mm 15 mm 16 mm S S S 7 mm 15 mm 16 mm S S S 8 mm 15 mm 16 mm S S S 9 mm 15 mm 16 mm S S S 10 mm 15 mm 16 mm S S S 11 mm 15 mm 16 mm S S S 12 mm 15 mm 16 mm 22 DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
29 Filling volume The table below shows the approximate graft volume (in cc) that ACIS implants will hold, depending on the footprints, heights and sagittal profiles. Convex Parallel Lordotic Height Height Height Small Standard Large Small Standard Large Small Standard Large ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 22
30 Instruments Double-sided Trial Implants ACIS Trial Implant, standard, lordotic, heights 5/6 mm; 7/8 mm; 9/10 mm; /12 mm, double-sided, blue ACIS Trial Implant, standard, parallel, heights 5/6 mm; 7/8 mm; 9/10 mm; /12 mm, double-sided, purple ACIS Trial Implant, standard, convex, heights 5/6 mm; 7/8 mm; 9/10 mm; /12 mm, double-sided, yellow ACIS Trial Implant, large, lordotic, heights 5/6 mm; 7/8 mm; 9/10 mm; /12 mm, double-sided, blue ACIS Trial Implant, large, parallel, heights 5/6 mm; 7/8 mm; 9/10 mm; /12 mm, double-sided, purple ACIS Trial Implant, large, convex, heights 5/6 mm; 7/8 mm; 9/10 mm; /12 mm, double-sided, yellow ACIS Trial Implant, small, lordotic, heights 5/6 mm; 7/8 mm; 9/10 mm; /12 mm, double-sided, blue ACIS Trial Implant, small, parallel, heights 5/6 mm; 7/8 mm; 9/10 mm; /12 mm, double-sided, purple ACIS Trial Implant, small, convex, heights 5/6 mm; 7/8 mm; 9/10 mm; /12 mm, double-sided, yellow DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
31 ACIS Insertion Device Turning Knob for ACIS Insertion Device ACIS Implant Holder Cancellous Bone Impactor Packing Block Inner Shaft, small, with Stop, for No Inner Shaft, standard/large, without Stop, for No Inner Shaft, standard/large, with Stop, for No ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 22
32 Instruments Inner Shaft, small, without Stop, for No Endplate Rasp Impactor, flat Mallet 33 DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
33 Sets ACIS Tray for Basic Instruments ACIS Tray for Additional Instruments ACIS Tray for Trial Implants Lid for Modular Tray, size 1/ Vario Case, Framing, size 1/2, height 88 mm Vario Case, Framing, size 1/2, height 126 mm Lid (Stainless Steel), size 1/2, for Vario Case ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 33
34 Additionally Available ACF Holder ACIS Trial Implant, standard, parallel, height 4 mm S ACIS, standard, parallel, height 4 mm, sterile 32 DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
35 Also Available from Synthes: chronos Putty Spine Synthetic cancellous bone graft substitute: chronos Putty chronos Putty is a synthetic, porous, resorbable and biocompatible bone graft substitute consisting of chronos Granules Bone Void Filler and sodium hyaluronate of non-animal origin. The synthetic sodium hyaluronate used in chronos Putty allows improved handling properties and confers positional stability to the product during handling and use. Mixing chronos Putty with bone marrow or blood introduces blood cells, growth factors and, in the case of bone marrow, osteoprogenitor cells. Autologous bone marrow features an optimal osteogenic potential. 9,13 Perfusion of the b-tcp component of chronos Putty with bone marrow aspirate has shown clear remodeling of chronos Bone Void Filler into new host bone 12 weeks postoperatively. 8,9 Osteoinductive with bone marrow Bone marrow aspirate and blood Autologous bone marrow features an enhanced osteogenic potential. Mixing chronos Putty with bone marrow or blood introduces blood cells, growth factors and, in the case of bone marrow, osteoprogenitor cells. 9,13 Perfusion of the b-tcp component of chronos Putty with bone marrow aspirate has been shown to have the following advantages: 4 times more bone 6 weeks postoperatively if perfused with bone marrow vs. blood 9 Clear remodeling of chronos into new host bone 12 weeks postoperatively 8,9 Flexible handling Sodium hyaluronate Sodium hyaluronate is a polysaccharide naturally occurring in the human body. It plays an essential role in cell proliferation, migration and adhesion. Its degradation products induce angiogenesis Sodium hyaluronate has also been shown to stimulate bone formation. 11,12 The synthetic sodium hyaluronate used in chronos Putty provides flexible handling properties and confers positional stability to the product during handling and use. Enhanced Remodeling chronos Granules chronos Putty consists of chronos Granules and sodium hyaluronate of non-animal origin. chronos is made of pure b-tricalcium phosphate (b-tcp). Osteoconductive Optimised pore size scaffold for bone tissue infiltration 3-6 Interconnected pores for bone growth through the whole implant 4,6,7 100% Synthetic Controlled quality ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 33
