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Universal Spinal System (USS).Designed to achieve the goals of scoliosis surgery.
Technique Guide
Introduction
Surgical Technique
Technique Options
Product Information
Table of Contents
Universal Spinal System 2
AO ASIF Principles of Internal Fixation 3
Indications 4
Hook Placement 5
Preparing the Pedicle 7
Inserting the Screw 10
Contouring the Rod 12
Assembling the Construct 14
Distraction and Compression 17
Tightening the Construct 19
Attaching Transconnector 22
Attaching Transconnector Clamp to Rod 23
Attaching Transverse Bars 25
Attaching the Open Transverse Bar 26
Attaching the Closed Transverse Bar 28
Reduction Procedure for Spondylolisthesis 30
Anterior Approach 31
Implants 32
Instruments 35
Sets 48
Sterilization Parameters 48
Image intensifier control
Synthes Spine
Universal Spinal System
Goals of Scoliosis Surgery– Correct sagittal and coronal alignment
– Restore balance in the spine
– Prevent further progression of deformity
– Fuse the fewest number of vertebral segments
– Protect the spinal cord
The Universal Spinal System is designed to achieve the goalsof scoliosis surgery. The system is based upon:– Independent anchorage of hooks and/or screws to the
spine and independent rod positioning
– Simple connection between the implant and the rod
– Segmental correction and stabilization
Features and BenefitsLow-profile system
Side-opening, top-tightening construct– Simplifies intraoperative procedure
– Requires no implant preloading onto rod
– Single Core Screws offered in titanium and stainless steel (Fig. 1)
– Dual Core Screws offered in titanium (Fig. 2)
Technique adaptabilityDesigned to correct scoliosis by segmental correction or global derotation.
Versatile linkage mechanismAllows addition or removal of anchorage points to an assembled construct.
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Fig. 1Single Core
Fig. 2Dual Core
AO ASIF Principles of Internal Fixation
The AO ASIF Principles of Internal Fixation
In 1958, the AO ASIF (Association for the Study of InternalFixation) formulated four basic principles,1 which have become the guidelines for internal fixation. They are:
– Anatomical reduction
– Stable internal fixation
– Preservation of blood supply
– Early, active pain-free mobilization
The fundamental aims of fracture treatment in the limbs andfusion of the spine are the same. A specific goal in the spineis returning as much function as possible to the injured neural elements.2
AO ASIF Principles as Applied to the Spine3
Anatomical AlignmentRestoration of normal spinal alignment to improve the biomechanics of the spine.
Stable Internal FixationStabilization of the spinal segment to promote bony fusion.
Preservation of Blood SupplyCreation of an optimal environment for fusion.
Early, Pain-Free MobilizationMinimization of damage to the spinal vasculature, dura, andneural elements, which may contribute to pain reduction andimproved 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. 1991.
2. Ibid.3. M. Aebi, J.S. Thalgott, and J.K. Webb. AO ASIF Principles in Spine Surgery.
Berlin; Springer-Verlag. 1998.
Synthes Spine 3
Indications
Posterior Components
The Synthes Universal Spinal System (USS) devices are non-cervical spinal fixation devices intended for use as posteriorpedicle screw fixation systems (T1–S2), a posterior hook fixation system (T1–L5) or as an anterolateral fixation system(T8 – L5). Pedicle screw fixation is limited to skeletally maturepatients with the exception of the Synthes Small Stature USS.
The Synthes USS devices are indicated for all of the followingregardless of the intended use: degenerative disc disease (defined as discogenic back pain with the degeneration of the disc confirmed by history and radiographic studies),spondylolisthesis, trauma (i.e. fracture or dislocation), deformities or curvatures (i.e. scoliosis, kyphosis, and/or lordosis), Scheuermann’s Disease, tumor, stenosis,pseudoarthrosis, and failed previous fusion.
In addition, the Synthes USS is intended for treatment of severe spondylolisthesis (Grades 3 and 4) of the L5–S1 vertebrae in skeletally mature patients receiving fusion by autogenous bone graft, having implants attached to lumbarand sacral spine with removal of the implants after the attainment of solid fusion.
When used with the 3.5 mm/6.0 mm parallel connectors,the Synthes USS can be linked to the CerviFix System. Also, the Synthes USS can be interchanged with all USS 6.0 mm rods and transconnectors.
Anterior Components
The anterior components of the Synthes USS are intendedfor anterolateral screw and/or staple fixation for the correctionof anterolateral lordotic deformities of the spine, lumbar scoliosis, pseudoarthrosis and fracture or dislocation of thethoracolumbar spine (T8–L5).
Please refer to product insert GP0001 for complete system description, indications and warnings.
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Synthes Spine 5
Hook Placement
2 If necessary, prepare pedicle for pedicle hook
Instrument
388.51 Pedicle Finder
03.622.012 Pedicle Finder (with silicone handle)
Use the Pedicle Finder to open the facet capsule and locatethe pedicle. Remove a small piece of the inferior articularprocess to ensure proper seating of the pedicle hook.
An osteotome can be used to remove a small piece of the inferior articular process. This allows proper seating of the Pedicle Hook (up-going).
