SURGICAL TECHNIQUE MODULAR CERVICAL CAGE

Transcription

1 MODULAR CERVICAL CAGE

2 Table of Contents Surgical approach to the disc to 2 Sizing of the implant to 4 Selection of the implant to 6 Filling of the cage Positioning of the cage Fixation of the cage with the anchor to 12 X-Ray control of the positioning to 14

3 Surgical approach to the disc 1 Surgical approach to the disc The surgical approach to the selected intervertebral space is performed after identification of the level concerned by image intensifier. The surgical technique used for intervertebral space exposure is that which is normally used in anterior approach to the cervical spine. 2 Freshening of the end-plate The discectomy is performed according to the standard surgical procedure. A curette or rasp is used to prepare the bed of the implant and the grafting surfaces. The whole of the intervertebral space must be freshened as widely as possible. This is the final stage of discectomy and ensures a very careful preparation of the surfaces for fusion. 2-3

4 Sizing of the implant 3 Width and depth selection One should position various trials in front of the intervertebral space in order to determine the maximum width available for the cage. The choice can be made between the following widths: 14, 15.5 or 17mm. Introduction into the intervertebral space of the various pre-sized trials allows the depth available to be determined by X-ray control. The depths available are: 12 or 14mm. 4 Height selection Heights available are: 4.5, 5, 6 or 7mm (4.5mm height not shown). Selection and introduction of the correct trial should give the desired disc height restoration, while ensuring good stability. 5 Selection of the implant Selection of the cage implant The color code and the trial height determine the choice of the final implant. The choice of an open cage will allow supplementary impaction of autologous graft once the implant is in place. 6 Attachment of the cage to the cage holder 4-5

5 Filling of the cage 7 Filling the open cage or closed cage with bone graft 8 Positioning of the cage Positioning of the open or closed cage A mallet can be used to impact the implant. A gentle impaction, along the axis of the cage holder, is carried out until the lip of the holder comes into contact with the adjacent vertebra. 6-7

6 Fixation of the cage with the anchor 9 Stability control If the primary stability of the cervical cage is deemed unsatisfactory, it is advisable to use a self-retaining anchor in order to increase the primary stability. X-Ray should be used for visual control of the implant positioning previous to the fixation of the anchor. 10 Positioning of the Anchor The anchor holder is used to place the anchor in the slot provided in the cage holder. During the impaction of the anchor, the cage holder should be maintained in the sagital axis to avoid any rotation of the implant. 11 Insertion of the anchor in the cage holder One of the two anchor impactors is used to impact the anchor through the slot in the cage holder. 12 Anchor impaction Impaction of the anchor is complete when the impactor is fully seated in the cage holder. 8-9

7 X-Ray control of the positioning 13 X-Ray control Removal of the cage holder allows an X-ray or visual control of the MC+ implant after positioning. 14 Graft complement (open cage) After positioning the cage and if necessary, extra graft material can be added using the graft impactor to completely fill the fusion chamber. 10

8 France Hôtel de Bureaux 1, 4 rue Gustave Eiffel, Rosières Près Troyes Adresse postale : Technopôle de l Aube BP Troyes Cedex 9, France +33 (0) China Beijing Global Trade Center #36 North Third Ring Road East, Unit 06, Level 19, Building A, Dongcheng District, Beijing, China, Brazil Av. Pereira Barreto, 1395 Torre sul - CJ Bairro Paraiso Santo André - São Paulo CEP : Brazil LDR, LDR Spine, LDR Médical, BF+, BF+(ph), Easyspine, C-Plate, SpineTune, MC+, Mobi, Mobi-C, Mobi-L, Mobidisc, ROI, ROI-A, ROI-T, ROI-C, Avenue L and vertebridge are trademarks or registered trademarks of LDR Holding Corporation or its affiliates in France, the United States or other countries. United States Research Boulevard Suite 200 Austin, TX USA Ref: MC ST 1 EN B Document intended for the exclusive use of healthcare professionals. MC+ - Sterile anterior cervical cage- is a class IIb CE marked medical device made by the LDR Medical S.A.S. Company and for which the conformity assessment was carried out by the notified body G-Med N MC+ is intended for mono and multi-segmental fixation of the cervical vertebrae by anterior approach for the levels C3 to C7. Before any surgical procedure, read carefully the instructions and the surgical technique.