36 Also Available from Synthes: chronos Putty Spine Ordering information chronos Putty for Spine* Article number Product name Liquid to add S chronos Putty, 1.0 cc 0.80 ± 0.25 ml S chronos Putty, 2.5 cc 2.00 ± 0.5 ml S chronos Putty, 5.0 cc 4.00 ± 0.5 ml S chronos Putty, 10.0 cc 8.00 ± 0.5 ml Bone Marrow Aspiration System (BMAS) Art.No. Diameter Length Syringe S 11 ga 11 cm 20 ml S 11 ga 15 cm 20 ml *Manufactured by: Mathys AG Bettlach Güterstrasse 5 CH-2544 Bettlach Distributed by: Synthes GmbH Eimattstrasse 3 CH-4436 Oberdorf 33 DePuy Synthes ACIS Anterior Cervical Interbody Spacer Surgical Technique
37 Bibliography 1. Aebi M, JS Thalgott, JK Webb. AO ASIF Principles in Spine Surgery. Berlin: Springer-Verlag Aebi M, Arlet V, Webb JK (2007): AOSPINE Manual (2 vols), Stuttgart, New York: Thieme. 3. J. M. Toth et al. Evaluation of porous biphasic calcium phosphate ceramics for anterior cervical interbody fusion in a caprine model. Spine 1995; 20(20): X. Zou et al. Stimulation of porcine bone marrow cells by hyaluronan, dexamethasone and rhbmp-2. Biomaterials 2004; 25: J. E. Block. The role and effectiveness of bone marrow in osseous regeneration. Medical Hypothesis 2005; 65: J. X. Lu et al. Role of interconnections in porous bioceramics on bone recolonization in vitro and in vivo. J Mater Sci Mater Med. 1999; 10(2): Y. Hiu-Yan et al. Novel Approach for Quantification of Porosity for Biomaterial Implants using Microcomputed Tomography (μct). J Biomed Mater Res. 2005; 75B: T. J. Blokhuis et al. Properties of Calcium Phosphate Ceramics in Relation to Their In Vivo Behavior. J Trauma. 2000; 48(1): D. L. Wheeler et al. Grafting of Massive Tibial Subchondral Bone Defects in a Caprine Model Using b-tricalcium Phosphate versus Autograft. J Orthop Trauma 2005; 19(2): T. Stoll et al. New Aspects in Osteoinduction. Mat.-wiss. u. Werkstofftech. 2004; 35(4): S. Becker et al. Osteopromotion by a b-tricalcium Phosphate/Bone Marrow Hybrid Implant for Use in Spine Surgery. Spine 2006; 31(1): D.C. West et al. Angiogenesis induced by degradation products of hyaluronic acid. Science 1985; 228(4705): T. Sasaki et al. Stimulation of osteoinduction in bone wound healing by high-molecular weight hyaluronic acid. Bone 1995; 16/1): ACIS Anterior Cervical Interbody Spacer Surgical Technique DePuy Synthes 33
38
39
40 DSEM/SPN/1016/0566(1) 09/17 Synthes GmbH Eimattstrasse Oberdorf Switzerland Tel: Fax: Not all products are currently available in all markets. This publication is not intended for distribution in the USA. All surgical techniques are available as PDF files at DePuy Synthes Spine, a division of Synthes GmbH All rights reserved
ACIS Anterior Cervical Interbody Spacer
Implants and Instruments for Interbody Fusion Available in both PEEK and ProTi 360º Titanium Integrated Technology ACIS Anterior Cervical Interbody Spacer Surgical Technique Image intensifier control This
More informationACIS Anterior Cervical Interbody Spacer
An enhanced system of implants and instruments for interbody fusion ACIS Anterior Cervical Interbody Spacer Surgical Technique Image intensifier control This description alone does not provide sufficient
More informationInterbody fusion cage for the transforaminal approach. Travios. Surgical Technique
Interbody fusion cage for the transforaminal approach Travios Surgical Technique Image intensifier control This description alone does not provide sufficient background for direct use of DePuy Synthes
More informationECD EXPANDABLE CORPECTOMY DEVICE Continuously Expandable Vertebral Body Replacement for Tumour Cases
ECD EXPANDABLE CORPECTOMY DEVICE Continuously Expandable Vertebral Body Replacement for Tumour Cases Instruments and implants approved by the AO Foundation. This publication is not intended for distribution
More informationTSLP Thoracolumbar Spine Locking Plate
Anterior thoracolumbar spine locking plate TSLP Thoracolumbar Spine Locking Plate Surgical Technique Image intensifier control This description alone does not provide sufficient background for direct use
More informationCSLP-Cervical Spine Locking Plate
For anterior, cervical fixation CSLP-Cervical Spine Locking Plate Surgical Technique Image intensifier control This description alone does not provide sufficient background for direct use of DePuy Synthes
More informationSynCage-C short. Surgical Technique. This publication is not intended for distribution in the USA.
