Thoracolumbar Anterior Compression (TAC) System. Allows distraction, compression, and lateral fixation of the lower thoracic and lumbar spine.
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1 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 Foundation
2 Table of Contents Introduction Thoracolumbar Anterior Compression (TAC) System 2 AO Principles 6 Indications 7 Surgical Technique Insert Staples 8 Construct Assembly 10 Product Information Instruments 11 Set List 12 Sterilization Parameters 12 Image intensifier control Synthes Spine
3 Thoracolumbar Anterior Compression (TAC) System The Thoracolumbar Anterior Compression (TAC) System is designed to provide internal fixation for the thoracolumbar spine in cases of trauma, tumor or deformity. The system construct consists of two or more staples, available in various sizes and orientation, which were designed for use with the following Synthes screw/ rod systems: Pangea Monoaxial Screw Implant and Instrument Set Click X Monoaxial Instrument and Titanium Screw and Hook Implant Set Dual-Opening Universal Spine System (USS) Instrument and Titanium Implant Set USS Hook and Screw Instrument Set Small Stature USS Instrument and Titanium Implant Set The TAC System allows distraction and compression of the anterior column while also providing lateral fixation to promote fusion during the healing process. 2 Synthes Spine Thoracolumbar Anterior Compression (TAC) System
4 Staples Prong design that limits splitting or shearing of vertebral body and prevents lift-off during screw insertion Screw holes accommodate all Synthes monoaxial screw systems Threaded guide holes for easy impactor attachment and detachment Suitable for hemicorpectomies or avoidance of pedicle screws Contoured to better fit the vertebral body s anatomy Made of Ti-6Al-7Nb alloy Contoured Hole orientation options (available for each size) Superior Inferior Parallel* Staple sizes Color Hole Dia. (mm) Width (mm) Length (mm) Purple Blue Green Hole diameter Width Length *Suitable for hemi-corpectomies or avoidance of pedicle screws. Synthes Spine 3
5 Thoracolumbar Anterior Compression (TAC) System continued Rods and screws A key feature of the TAC System is its versatility in accommodating a variety of existing Synthes monoaxial screw systems. This allows surgeons the flexibility to choose a screw system based on mechanical requirements, technique preference, and/or indication. All rods are made from titanium and are typically 6.0 mm in diameter (rods used in Small Stature USS are 5.0 mm). Rods are available in various lengths and forms (straight or curved) depending on the screw system. 4 Synthes Spine Thoracolumbar Anterior Compression (TAC) System
6 The various screw systems that TAC accommodates provide several options for rod insertion, rod capture, and overall construct profile: Synthes System Rod Dia. (mm) Rod Insertion Rod Capture Minimum Profile with TAC (mm) Pangea Monoaxial 6.0 top-loading Quarter-turn locking cap 14 Screw Implant and Instrument Set Click X Monoaxial 6.0 top-loading Threaded locking cap 15 Dual Opening USS 6.0 side-loading Collars and nuts 14 (either side) USS 6.0 side-loading Collars and nuts 16 (one side only) Small Stature USS 5.0 side-loading Collars and nuts 12.5 (either side) Synthes Spine 5
7 AO Principles In 1958, the AO formulated four basic principles, which have become the guidelines for internal fixation. 1 They are: Anatomical reduction Stable internal fixation Preservation of blood supply Early, active mobilization The fundamental aims of fracture treatment in the limbs and fusion of the spine are the same. A specific goal in the spine is returning as much function as possible to the injured neural elements. 2 AO Principles as Applied to the Spine 3 Anatomical alignment Restoration of normal spinal alignment to improve the biomechanics of the spine. Stable internal fixation Stabilization of the spinal segment to promote bony fusion. Preservation of blood supply Creation of an optimal environment for fusion. Early, active mobilization Minimized damage to the spinal vasculature, dura, and neural elements, which may contribute to pain reduction and improved function for the patient. 1. M.E. Müller, M. Allgöwer, R. Schneider, and H. Willenegger AO Manual of Internal Fixation, 3rd Edition. Berlin: Springer-Verlag, Ibid. 3. M. Aebi, J.S. Thalgott, and J.K. Webb. AO ASIF Principles in Spine Surgery. Berlin: Springer-Verlag, Synthes Spine Thoracolumbar Anterior Compression (TAC) System