1 If necessary, prepare lamina for lamina hook
Instrument
388.52 Lamina Finder
388.104 Small Lamina Finder (with silicone handle)
388.105 Medium Lamina Finder (with silicone handle)
388.106 Large Lamina Finder (with silicone handle)
Use the appropriate Lamina Finder to separate the ligamentumflavum from the underside of the lamina to ensure good bonycontact with the lamina hook. The Lamina Finder can beused to prepare for down-going or up-going lamina hooks.
Hook Placement continued
3 Place hook
Instruments
388.61 Hook or Screw Holder (“Stick”)
388.621 Handle for Hook or Screw Holder
388.63 Hook Positioner
388.110 Hook Positioner (with silicone handle)
Align the Hook or Screw Holder (“Stick”) with the appropriatehook, and secure. Snap the “Stick” into the Handle for Hookor Screw Holder by depressing the button on the handle.
Place the hook in the desired location. The Hook Positionermay also be used to facilitate placement of the hook.
After the hook is properly seated, remove the handle. The “Stick” can remain attached to the hook.
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388.621
388.61
Synthes Spine 7
Preparing the Pedicle for Screw Placement
1Identify the pedicle
The entry point for each lumbar pedicle is at the intersectionof a horizontal line bisecting the transverse process and a vertical line drawn along the lateral border of the superior articular process.
The point of entry for each thoracic pedicle is at the intersection of a line through the transverse process and a line through the inferolateral edge of the facet joint.
Preparing the Pedicle for Screw Placement continued
2Prepare the pedicle
Instruments
03.622.005 Thoracic Pedicle Probe, 3 mm width at tip (with silicone handle)
388.536 Pedicle Probe with Palm Handle for 4.0 mm and 4.2 mm Screws (with silicone handle)
388.539 Pedicle Probe for 7.0 mm, 8.0 mm, and 9.0 mm screws
388.54 Probe for 5.0 mm and 6.0 mm screws
388.544 Pedicle Probe for 4.0 mm and 4.2 mm screws
388.55 Awl (for 5.0 mm – 9.0 mm screws)
388.551 Awl, for 4.0 mm and 4.2 mm screws
388.655 Probe with Palm Handle for 5.0 mm – 9.0 mmscrews (with silicone handle)
388.656 Awl with Palm Handle for 4.0 mm – 9.0 mmscrews (with silicone handle)
Use the appropriate awl to perforate the posterior cortex ofthe pedicle (Figure 1).
Open the pedicle canal using the appropriate probe (Figure 2).Displace the soft cancellous bone by advancing the probethrough the pedicle canal into the vertebral body. Use radiographic imaging to check position and orientation.
Important: Care should be taken not to perforate the wallsof the pedicle.
Note: Additionally available Pedicle Markers can be used toconfirm position and orientation using radiographic imaging.
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Figure 1 Figure 2
Synthes Spine 9
3Select proper screw length
Instruments
388.545 Straight Ball Tip Probe
388.546 Curved Ball Tip Probe
389.80 Ball Tip Probe
Palpate the walls of the pedicle and determine the depth ofthe pedicle canal using a ball tip probe. This instrument hasdepth markings at 25 mm, 30 mm, 40 mm, 50 mm, 60 mmand 70 mm.
Inserting the Screw
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4Insert screws
Instruments
388.61 Hook/Screw Holder (“Stick”)
388.621 Handle for Hook/Screw Holder
Insert the “Stick” into the appropriate side-opening screw andsecure with the coupling screw. Snap the “Stick” into theHandle by depressing the button on the handle.
Insert the side-opening screw into the prepared pedicle. Afterthe screw has been inserted, remove the handle by depressingthe button, leaving the “Stick” in place, if desired.
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Optional Methods of Screw Insertion
Instruments
388.33 Screwdriver
388.334 Screwdriver Shaft
388.36 Holding Sleeve for Long Small Hexagonal Screwdriver
388.38 Holding Sleeve (for 388.33, 03.602.001 and 388.334)
388.395 2.5 mm Hexagonal Screwdriver, long(with silicone handle)
388.61 Hook or Screw Holder (“Stick”)
388.621 Handle for Hook or Screw Holder
388.652 Ratchet T-Handle
03.602.001 Screwdriver, for side-opening implants(with silicone handle)
– The Screwdriver for side-opening implants may also be used for screw insertion.
– The Holding Sleeve may be used with either the screwdriveror the screwdriver shaft to retain the screw during initialinsertion into the pedicle.
– Either the Ratchet Handle and Screwdriver Shaft, or the Handle and the “Stick”, can be used to facilitate screw insertion. The metal ring on the Ratchet Handle may be positioned in a clockwise, counterclockwise orneutral position:
388.334
388.652
Position Function
Clockwise Screw insertion
Counterclockwise Screw removal
Neutral Nonratcheting
or 388.38
Contouring the Rod
1Determine rod contour
Instruments
388.902 Coated Rod Template for 6.0 mm rod, 150 mm
388.905 Coated Rod Template for 6.0 mm rod, 500 mm
When the screws and hooks have been placed and their positionconfirmed radiographically, determine the contour of the rodby using the appropriate 6.0 mm Coated Rod Template.