SynCage-C short Surgical Technique This publication is not intended for distribution in the USA. Instruments and implants approved by the AO Foundation. Table of contents Implants 2 Indications/contra-indications
More informationTELEFIX SURGICAL TECHNIQUE. Implant system for the anterior stabilization of the thoracolumbar spine
TELEFIX Implant system for the anterior stabilization of the thoracolumbar spine Instruments and implants approved by the AO Foundation. This publication is not intended for distribution in the USA. SURGICAL
More informationPEEK Cage for Posterior Lumbar Interbody Fusion (PLIF) Plivios Revolution. Surgical Technique
PEEK Cage for Posterior Lumbar Interbody Fusion (PLIF) Plivios Revolution Surgical Technique Image intensifier control This description alone does not provide sufficient background for direct use of DePuy
More informationARCH Laminoplasty System
Dedicated System for Open-door Laminoplasty ARCH Laminoplasty System Surgical Technique Image intensifier control This description alone does not provide sufficient background for direct use of DePuy Synthes
More informationOblique Posterior Atraumatic Lumbar cage system OPAL. Surgical Technique
Oblique Posterior Atraumatic Lumbar cage system OPAL Surgical Technique Image intensifier control This description alone does not provide sufficient background for direct use of DePuy Synthes products.
More informationThe vertebral body replacement with ratchet mechanism. Synex. Surgical Technique
The vertebral body replacement with ratchet mechanism Synex Surgical Technique Image intensifier control This description alone does not provide sufficient background for direct use of DePuy Synthes products.
More informationThe Versatile Polyaxial Solution for the Universal Spine Systems. USS II Polyaxial. Surgical Technique
The Versatile Polyaxial Solution for the Universal Spine Systems USS II Polyaxial Surgical Technique Image intensifier control This description alone does not provide sufficient background for direct use
More informationVECTRA-T SURGICAL TECHNIQUE. The Translational Anterior Cervical Palate System. This publication is not intended for distribution in the USA.
VECTRA-T The Translational Anterior Cervical Palate System This publication is not intended for distribution in the USA. SURGICAL TECHNIQUE Image intensifier control This description alone does not provide
More informationSYNCAGE EVOLUTION. This publication is not intended for distribution in the USA. SURGICAL TECHNIQUE
SYNCAGE EVOLUTION This publication is not intended for distribution in the USA. SURGICAL TECHNIQUE Image intensifier control Warning This description alone does not provide sufficient background for direct
More informationT-PAL. Transforaminal Posterior Atraumatic Lumbar Cage System.
T-PAL. Transforaminal Posterior Atraumatic Lumbar Cage System. Technique Guide This publication is not intended for distribution in the USA. Instruments and implants approved by the AO Foundation. Image
More informationSYNCAGE-LR Implant and instrument system for anterior lumbar interbody fusion
SYNCAGE-LR Implant and instrument system for anterior lumbar interbody fusion Instruments and implants approved by the AO Foundation. This publication is not intended for distribution in the USA. SURGICAL
More informationTechnique Guide. ECD Expandable Corpectomy Device. Continuously Expandable Vertebral Body Replacement for Tumour Cases.
Technique Guide ECD Expandable Corpectomy Device. Continuously Expandable Vertebral Body Replacement for Tumour Cases. Table of Contents Introduction Overview 2 AO ASIF Principles 4 Indications and Contraindications
More informationTechnique Guide. Zero-P VA. Variable angle zero-profile anterior cervical interbody fusion (ACIF) device.
Technique Guide Zero-P VA. Variable angle zero-profile anterior cervical interbody fusion (ACIF) device. Image intensifier control Warning This description alone does not provide sufficient background
More informationContact Fusion Cage. Surgical Technique
Contact Fusion Cage Surgical Technique Image intensifier control This description alone does not provide sufficient background for direct use of DePuy Synthes products. Instruction by a surgeon experienced
More informationXRL A modular expandable radiolucent vertebral body replacement system
XRL A modular expandable radiolucent vertebral body replacement system This publication is not intended for distribution in the USA. SURGICAL TECHNIQUE Table of Contents Introduction XRL 2 AO Spine Principles
More informationEXACTECH SPINE. Operative Technique. Cervical Spacer System. Surgeon focused. Patient driven. TM
EXACTECH SPINE Operative Technique Cervical Spacer System Surgeon focused. Patient driven. TM ACAPELLA ONE Acapella One Cervical Spacer System is an anterior cervical discectomy and fusion device with
More informationSynCage. Surgical Technique. This publication is not intended for distribution in the USA. Instruments and implants approved by the AO Foundation.
