mambo modular cervical plate system
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1 mambo modular cervical plate system
2 mambo modular cervical plate system Overview of system & implant components Philosophy of dynamic instrumentation Indications & Surgical technique Tray design Seite I Page 2
3 mambo Components Plates XXS S M L 1-seg mm mm mm mm 2-seg mm mm mm 3-seg mm mm mm 4-seg mm mm mm 5-seg mm mm mm 6-seg mm mm mm All plates have the same width of 18 mm. Seite I Page 3
4 mambo Components Cranial & Caudal Plates S M L Seite I Page 4
5 mambo Components Extension Plates S M L The modular systems offers the option of individual plate lengths. Seite I Page 5
6 mambo Komponenten Platten XXS S M L Pre-fixed mono- and bisegmental Plates (incl. settlingscrew) Pre-contoured Plates (8 per Segment)
7 mambo Components Plates - Product Numbers mambo single plate XXS yellow CS mambo cranial plate S yellow CS mambo extension plate S yellow CS mambo caudal plate S yellow CS mambo cranial plate M green CS mambo extension plate M green CS mambo caudal plate M green CS mambo cranial plate L blue CS mambo extension plate L blue CS mambo caudal plate L blue CS Seite I Page 7
8 mambo Components Settling Screw Clamping Screw CS CS DYNAMIC INSTRUMENTATION RIGID INSTRUMENTATION Seite I Page 8
9 mambo Components Bone Screw CS 1830-XX (i.e. CS for 13 mm) Rescue Screw CS 1832-XX (i.e. CS for 13 mm) Lengths 13, 15, 17, 19 mm Diameter 3,5 mm Conic Core Diameter HA 4 Thread (upgrade 1,5 mm) Screw head with 3 nuts Lengths 13, 15, 17, 19 mm Diameter 4,0 mm Cylindric Core Diameter HA 4 Thread (upgrade 1,5 mm) Screw head with 3 nuts Seite I Page 9
10 mambo Backout protection Screw head with 3 nuts locks into plate with asterisk screw hole press-fit Seite I Page 10
11 Philosophy: Dynamic and constrained instrumentation rigid / constrained instrumentation fixed screw angle, fixed screw head, one fixed plate dynamic Various screw angulations, plate consisting of plate components which can slide => axial settling possible Seite I Page 11
12 Philosophy: Dynamic and constrained instrumentation Static / rigid Dynamic Bone Graft Bone Graft Initial bone graft Initial load transfer through implant construct and through anterior column / graft right after graft insertion. Seite I Page 12
13 Philosophy: Dynamic and constrained instrumentation Static / rigid Dynamic Bone graft resorption Bone Graft constant Bone Graft settling Load sharing after graft Settling / resorption. Seite I Page 13
14 Dynamic Biomechanical Concept = load transfer through the bone graft, not the implant less implant failure = load sharing earlier and more effectual fusion = reduced bone graft resorption = reduced loss of correction Julius Wolff, The controls exerted by mechanical forces, recognized for over a century, have been formulated as Wolff's law: Every change in the function of a bone is followed by certain definite changes in its internal architecture and its external conformation. Seite I Page 14
15 Indications Instabilities resulting from various causes such as conditions after anterior removal of the intervertebral discs fractures tumours pseudarthrosis resulting from previous unsuccessful operations of the cervical spine degenerative disease Seite I Page 15
16 mambo Surgical Technique Applying of the reposition tool The guiding sleeves CS /-03 (one with plate stop) are positioned on the middle of the vertebral body. Seite I Page 16
17 mambo Surgical Technique Open the cortical bone Using the awl CS (penetration depth 4 mm). Seite I Page 17
18 mambo Surgical Technique Placing the reposition pins After the opening of the cortical bone by the awl the reposition pins CS /-06/-07 (available in 3 lengths: 14, 16, 18 mm) are inserted into the guiding sleeves of the reposition tool using the screwdriver torx 15 CS Reposition Pin Seite I Page 18
19 mambo Surgical Technique Distraction Distraction of intervertebral space for removing and implantation of bone graft or cage using the adjuster (CS 1852). Turning the knob to fix distraction. Seite I Page 19
20 mambo Surgical Technique Measuring plate length Determination of the appropriate plate length using the measuring gauge CS Seite I Page 20
21 mambo Surgical Technique Inserting of the plate Inserting the plate by using the plate holder CS Alignment of the caudal plate with notch to the guiding sleeve with plate stop (to press the plate on the vertebral body). Seite I Page 21
22 mambo Surgical Technique Temporary plate fixation Prefixation by inserting temporary fixation pin CS 1858 using the pininserter instrument CS unlocked locked Seite I Page 22
23 mambo Surgical Technique Preparing for screw insertion Using the single drill jig CS 1862 or the double drill jig CS Seite I Page 23
24 mambo Surgical Technique Implantation of screws Implanting bone screws or rescue screws by using the screwdriver torx 15. After implanting caudal screws if necessary compression can be carried out by the reposition tool. Seite I Page 24
25 mambo Surgical Technique Removing of temporary fixation pin Using the pininserter instrument. Seite I Page 25
26 mambo Tray CS Tray lid CS Layer for bone & rescue screws CS Storage disc for settling & clamping screws CS Layer implants & measurement (TOP) CS Layer implantation (MIDDLE) CS Layer preparation & manipulation (BOTTOM) Seite I Page 26
27 mambo Summary & Advantages Cervical plate system for anterior stabilization Possibility of dynamic and constrained instrumentation Modular design for individual plate lengths Gliding plate components allow optimal screw placement One-step locking mechanism and back-out protection Pre-contoured and assembled plates Color-coded implants Clearly arranged set Seite I Page 27
28 Thank You Seite I Page 28
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Fibula Rod System Fibula Rod System Since 1988, Acumed has been designing solutions for the demanding situations facing orthopaedic surgeons, hospitals and their patients. Our strategy has been to know