2Cut rod to length (if necessary)
Instruments
388.72 Rod Cutter
388.750 Table Top Rod Cutter
388.751 Handheld Rod Cutter
Adjust the rod length using the Rod Cutter, the Table Top Rod Cutter, or the Handheld Rod Cutter. All rod cuttingshould take place outside the operative field.
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Synthes Spine 13
388.91, 388.92 388.961
3Contour the rod
Instruments
388.91– Bending Irons, left and right388.92
388.112– In Situ Benders, right and left388.113
388.961 Rod Bender
03.620.020 Rod Bender
03.622.061– Coronal Benders, left and right03.622.062
Use the Rod Bender or the Bending Irons to contour the rodto match the rod template. Use the knob on the Rod Benderto adjust the bend radius. Use the Bending Irons, CoronalBenders or In Situ Benders for in situ rod bending.
Assembling the Construct
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1Introduce the rod
Instruments
388.44 Rod Holding Forceps
388.94 Rod Pusher
388.114 Rod Pusher (with silicone handle)
03.622.081 Rod Holding Forceps with Clamp Grip
Position the rod parallel to the side opening of the screwsand hooks using the Rod Holding Forceps or Rod HoldingForceps with Clamp Grip.
Introduce the rod into the side-opening screw or hook usingthe Rod Pusher.
2Apply the collars and the nuts
Instruments
388.15 Socket Wrench with straight handle, 11 mm
03.602.014 Socket Wrench with Straight Handle, 11 mm (with silicone handle)
Load a Collar and Nut into the 11 mm Socket Wrench. Notethat the collar can be loaded in only one direction. Place theinstrument over the head of the implant and seat both thecollar and the nut. Tighten the nut using the Socket Wrench.
Stacked nutand collar
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Optional Method for Assembling the Construct
Assembly using the “Persuader”
Instruments
388.50 Rod Introduction Pliers, for side-openingimplants (“Persuader”)
388.61 Hook or Screw Holder (“Stick”)
Use the “Persuader” with the “Stick” for construct assembly.The “Persuader” has a specialized holding sleeve that enablesa collar to be preloaded and retained in the correct orientation.
1Load collar
Load a collar onto the barrel of the “Persuader.”
Note: The collar can be loaded in only one direction.
Collar
Optional Method for Assembling the Construct continued
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3Seat collar
Instruments
388.110 Hook Positioner (with silicone handle)
388.13 Socket Wrench with L-handle, 11 mm
388.15 Socket Wrench with straight handle, 11 mm
388.63 Hook Positioner
03.602.014 Socket Wrench with Straight Handle, 11 mm(with silicone handle)
Use the Hook Positioner to tap the collar onto the implant assembly.
Once the collar is pushed down over the implant, remove the Distraction Clip and the “Persuader”. Place a Nut overthe construct and tighten it with the Socket Wrench.
2Engage rod
Instruments
388.410 Distraction Forceps, curved (for 6.0 mm rods)
388.605 Distraction Clip
Position the barrel of the “Persuader” over the “Stick” andadvance it downward over the implant. Engage the rod withthe jaws opposite the barrel of the “Persuader” and squeezethe handle to insert the rod into the hook or screw.
If biplanar reduction of the rod is necessary, use the DistractionClip and the Distraction Forceps with the “Persuader” toguide the rod into the hook or screw opening. The DistractionForceps allow manipulation of the construct to achieve thedesired sagittal-plane contour.
Place the Distraction Clip over the “Stick” to allow reduction.Use the Distraction Forceps against the Distraction Clip whilesqueezing the “Persuader” until the rod is seated in thehook or screw.
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Distraction and Compression
1Determine point of fixation
Instruments
388.44 Rod Holding Forceps
298.910 Half Ring
498.910 Titanium Half Ring
03.622.081 Rod Holding Forceps with Clamp Grip
Use the Rod Holding Forceps or a Half Ring as a point of fixation, if necessary, against which to distract or compress.
2If distraction is required
Instruments
388.118 Parallel Distraction Forceps
388.15 Socket Wrench with straight handle, 11 mm
388.410 Distraction Forceps, curved (for 6.0 mm rods)
03.602.014 Socket Wrench with Straight Handle, 11 mm (with silicone handle)
Use the Distraction Forceps and ensure the nut is loose before distracting against the point of fixation. Once in thedesired position, tighten the nut using the Socket Wrench.
Distraction and Compression continued
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3If compression is required
Instruments
388.119 Parallel Compression Forceps
388.15 Socket Wrench with straight handle, 11 mm
388.42 Compression Forceps
03.602.014 Socket Wrench with Straight Handle, 11 mm (with silicone handle)
Use the Compression Forceps and ensure the nut is loose before compressing against the point of fixation (Figure 3).Once in the desired position, tighten the nut using theSocket Wrench (Figure 4).
4If derotation is required
Instruments
388.15 Socket Wrench with straight handle, 11 mm
03.602.014 Socket Wrench with Straight Handle, 11 mm (with silicone handle)
03.622.082 Rod Rotation Wrench, for 6.0 mm hexagonal-end Rods
Make certain that all nuts are loose. Grasp the rod with theRod Holding Forceps and slowly rotate in the proper direction.Alternatively, the Rod Rotation Wrench is available for rotatinghex end rods. Once in the desired position, tighten the nutusing the Socket Wrench.