SynCage Surgical Technique This publication is not intended for distribution in the USA. Instruments and implants approved by the AO Foundation. Image intensifier control Warning This description alone
More informationAugmentable Pedicle Screws for Osteoporotic Bone. Perforated Click X. Surgical Technique
Augmentable Pedicle Screws for Osteoporotic Bone Perforated Click X Surgical Technique Image intensifier control This description alone does not provide sufficient background for direct use of DePuy Synthes
More informationOPAL SURGICAL TECHNIQUE. Oblique Posterior Atraumatic Lumbar cage system
OPAL Oblique Posterior Atraumatic Lumbar cage system Instruments and implants approved by the AO Foundation. This publication is not intended for distribution in the USA. SURGICAL TECHNIQUE Image intensifier
More informationSynex System TECHNIQUE GUIDE. An expandable vertebral body replacement device
Synex System TECHNIQUE GUIDE An expandable vertebral body replacement device Original Instruments and Implants of the Association for the Study of Internal Fixation AO ASIF Synex System Overview The Synex
More informationSurgical technique. SynCage-C short
Surgical technique SynCage-C short Table of contents Implants 2 Indications/contra-indications 3 Surgical technique 4 Image intensifier control Warning This description is not sufficient for immediate
More informationSYNEX The vertebral body replacement with ratchet mechanism
SYNEX The vertebral body replacement with ratchet mechanism Instruments and implants approved by the AO Foundation. This publication is not intended for distribution in the USA. SURGICAL TECHNIQUE Image
More informationTechnique Guide. T-PAL. Transforaminal posterior atraumatic lumbar spacer system.
Technique Guide T-PAL. Transforaminal posterior atraumatic lumbar spacer system. Table of Contents Introduction T-PAL 2 AO Principles 4 Indications and Contraindications 5 Surgical Technique Preparation
More informationchronos STRIP Bone Void Filler
chronos STRIP Bone Void Filler Osteoconductive beta-tricalcium phosphate (b-tcp) composite This publication is not intended for distribution in the USA. SURGICAL TECHNIQUE TABLE OF CONTENTS INTRODUCTION
More informationCervios and Cervios chronos. Radiolucent cage system for anterior cervical interbody fusion.
Cervios and Cervios chronos. Radiolucent cage system for anterior cervical interbody fusion. Surgical Technique This publication is not intended for distribution in the USA. Instruments and implants approved
More informationARCH Laminoplasty System. Dedicated System for Open-door Laminoplasty.
ARCH Laminoplasty System. Dedicated System for Open-door Laminoplasty. Surgical Technique This publication is not intended for distribution in the USA. Instruments and implants approved by the AO Foundation.
More informationPlivios and Plivios chronos. Radiolucent cage system for posterior lumbar interbody fusion.
Plivios and Plivios chronos. Radiolucent cage system for posterior lumbar interbody fusion. Surgical Technique This publication is not intended for distribution in the USA. Instruments and implants approved
More informationOBSOLETED. LCP Medial Distal Tibia Plate, without Tab. The Low Profile Anatomic Fixation System with Angular Stability and Optimal Screw Orientation.
LCP Medial Distal Tibia Plate, without Tab. The Low Profile Anatomic Fixation System with Angular Stability and Optimal Screw Orientation. Surgical Technique LCP Small Fragment System This publication
More informationLCP Medial Distal Tibia Plate, without Tab. The Low Profile Anatomic Fixation System with Angular Stability and Optimal Screw Orientation.
LCP Medial Distal Tibia Plate, without Tab. The Low Profile Anatomic Fixation System with Angular Stability and Optimal Screw Orientation. Technique Guide LCP Small Fragment System Table of Contents Introduction
More informationCervical Spacer System surgical technique
Blackhawk TM Cervical Spacer System surgical technique Blackhawk TM The BLACKHAWK Cervical Spacer System is designed to provide biomechanical stabilization as an adjunct to fusion. Spinal fixation should
More informationLCP Low Bend Medial Distal Tibia Plates 3.5 mm. Anatomic plates with low profile head for intra- and extraarticular fractures.