8 Indications The TAC System, when used in skeletally mature patients, is intended for anterolateral stabilization of the thoracolumbar spine (T8 L5) for: Trauma fracture, dislocation, or subluxation Tumor Correction of anterolateral lordotic deformities Lumbar scoliosis Pseudoarthrosis Synthes Spine 7
9 Insert Staples 1 Determine staple size and hole orientation Instruments Template for 5.2 mm Staples Template for 6.2 mm Staples Template for 7.0 mm Staples Align each template to the staple site to determine which staple size and hole orientation is most suitable. Note: the colored ring on each template handle designates the corresponding staple size. 5.2 mm staples purple 6.2 mm staples blue 7.0 mm staples green 2 Assemble impactor Instrument Staple Impactor Cannulated handle Threaded impactor shaft Assemble the staple impactor by sliding the threaded impactor shaft into the cannulated handle and turning the impactor knob clockwise. Impactor knob 8 Synthes Spine Thoracolumbar Anterior Compression (TAC) System
10 3 Capture staple Align the staple impactor with the chosen staple by inserting the nonthreaded post at the bottom end of the impactor into the nonthreaded guide hole. Turn the impactor knob clockwise to insert the threaded shaft into the threaded staple hole to capture the staple. Threaded staple hole Nonthreaded guide hole 4 Seat staple Drive the staple prongs through the cortical bone of the vertebral body and seat the staple by striking the staple impactor with a small mallet. Once prong insertion is maximized, remove the staple impactor by turning the impactor knob counterclockwise. Repeat steps 1 4 to implant additional staple(s). Synthes Spine 9
11 Construct Assembly The TAC System can accommodate a variety of Synthes monoaxial screws. Surgeon preference will determine which Synthes screw system will be used: Pangea Monoaxial Screw Implant and Instrument Set Click X Monoaxial Screw and Hook Instrument and Titanium Implant Set Dual Opening USS Instrument and Titanium Implant Set Titanium USS Screw Introduction Set USS Rod Instrument Set USS Hook and Screw Instrument Set Small Stature USS Instrument and Titanium Implant Set The implants, instruments, and techniques used for screw insertion, rod assembly, and final tightening of the TAC construct will be the same as specified in the technique guide for each individual system, with the exception that screws will be inserted through the staple holes laterally on the vertebral body instead of through the pedicles. Please refer to the technique guide that corresponds to the selected screw system for further details on construct assembly. 10 Synthes Spine Thoracolumbar Anterior Compression (TAC) System
12 Instruments Staple Impactor Used to hold, drive, and seat staple into vertebral body Template, for 5.2 mm Titanium Staples Template, for 6.2 mm Titanium Staples Template, for 7.0 mm Titanium Staples Used to determine appropriate staple size and hole orientation. Can also be used for osteotomies. Synthes Spine 11
13 Thoracolumbar Anterior Compression System Instrument and Titanium Implant Set ( ) Graphic Cases Graphic Case, for 5.2 mm 7.0 mm Staples and Impactor Set Module for 5.2 mm 7.0 mm Staples Implants Titanium Parallel Staples, 2 ea mm mm mm Titanium Inferior Staples, 2 ea mm mm mm Titanium Superior Staples, 2 ea mm mm mm Instruments Staple Impactor, 2 ea. Templates for Titanium Staples mm mm mm Also Available Plate/ Rod Cutter Note: The Module for 5.2 mm 7.0 mm Staples ( ) can also be placed in the Graphic Case, for Click X Monoaxial Rod and Connector Set ( ). Sterilization Parameters for Set ( ) This Synthes set with all additionally available items, as marked in the case, can be sterilized by the following parameters. For more information, please refer to graphic case package insert. Method Cycle Temperature Exposure Time Steam Prevacuum C 8 Minutes (Wrapped) ( F) Steam Gravity Displacement C 15 Minutes (Wrapped) ( F) 12 Synthes Spine Thoracolumbar Anterior Compression (TAC) System
14 Synthes Spine 1302 Wrights Lane East West Chester, PA Telephone: (610) To order: (800) Fax: (610) Synthes (Canada) Ltd Meadowpine Boulevard Mississauga, Ontario L5N 6P9 Telephone: (905) To order: (800) Fax: (905) Synthes, Inc. or its affiliates. All rights reserved. Synthes is a trademark of Synthes, Inc. or its affiliates. Printed in U.S.A. 12/07 J7747-A
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