Figure 3 Figure 4
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Provisional Tightening of the Construct
Methods for Provisional TighteningOption 1
Tightening using the screwdriver for countertorque
Instruments
388.13 Socket Wrench with L-Handle, 11 mm
388.14 Socket Wrench with straight handle, 6 mm
388.33 Screwdriver, for side-opening implants
03.602.001 Screwdriver, for side-opening implants(with silicone handle)
03.602.013 Socket Wrench with Straight Handle, 6 mm(with silicone handle)
Place the Screwdriver (without holding sleeve) through theSocket Wrench with L-Handle. Hold the Screwdriver stationaryas countertorque while turning the L-handle wrench to secure the nut. Application of countertorque reduces thetorque on the bone while tightening the nut.
Note: Any distraction or compression must be completedbefore final tightening. The 10 Nm Torque Wrench must beused for final construct tightening.
Provisional Tightening of the Construct continued
20 Synthes Spine Universal Spinal System
Option 2
Tightening using the Internal Counter Torque
Instruments
388.13 Socket Wrench with L-Handle, 11 mm
388.263 Internal Counter Torque
Insert the Internal Counter Torque into the Socket Wrenchwith L-Handle to reduce torque on the bone while tighteningthe nut. Hold the Internal Counter Torque stationary andturn the Socket Wrench with L-Handle to secure the nut.
Note: Any distraction or compression must be completedbefore final tightening. The 10 Nm Torque Wrench must beused for final construct tightening.
Option 3
Tightening using the 6 mm Socket Wrench withStraight Handle for countertorque
Instruments
388.13 Socket Wrench with L-Handle, 11 mm
388.14 Socket Wrench with straight handle, 6 mm
388.61 Hook or Screw Holder (“Stick”)
03.602.013 Socket Wrench with Straight Handle, 6 mm(with silicone handle)
Place the Socket Wrench with L-Handle over the Hook orScrew Holder and insert the 6 mm Socket Wrench withStraight Handle. Hold the straight handle wrench stationaryand turn the L-Handle wrench to secure the nut.
Note: Any distraction or compression must be completedbefore final tightening. The 10 Nm Torque Wrench must beused for final construct tightening.
Synthes Spine 21
Final Tightening
Option 1
The 10 Nm Torque Wrench must be used for finalconstruct tightening
Instruments
388.261 10 Nm Torque Wrench, 11 mm width across flats
388.263 Internal Counter Torque
Place the Torque Wrench over the nut. Insert the InternalCounter Torque into the wrench. Hold the Internal CounterTorque stationary while turning the Torque Wrench. Thewrench will “click” at the preset torque of 10 Nm.
Option 2
The 10 Nm Torque Wrench and Counter Torque Sleevecan also be used for final construct tightening
Instruments
388.261 10 Nm Torque Wrench, 11 mm width across flats
388.262 Counter Torque Sleeve
Place the Counter Torque Sleeve over the screw or hookhead. Insert the 10 Nm Torque Wrench into the CounterTorque Sleeve. Hold the Counter Torque Sleeve stationarywhile turning the 10 Nm Torque Wrench. The wrench will“click” at the preset torque of 10 Nm.
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Technique Options
1Measure distance between rods
Instrument
388.865 Measuring Template, for Low Profile Transconnectors
The Low Profile Transconnector is used as a construct stabilizerto reduce rotation.
Use the Measuring Template to measure the distance between the two rods and determine the appropriatetransconnector length.
2Secure transconnector to rods
Instruments
388.31 Long Small Hexagonal Screwdriver
388.395 2.5 mm Hexagonal Screwdriver, long(with silicone handle)
Loosen all of the setscrews and place the appropriate lengthLow Profile Transconnector onto the rods. Use the HexagonalScrewdriver to secure the transconnector to the rods bytightening the setscrews on each end.
When using an adjustable length transconnector, adjust thedistance between the rods, if desired, by compressing or distracting. Then, tighten the center setscrew on the rotatingshaft using the Hexagonal Screwdriver.
Notes:For transconnectors with angular adjustment, tighten thestargrind setscrew to lock the angle between the rods.
If any part of the construct requires further adjustment, all transconnector setscrews must be loosened. After final adjustment, retighten the setscrews.
Attaching Transconnector
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Attaching Transconnector Clamp to Rod
Instruments
388.31 Long Small Hexagonal Screwdriver
388.36 Holding Sleeve for 388.31 and 388.395
388.395 2.5 mm Hexagonal Screwdriver, long(with silicone handle)
Use a USS Preassembled Transconnector Clamp or anTransconnector Clamp (composed of a unassembled clampbody and collar) to provide additional rotational stability.
1Attach clamp to screwdriver
When assembling the transconnector clamp, place the transconnector collar over the holding sleeve on the hexagonal screwdriver.
Insert the hexagonal screwdriver into the clamp bodysetscrew and slide the holding sleeve down to secure theclamp body to the screwdriver.
2Attach clamp to rod
Place the clamp body onto the 6.0 mm rod and slide the collar down to attach the clamp body to the rod.