LCP Low Bend Medial Distal Tibia Plates 3.5 mm. Anatomic plates with low profile head for intra- and extraarticular fractures. Surgical Technique This publication is not intended for distribution in the
More informationTransforaminal Lumbar Interbody Fusion Cage (TLIF)
Transforaminal Lumbar Interbody Fusion age (TLIF) 990100010 DOULE ENGINE MEDIL MTERIL O., LTD. No. 218 Houxiang Road, Haicang District, Xiamen 361022, P.R.hina Tel: +86 592 6087101 Fax: +86 592 6587078
More informationTABLE OF CONTENTS. ShurFit Anterior Cervical Interbody Fusion (ACIF) System Overview 2. Implant Specifications 3. Instrument Features 4
Surgical Technique TABLE OF CONTENTS ShurFit Anterior Cervical Interbody Fusion (ACIF) System Overview 2 Product Highlights 2 Indications 2 Implant Specifications 3 Instrument Features 4 Surgical Technique
More informationPERFORATED CLICK X Augmentable pedicle screws for osteoporotic bone
PERFORATED CLICK X Augmentable pedicle screws for osteoporotic bone Instruments and implants approved by the AO Foundation. This publication is not intended for distribution in the USA. SURGICAL TECHNIQUE
More informationC-THRU Anterior Spinal System
C-THRU Anterior Spinal System Surgical Technique Manufactured From Contents Introduction... Page 1 Design Features... Page 2 Instruments... Page 3 Surgical Technique... Page 4 Product Information... Page
More informationMinimally Invasive Posterior Instruments
A Comprehensive Set Supporting Both Direct and Transforaminal Posterior Approaches to the Lumbar Spine Minimally Invasive Posterior Instruments Support mini-open procedures and ideal for use with Minimally
More informationReplacement Device A modular expandable radiolucent vertebral body replacement system
XRL Vertebral Body Replacement Device A modular expandable radiolucent vertebral body replacement system SURGICAL TECHNIQUE TABLE OF CONTENTS Introduction XRL System 2 AO Principles 5 Indications and Contraindications
More informationThoracolumbar Spine Locking Plate (TSLP) System. A low-profile plating system for anterior stabilization of the thoracic and lumbar spine.
Thoracolumbar Spine Locking Plate (TSLP) System. A low-profile plating system for anterior stabilization of the thoracic and lumbar spine. Technique Guide Instruments and implants approved by the AO Foundation
More informationSurgical Technique INTERSOMATIC CERVICAL CAGE
R INTERSOMATIC CERVICAL CAGE NEOCIF IMPLANTS NEOCIF is an implant designed to make anterior cervical interbody fusion (ACIF) easier and to remove the need for structural autologous graft. The cage is made
More informationSYNFIX. LR Stand Alone Spacer. Instruments and implants for stand alone anterior lumbar interbody fusion (ALIF). Technique Guide
SYNFIX LR Stand Alone Spacer. Instruments and implants for stand alone anterior lumbar interbody fusion (ALIF). Technique Guide Table of Contents Introduction SYNFIX LR Stand Alone Spacer 2 AO Principles
More informationSYNFIX EVOLUTION SECURED SPACER SYSTEM
SYNFIX EVOLUTION SECURED SPACER SYSTEM Instruments and implants for stand-alone anterior lumbar interbody fusion Instruments and implants approved by the AO Foundation. This publication is not intended
More informationLuminary ALIF. Disc preparation and implant insertion instruments.
Luminary ALIF. Disc preparation and implant insertion instruments. Technique Guide Instruments and implants approved by the AO Foundation Table of Contents Introduction Luminary ALIF 2 AO Principles 4
More informationTechnique Guide. Cervios and Cervios chronos. Radiolucent cage system for anterior cervical interbody fusion.
Technique Guide Cervios and Cervios chronos. Radiolucent cage system for anterior cervical interbody fusion. Table of Contents Introduction Cervios and Cervios chronos 2 AO Principles 6 Indications and
More informationSynCage Surgical Technique
SynCage Surgical Technique This publication is not intended for distribution in the USA. Instruments and implants approved by the AO Foundation. Contents Product Overview.........................................
More informationInstruments and implants for stand-alone anterior lumbar interbody fusion (ALIF) SynFix-LR System. Surgical Technique
Instruments and implants for stand-alone anterior lumbar interbody fusion (ALIF) SynFix-LR System Surgical Technique Image intensifier control This description alone does not provide sufficient background
More informationCervical Solutions. Optio-C Anterior Cervical Plate. with Allograft/Autograft. Surgical Technique Guide
Cervical Solutions Optio-C Anterior Cervical Plate with Allograft/Autograft Surgical Technique Guide 2 Optio-C Anterior Cervical Plate with Allograft/Autograft Surgical Technique Guide The Optio-C System
More informationTechnique Guide. chronos Strip. Osteoconductive betatricalcium phosphate ( -TCP) composite.