24 Synthes Spine Universal Spinal System
Technique Options continued
4Insert the 3.5 mm bar
Instrument
388.45 Bar Holding Forceps
Use the Bar Holding Forceps to insert the 3.5 mm bar into thebar channel located below the setscrew. Ensure that the barchannel, collar cutout and setscrew allow bar insertion. The3.5 mm bar can be adjusted ± 20° with respect to the clamp.
Repeat the procedure on the contralateral side.
5Tighten the setscrewsTighten the setscrews in both clamp bodies with the HexagonalScrewdriver to secure the construct.
3Determine length of 3.5 mm bar
Instrument
388.902 Coated Rod Template
Use the Coated Rod Template to determine the length of the 3.5 mm bar and cut the bar to length with a Rod Cutter.
20°
20°
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The Universal Spinal System offers both Open Transverse Bars(Figure 5) and Closed Transverse Bars (Figure 6) for implant-to-rod attachment.
The transverse bar acts as a lateral extension to the hookor screw in situations where the rod contour or patientanatomy prevents direct hook- or screw-to-rod connection.
The transverse bar permits variation in the sagittal angulationof the implant along the 6.0 mm rod (Figure 7). The sagittal andaxial alignment can be achieved independently of each other.
The transverse bar also allows medial/ lateral displacement ofthe hook or screw from the 6.0 mm rod and rotation of theimplant around the 6.0 mm rod (Figure 8). The bar lengthsare 15 mm, 20 mm, 25 mm and 30 mm.
Attaching Transverse Bars
Figure 5
Figure 6
Figure 7 Figure 8
Technique Options continued
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1Attach clamp to screwdriver
Instruments
388.31 Long Small Hexagonal Screwdriver
388.36 Holding Sleeve for 388.31 and 388.395
388.395 2.5 mm Hexagonal Screwdriver, long(with silicone handle)
The Open Transverse Bar can be used after the construct hasalready been secured. The Open Transverse Bar consists oftwo implants: the Clamp for Open Transverse Bar and theOpen Transverse Bar.
Note: A frontal hook must be used with a transverse bar.
Attach the Clamp for Open Transverse Bars to the hexagonalscrewdriver with holding sleeve by engaging the setscrew ofthe clamp with the holding sleeve.
2Place clamp on rod
Place the opening of the Open Transverse Bar on top of the6.0 mm rod. Position the Clamp for Open Transverse Bars to straddle the Open Transverse Bar.
Note: If the transverse bar is placed below the 6.0 mm rod,rotate the clamp to straddle the rod when securing the barto the rod.
Attaching the Open Transverse Bar
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3Tighten the setscrew
Instruments
388.31 Long Small Hexagonal Screwdriver
388.36 Holding Sleeve for 388.31 and 388.395
388.395 2.5 mm Hexagonal Screwdriver, long(with silicone handle)
388.49 Rod Crimping Pliers
388.50 Rod Introduction Pliers, for side-openingimplants (“Persuader”)
388.395 2.5 mm Hexagonal Screwdriver, long(with silicone handle)
Introduce the transverse bar into the frontal hook or side-opening screw with the Rod Crimping Pliers or “Persuader”.Tighten the setscrew on the clamp with the Long SmallHexagonal Screwdriver.
Proceed with step 5 on page 29.
28 Synthes Spine Universal Spinal System
Technique Options continued
The Closed Transverse Bar is used when it can be preloadedonto the rod, particularly when the hook or screw cannot be easily aligned with the rod.
Note: A frontal hook must be used with a transverse bar.
Attaching the Closed Transverse Bar
1Attach bar to screwdriver
Instruments
388.31 Long Small Hexagonal Screwdriver
388.36 Holding Sleeve for 388.31 and 388.395
388.395 2.5 mm Hexagonal Screwdriver, long(with silicone handle)
Attach the Closed Transverse Bar to the hexagonal screwdriverwith holding sleeve by engaging the setscrew of the transversebar with the holding sleeve.
2Place bar on rod
Place the Closed Transverse Bar on the 6.0 mm rod.
3Align bar to screw or hook
Use the hexagonal screwdriver with holding sleeve to alignthe transverse bar with the screw or frontal hook.
Synthes Spine 29
4Attach transverse bar
Instruments
388.49 Rod Crimping Pliers
388.50 Rod Introduction Pliers, for side-openingimplants (“Persuader”)
Introduce the transverse bar into the frontal hook or side-opening screw with the Rod Crimping Pliers or “Persuader”.Tighten the setscrew on the transverse bar to secure it in position.
5Place collar and nut
Place the 6 mm Collar with grooves over the screw or frontal hook.
Place a Nut over the ”Stick” and tighten using the 11 mmSocket Wrench.
Technique Options continued
30 Synthes Spine Universal Spinal System
Instruments
388.118 Parallel Distraction Forceps
388.410 Distraction Forceps, curved (for 6.0 mm rods)
388.44 Rod Holding Forceps
388.50 Rod Introduction Pliers (“Persuader”)
388.605 Distraction Clip
03.622.081 Rod Holding Forceps with Clamp Grip
Position a Distraction Clip or Rod Holding Forceps on theknurling of the “Stick.” Place Distraction Forceps between theDistraction Clip or the Rod Holding Forceps and the barrel ofthe “Persuader.” Slowly squeeze the Distraction Forceps andthe “Persuader” to reduce the spondylolisthesis.
Reduction Procedure for Spondylolisthesis
Synthes Spine 31
Staples and washers can be used to provide secure anchoragefor anterolateral constructs.
1Insert staple
Instruments
385.805 Staple Impactor
03.602.011 Staple Impactor (with silicone handle)
Position the staple on the anterolateral aspect of the thora-columbar spine to accommodate optimal screw placement.Drive the tips through the cortical bone and seat the stapleusing the Staple Impactor and a small mallet.
2Washers
Place the washer over the screw. Use the other implants (rod, collars, and nuts) to complete the construct.
Anterior Approach
32 Synthes Spine Universal Spinal System
Implants
Hooks– Low-profile design
– Side-opening design allows rod attachment to side of the hook
– Multiple designs for use around the lamina, pedicle or transverse process
– Specialized lamina hooks for thoracic and lumbar applications
– Frontal hooks for attachment to the transverse bar
Collars and Nuts– Secure screws and hooks to the 6.0 mm rod
– Collars capture the rod, yet allow longitudinal adjustmentsalong the rod before tightening
– 11 mm nuts secure the construct
Screws– Low-profile design
– Side-opening design simplifies intraoperative rod-to-screwassembly
– Both screw types are self-tapping
– Available in stainless steel or titanium single core, singlelead design of 4.2 mm, 5.0 mm, 6.0 mm, 7.0 mm, 8.0 mmand 9.0 mm diameters, in lengths ranging from 25 mm to140 mm (Fig.1)
– Available in titanium dual core, single lead design of 4.0 mm,5.0 mm, 6.0 mm, 7.0 mm, 8.0 mm and 9.0 mm diameters,in lengths ranging from 25 mm to 100 mm (Fig.2)
– Dual core screws with rounded tips promote safe screw insertion
Thoracic Lamina Hook
Lamina Hook TransverseProcess Hook
PedicleHook
13.5 mm
Fig. 1Single Core
Fig. 2Dual Core
Synthes Spine 33
Transverse Bars– Provide a lateral extension from the 6.0 mm rod to the
hook or screw
– Eliminate the need for severe rod contouring, which might otherwise be required for direct hook- or screw-to-rod connection
– Used with screws and front-opening hooks
– Available in lengths of 15 mm, 20 mm, 25 mm and 30 mm
Parallel Connectors– The 6.0 mm /6.0 mm connector extends USS constructs
– The 5.0 mm /6.0 mm connector allows attachment to the Small Stature USS.
– The 3.5 mm /6.0 mm connector allows attachment of the USS to the CerviFix System
Rods– Available in 6.0 mm diameter
– Hard and soft rods are available for system versatility
– 50 mm to 500 mm lengths in 50 mm increments
– Hex end rod in 500 mm length also available
5.0 mm /6.0 mm 3.5 mm /6.0 mm6.0 mm /6.0 mm
Implants continued
34 Synthes Spine Universal Spinal System
Low Profile Transconnector– Links both rods, providing the construct with rotational
stability
– Clamp body and collar of transconnector assembly allows20° of angulation
– Preassembled for ease of placement
– Available in four fixed lengths (15 mm, 18 mm, 21 mm and24 mm) and eight adjustable lengths (25.5 mm – 83 mm)
– Stargrind allows attachment to non-parallel rods
Staples and Washers– Provide secure anchorage for anterolateral constructs
in the thoracolumbar spine
– Sizes for use with 5.0 mm, 6.0 mm, 7.0 mm and 8.0 mm screws
Stargrind
Center shaft allows 45° rotationabout the horizontal axis.