Technique Guide chronos Strip. Osteoconductive betatricalcium phosphate ( -TCP) composite. Table of Contents Introduction chronos Strip 2 Indications and Contraindications 3 Surgical Technique Preparation
More informationOPERATIVE TECHNIQUE. CONSTRUX Mini PTC. Mini PTC Spacer System
OPERATIVE TECHNIQUE CONSTRUX Mini PTC Mini PTC Spacer System TABLE OF CONTENTS Introduction 1 Operative Technique 2 Part Numbers 6 Indications For Use 7 INTRODUCTION 1 INTRODUCTION The CONSTRUX Mini PTC
More informationZero-P Instruments and Implants. Zero-profile anterior cervical interbody fusion (ACIF) device.
Zero-P Instruments and Implants. Zero-profile anterior cervical interbody fusion (ACIF) device. Technique Guide Instruments and implants approved by the AO Foundation Table of Contents Introduction Zero-P
More informationEFSPINE CERVICAL COMBINED SET DISC PROTHESIS ORGANIZER BOX
EFSPINE CERVICAL COMBINED SET INSTRUMENTS CERVICAL CAGE & DISC PROTHESIS ORGANIZER BOX Cervical Thoracic Thoraco - Lumbar Sacral EFSPINE CERVICAL COMBINED SET CERVICAL IMPLANTS INTRODUCTION Cervical Disc
More informationAlamo C. Cervical Interbody System Surgical Technique. An Alliance Partners Company
Cervical Interbody System Surgical Technique Table of Contents Indications for Use................................1 Device Description............................... 1 Alamo C Instruments..............................
More informationPARADIGM SPINE. Anterior Cervical Fusion Cage. Cervical Interbody Fusion
PARADIGM SPINE Anterior Cervical Fusion Cage Cervical Interbody Fusion DESIGN RATIONALE The OptiStrain TM C* interbody fusion cage follows well established biomechanical principles: The slot design of
More informationSolitaire Anterior Spinal System
Surgical Technique Solitaire Anterior Spinal System Independent Stabilization for the Anterior Column Available in Titanium and Contents Introduction... Page 1 Design Features... Page 2 Instruments...
More informationFACET WEDGE. Facet joint fixation device.
FACET WEDGE. Facet joint fixation device. Technique Guide Synthes FACET WEDGE Technique Guide /44 Synthes FACET WEDGE Technique Guide /44 Table of Contents Introduction FACET WEDGE 3 AO Principles 4 Indications
More informationTrephine System. Principle-based anterior lumbar interbody fusion.
Trephine System. Principle-based anterior lumbar interbody fusion. Technique Guide Instruments and implants approved by the AO Foundation Table of Contents Introduction Trephine System 2 AO Principles
More informationApache Cervical Interbody Fusion Device. Surgical Technique. Page of 13. LC-005 Rev F
LC-005 Rev F Apache Cervical Interbody Fusion Device Page of 13 Surgical Technique INDICATIONS: When used as an intervertebral body fusion device, the Genesys Spine Interbody Fusion System is indicated
More informationCollinear Reduction Clamp
For minimally invasive fracture reduction Collinear Reduction Clamp Surgical Technique Image intensifier control This description alone does not provide sufficient background for direct use of DePuy Synthes
More informationImola Lateral IBF System Surgical Technique
Imola Lateral IBF System Surgical Technique IMOLA CIRCUIT TABLE OF CONTENTS Design Rationale Instructions for Use Surgical Technique 1. Table Mounting 2. Surgical Planning & Targeting 3. Access and Preparation
More informationSpinal Correction FRA Spacer System. For use with the Small Stature FRA Spacer and the FRA Spacer.
Spinal Correction FRA Spacer System. For use with the Small Stature FRA Spacer and the FRA Spacer. Technique Guide Instruments and implants approved by the AO Foundation Table of Contents Introduction
More informationThoracolumbar Anterior Compression (TAC) System. Allows distraction, compression, and lateral fixation of the lower thoracic and lumbar spine.
Thoracolumbar Anterior Compression (TAC) System. Allows distraction, compression, and lateral fixation of the lower thoracic and lumbar spine. Technique Guide Instruments and implants approved by the AO
More informationPLIVIOS REVOLUTION PEEK Cage for Posterior Lumbar Interbody Fusion (PLIF)
PLIVIOS REVOLUTION PEEK Cage for Posterior Lumbar Interbody Fusion (PLIF) Instruments and implants approved by the AO Foundation. This publication is not intended for distribution in the USA. SURGICAL
More informationBAK/C Cervical Anterior Interbody Fusion System
Surgical Technique BAK/C Cervical Anterior Interbody Fusion System The Comfortable Choice for Cervical Fusion BAK/C Cervical Surgical Technique 1 The BAK/C Cervical Fusion System is an alternative to conventional
More informationCROSS -FUSE P E E K V B R / I B F SYST E M
S U R G I C A L T E C H N I Q U E CROSS -FUSE P E E K V B R / I B F SYST E M S U R G I C A L S Y S T E M O V E R V I E W 2 CROSS-FUSE P E E K V B R / I B F S Y S T E M S U R G I C A L T E C H N I Q U E
More informationPlivios Revolution. PEEK Cage for Posterior Lumbar Interbody Fusion (PLIF).