Adjustable length
Transconnector Assemblies– Links both rods to provide the construct with rotational
stability
– Available in configurations shown to the right
– Clamp body and collar of the transconnector assemblies permit 20° of angulation
– Rod available in 3.5 mm diameter, 80 mm and 120 mm length
Fixed length
Synthes Spine 35
Instruments for Hook Placement
388.52 Lamina Finder
388.51 Pedicle Finder
388.61 Hook or Screw Holder (“Stick”)
388.63 Hook Positioner
388.621 Handle for Hook or Screw Holder
388.110 Hook Positioner
36 Synthes Spine Universal Spinal System
Lamina Finders388.104 Small388.105 Medium388.106 Large
03.622.012 Pedicle Finder
Instruments for Hook Placement continued
Synthes Spine 37
Instruments for Pedicle Preparation
388.551 Awl for 4.0 mm and 4.2 mm screws388.55 Awl (for 5.2 mm–9.0 mm screws)
388.544 Pedicle Probe for 4.0 mm and 4.2 mm screws388.54 Probe (for 5.0 mm and 6.0 mm screws)388.539 Pedicle Probe for 7.0 mm, 8.0 mm, and
9.0 mm screws
388.656 Awl with Palm Handle (for 4.0 mm–9.0 mm screws)
388.536 Pedicle Probe with Palm Handle for 4.0 mmand 4.2 mm screws
388.655 Probe with Palm Handle (for 5.0 mm–9.0 mm screws)
03.622.005 Thoracic Pedicle Probe (3 mm width at tip)
Instruments for Pedicle Preparation continued
38 Synthes Spine Universal Spinal System
Taps for Dual Core Screws, single lead,6 mm hex coupling
03.602.004 for 4.0 mm screws03.602.005 for 5.0 mm screws03.602.006 for 6.0 mm screws03.602.007 for 7.0 mm screws03.620.108 for 8.0 mm screws03.620.109 for 9.0 mm screws
388.545 Straight Ball Tip Probe388.546 Curved Ball Tip Probe389.80 Ball Tip Probe
Cannulated Tap for Dual Core Screws,single lead, 6 mm hex coupling
03.602.034 for 4.0 mm screws03.602.035 for 5.0 mm screws03.602.036 for 6.0 mm screws03.602.037 for 7.0 mm screws311.615 for 8.0 mm screws311.616 for 9.0 mm screws
Instruments for Screw Insertion
Synthes Spine 39
388.33 Screwdriver, for side-opening implants
388.38 Holding Sleeve (for 388.33, 03.602.001 and 388.334)
For alternative method of screw insertion
388.334 Screwdriver Shaft for side-opening screws
388.652 Ratchet T-Handle, 6 mm hex coupling
388.621 Handle for Hook or Screw Holder
03.602.001 Screwdriver, for side-opening implants
388.61 Hook or Screw Holder (“Stick”)
Instruments for Rod Contouring
40 Synthes Spine Universal Spinal System
Coated Rod Templates for 6.0 mm rod388.902 150 mm 388.905 500 mm
388.72 Rod Cutter
388.961 Rod Bender, with bend radius adjustment
388.91 Bending Iron, left388.92 Bending Iron, right
03.620.020 Rod Bender with radius adjustment and spring opening
Synthes Spine 41
03.622.061 Coronal Rod Bender, left
03.622.062 Coronal Rod Bender, right
388.112 In Situ Bender, right
388.113 In Situ Bender, left
388.44 Rod Holding Forceps, for 6.0 mm rods
03.622.081 Rod Holding Forceps, with Clamp Grip
Instruments for Construct Assembly
42 Synthes Spine Universal Spinal System
388.114 Rod Pusher (with silicone handle)
03.602.016 Collar Impactor (with silicone handle)
03.602.013 Socket Wrench with Straight Handle, 6 mm(with silicone handle)
389.225 Collar Impactor
388.14 Socket Wrench with straight handle, 6 mm
388.94 Rod Pusher, for 6.0 mm rods
Synthes Spine 43
388.605 Distraction Clip
388.49 Rod Crimping Pliers, for side-opening implants
388.13 Socket Wrench with L-Handle, 11 mm
388.50 Rod Introduction Pliers (“Persuader”),for side-opening implants
388.15 Socket Wrench with straight handle, 11 mm
03.602.014 Socket Wrench with Straight Handle, 11 mm(with silicone handle)
388.410 Distraction Forceps, curved (for 6.0 mm rods)
Reinforced instrument jaws provide strengthand rigidity for optimal transfer of distractionforce to the implants
Instruments for Distraction and Compression
388.42 Compression Forceps (for 6.0 mm rods)
Reinforced instrument jaws provide strengthand rigidity for optimal transfer of compressionforce to the implants
388.44 Rod Holding Forceps, for 6.0 mm rods
Ensures consistent and stable grip on rod with ratchet locking mechanism
44 Synthes Spine Universal Spinal System
03.622.006 Parallel Compressor with Extended Travel,for 6 mm rods
388.118 Parallel Distraction Forceps
388.119 Parallel Compression Forceps
Synthes Spine 45
498.910 Titanium Half Ring298.910 Half Ring
03.622.081 Rod Holding Forceps with Clamp Grip
03.622.082 Rod Rotation Wrench, for 6.0 mm hexagonal-end rods
Instruments for Tightening of Construct
46 Synthes Spine Universal Spinal System
388.261 10 Nm Torque Wrench, 11 mm width across flats
Important: For final tightening of the construct, this wrench must be used to apply the proper amount of torque.