Plivios Revolution. PEEK Cage for Posterior Lumbar Interbody Fusion (PLIF). Technique Guide This publication is not intended for distribution in the USA. Instruments and implants approved by the AO Foundation.
More informationnva Anterior Lumbar Interbody Fusion System
nva Anterior Lumbar Interbody Fusion System 1 IMPORTANT INFORMATION FOR PHYSICIANS, SURGEONS, AND/OR STAFF The nv a, nv p, and nv t are an intervertebral body fusion device used in the lumbar spine following
More informationTechnique Guide. ARCH Laminoplasty System. Dedicated System for Open-door Laminoplasty.
Technique Guide ARCH Laminoplasty System. Dedicated System for Open-door Laminoplasty. Table of Contents Introduction Overview 2 AO ASIF Principles 4 Indications and Contraindications 5 Product Information
More informationTechnique Guide. Insight Retractor. Minimal invasive access system to the posterior thoracolumbar spine.
Technique Guide Insight Retractor. Minimal invasive access system to the posterior thoracolumbar spine. Table of Contents Introduction Insight Retractor 2 AO Principles 4 Indications and Contraindications
More informationFor anterolateral and lateral approach. SynCage-LR 45 /90. Surgical Technique
For anterolateral and lateral approach SynCage-LR 45 /90 Surgical Technique Image intensifier control This description alone does not provide sufficient background for direct use of DePuy Synthes products.
More informationPILLAR AL. Anterior Lumbar Interbody Fusion (ALIF) and Partial Vertebral Body Replacement (pvbr) PEEK Spacer System OPERATIVE TECHNIQUE
PILLAR AL PEEK Spacer System Anterior Lumbar Interbody Fusion (ALIF) and Partial Vertebral Body Replacement (pvbr) OPERATIVE TECHNIQUE Table of Contents 1 INTRODUCTION 2 PRE-OPERATIVE TECHNIQUE 3 OPERATIVE
More informationIn-Space. Interspinous distraction through a mini-open, posterior, unilateral approach.
In-Space. Interspinous distraction through a mini-open, posterior, unilateral approach. Surgical Technique Posterior Approach PRODUCT OBSOLETED 30th September 2017 DSEM/SPN/0915/0348(1) This publication
More informationCSLP-CERVICAL SPINE LOCKING PLATE For anterior, cervical fixation
CSLP-CERVICAL SPINE LOCKING PLATE For anterior, cervical fixation Instruments and implants approved by the AO Foundation. This publication is not intended for distribution in the USA. SURGICAL TECHNIQUE
More informationPROXIMAL FEMORAL NAIL REMOVAL SET
PROXIMAL FEMORAL NAIL REMOVAL SET for PFN, TFN and PFNA/PFNA-II Instruments and Implants approved by the AO Foundation. This publication is not intended for distribution in the USA. SURGICAL TECHNIQUE
More informationproduct overview Implant heights range from 8mm-20mm in 2mm increments, with two lordocic angle options of 6 and 12.
ETHOS A-Spacer PEEK System Surgical Technique Guide Synchronizing Medical Innovation with Global Markets product overview The SyncMedical Ethos PEEK IBF System is an intervertebral body fusion device for
More informationRoyal Oak IBFD System Surgical Technique Posterior Lumbar Interbody Fusion (PLIF)
Royal Oak IBFD System Surgical Technique Posterior Lumbar Interbody Fusion (PLIF) Preoperative Planning Preoperative planning is necessary for the correct selection of lumbar interbody fusion devices.
More informationHawkeyeTM Peek. surgical technique
HawkeyeTM Peek surgical technique Introduction The ChoiceSpine HAWKEYE Vertebral Body Replacement (VBR) System is intended for use in the thoracolumbar spine (T1 - L5) to replace a collapsed, damaged,
More informationAdvantage ALIF. Keith Shevlin Managing Director
Advantage ALIF Unit 10, 9-11 Myrtle Street, Crows Nest NSW 2065 Keith Shevlin Managing Director keithshevlin@precisionsurgical.com.au Advantage ALIF Introduction & Indications for Use 1 Surgical Technique
More informationGIZA Surgical Technique
GIZA Surgical Technique Vertebral Body Replacement System Manufactured by Titanium alloy material provides mechanical integrity during insertion and distraction, x-ray visibility, and biocompatibility*
More informationUSS II ILIO-SACRAL Modular System for Stable Fixation in the Sacrum and Illium
USS II ILIO-SACRAL Modular System for Stable Fixation in the Sacrum and Illium Instruments and implants approved by the AO Foundation. This publication is not intended for distribution in the USA. TECHNIQUE
More information2.4 mm Variable Angle LCP Volar Extra-Articular Distal Radius System. For fragment-specific fracture fixation with variable angle locking technology.
Technique Guide 2.4 mm Variable Angle LCP Volar Extra-Articular Distal Radius System. For fragment-specific fracture fixation with variable angle locking technology. Table of Contents Introduction 2.4
More informationSurgical Technique. Apache Anterior Lumbar Interbody Fusion
Surgical Technique Apache Anterior Lumbar Interbody Fusion 2 Table of Contents Page Preoperative Planning 4 Patient Positioning 4 Disc and Endplate Preparation 4 Distraction/Size Selection 5 Implantation
More informationLCP Wrist Fusion Set. Anatomic plates for total wrist fusion.
LCP Wrist Fusion Set. Anatomic plates for total wrist fusion. Technique Guide This publication is not intended for distribution in the USA. Instruments and implants approved by the AO Foundation. Table
More informationCannulated Angled Blade Plate 3.5 and 4.5, 90.
Cannulated Angled Blade Plate 3.5 and 4.5, 90. Technique Guide This publication is not intended for distribution in the USA. Instruments and implants approved by the AO Foundation. Table of Contents Introduction
More informationTechnique Guide. 3.5 mm LCP Low Bend Medial Distal Tibia Plates. Part of the Synthes locking compression plate (LCP) system.
Technique Guide 3.5 mm LCP Low Bend Medial Distal Tibia Plates. Part of the Synthes locking compression plate (LCP) system. Table of Contents Introduction 3.5 mm LCP Low Bend Medial Distal Tibia Plates
More informationEIT TLIF Cage. For Natural Bone Ingrowth with EIT Cellular Titanium
EIT TLIF Cage For Natural Bone Ingrowth with EIT Cellular Titanium EIT TLIF Cage Surgical Technique EIT Cellular Titanium provides active fusion area» ~ 80% porosity» ~ 650 µm diamond pore size» open interconnected
More informationM.I.S. MAKE IT SMART IN ONE SYSTEM. Surgical Technique. Hip Knee Spine Navigation
M.I.S. MAKE IT SMART IN ONE SYSTEM Surgical Technique Hip Knee Spine Navigation M.U.S.T. Mini Open Surgical Technique Hip Knee Spine Navigation 2 C O N T E N T S 1 INTRODUCTION 4 2 SURGICAL TECHNIQUE 5
More informationMODULAR DESIGN OFFERS FREEDOM OF CHOICE. Surgical Technique
MODULAR DESIGN OFFERS FREEDOM OF CHOICE Surgical Technique Joint Spine Sports Med MectaLIF Anterior Surgical Technique 2 INDEX 1. INTRODUCTION 4 1.1 Material & Marker 5 2. INDICATIONS 5 3. CONTRAINDICATIONS
More informationTechnique Guide. Zero-P. Zero profile anterior cervical interbody fusion (ACIF) device.
Technique Guide Zero-P. Zero profile anterior cervical interbody fusion (ACIF) device. Image intensifier control Warning This description alone does not provide sufficient background for direct use of
More informationchronos Bone Void Filler. Beta-Tricalcium Phosphate ( β-tcp) bone graft substitute.
chronos Bone Void Filler. Beta-Tricalcium Phosphate ( β-tcp) bone graft substitute. Osteoconductive Resorbable Synthetic chronos Bone Void Filler chronos granules and preforms are synthetic, porous, osteoconductive,
More informationCERVIFIX Modular tension band system for posterior fixation of the occipito cervical spine, upper and lower cervical spine, and upper thoracic spine
CERVIFIX Modular tension band system for posterior fixation of the occipito cervical spine, upper and lower cervical spine, and upper thoracic spine PRODUCT OBSOLETED 30th June 2017 DSEM/SPN/1215/0387(1)
More informationSURGICAL TECHNIQUE MANUAL. InterFuse T
1 CONTENTS InterFuse T Product Description 3 Indications for Use 3 X-Ray Marker Locations 4 Product Specifications 4 Instrument Set 5 Step 1 Preoperative Planning 8 Patient Positioning 8 Step 2 Disc Removal
More informationThe Implant. (Klappen außen sind nur 192 mm breit!)
SEMIAL product information The Implant SEMIAL implants are designed to restore interbody vertebral disc height and maintain solid bony fusion when used in conjunction with bone graft material and supportive
More informationT-PAL Spacer System. Transforaminal posterior atraumatic lumbar spacer system.
T-PAL Spacer System. Transforaminal posterior atraumatic lumbar spacer system. One instrument, one technique Accommodates both open and MIS approaches A PEEK implant that works with patient anatomy Streamlined
More information