388.263 Internal Counter Torque
388.262 Counter Torque Sleeve
388.652 Ratchet T-Handle
388.61 Hook or Screw Holder (“Stick”)
388.621 Handle for Hook or Screw Holder
388.334 Screwdriver Shaft, for side-opening screws
Synthes Spine 47
Instruments for Attaching Transconnector
388.31 Long Small Hexagonal Screwdriver
388.36 Holding Sleeve, for Long Small Hexagonal Screwdriver
388.45 Bar Holding Forceps, for 3.5 mm bar
388.865 Measuring Template, for Low ProfileTransconnectors for 6.0 mm rods
385.805 Staple Impactor
Instruments for anterior approach
388.395 2.5 mm Hexagonal Screwdriver, long
03.602.011 Staple Impactor (with silicone handle)
48 Synthes Spine Universal Spinal System
Titanium Dual Core USS Hook, Rod and Clamp Implant Set (01.602.014)
Graphic Case60.602.004 Hook, Rod and Clamp Implant Set Graphic Case
ImplantsSide-Opening Hooks
Titanium Description Qty.498.310 Lamina Hook, small, right 5498.311 Lamina Hook, small, left 5498.312 Lamina Hook, small, frontal 2498.320 Lamina Hook, medium, right 5498.321 Lamina Hook, medium, left 5498.322 Lamina Hook, medium, frontal 2498.330 Lamina Hook, large, right 5498.331 Lamina Hook, large, left 5498.332 Lamina Hook, large, frontal 2498.340 Thoracic Lamina Hook, right 5498.341 Thoracic Lamina Hook, left 5498.342 Thoracic Lamina Hook, frontal 2498.350 Pedicle Hook, right 5498.351 Pedicle Hook, left 5498.352 Pedicle Hook, frontal 2498.380 Transverse Process Hook, right 4498.381 Transverse Process Hook, left 4498.382 Transverse Process Hook, frontal, right 2498.383 Transverse Process Hook, frontal, left 2
6.0 mm Hard Rods
Titanium Length (mm) Qty.498.102 50 2498.103 75 2498.104 100 2498.105 125 2498.106 150 2498.108 200 2498.112 300 2498.116 400 2498.119 500 2
6.0 mm Hexagonal-end Rods
Titanium Length (mm) Qty.04.622.317 500 2
Sterilization Parameters for Set (01.602.014)These Synthes sets with all additionally available items, as marked in the case,can be sterilized by the following parameters. For more information, please referto graphic case package insert.
Method Cycle Temperature Exposure Time
Steam Prevacuum 132° – 135°C 10 Minutes(Wrapped) (270° – 275°F)
Steam Gravity Displacement 132° – 135°C 28 Minutes(Wrapped) (270° – 275°F)
Synthes Spine 49
Implants continued
Collar, Nut
Titanium Description Qty.498.011 Collar with grooves 36
498.003 Nut, 11 mm 36
Half Ring
Titanium Description Qty.498.910 Half Ring 4
Low Profile Transconnectors for 6.0 mm Rods
Titanium Length (mm) Qty.
497.791 15 2497.792 18 2 497.793 21 3 497.794 24 3 497.795 25.5 – 30.5 4 497.796 31.5 – 34.0 3 04.620.203 33.0 – 36.5 3 497.797 35.0 – 41.0 3 04.620.204 38.5 – 48.0 2 497.798 42.0 – 55.0 2 04.620.205 49.0 – 69.0 2 497.799 56.0 – 83.0 2
3.5 mm Bars, for Transconnector
Titanium Length (mm) Qty.
498.120 80 4498.125 120 4
Clamps
Titanium Description Qty.498.250 Clamp for Open Transverse Bars 4
498.813 USS Preassembled Transconnector Clamp 4
Parallel Connectors
Titanium Diameters (mm/mm) Qty.498.960 3.5 / 6.0 2498.160 6.0 / 6.0 2498.162 5.0 / 6.0 2
Closed Transverse Bars
Titanium Length (mm) Qty.498.215 15 2498.220 20 2498.225 25 204.602.001 30 2
Open Transverse Bars
Titanium Length (mm) Qty.498.251 15 2498.252 20 2498.253 25 204.602.002 30 2
Instrument388.365 Measuring Template
Titanium Dual Core USS Screw Implant Set (01.602.013)
Sterilization Parameters for Set (01.602.013)This Synthes set with all additionally available items, as marked in the case, canbe sterilized by the following parameters. For more information, please refer tographic case package insert.
Method Cycle Temperature Exposure Time
Steam Prevacuum 132°–135°C 10 Minutes(Wrapped) (270°– 275°F)
Steam Gravity Displacement 132°–135°C 28 Minutes(Wrapped) (270°–275°F)
50 Synthes Spine Universal Spinal System
Graphic Case 60.602.003 Graphic Case for Dual Core USS Screw
Implant Set
Implants Dual Core USS Screws
ThreadDiameter Length
Titanium (mm) (mm) Qty.04.602.420 4.0 mm 20 mm 404.602.425 4.0 mm 25 mm 804.602.428 4.0 mm 28 mm 404.602.430 4.0 mm 30 mm 804.602.432 4.0 mm 32 mm 404.602.435 4.0 mm 35 mm 804.602.438 4.0 mm 38 mm 404.602.440 4.0 mm 40 mm 604.602.445 4.0 mm 45 mm 404.602.525 5.0 mm 25 mm 604.602.530 5.0 mm 30 mm 804.602.535 5.0 mm 35 mm 804.602.540 5.0 mm 40 mm 804.602.545 5.0 mm 45 mm 804.602.550 5.0 mm 50 mm 404.602.555 5.0 mm 55 mm 404.602.625 6.0 mm 25 mm 204.602.630 6.0 mm 30 mm 404.602.635 6.0 mm 35 mm 604.602.640 6.0 mm 40 mm 804.602.645 6.0 mm 45 mm 804.602.650 6.0 mm 50 mm 604.602.655 6.0 mm 55 mm 404.602.660 6.0 mm 60 mm 404.602.665 6.0 mm 65 mm 404.602.725 7.0 mm 25 mm 204.602.730 7.0 mm 30 mm 404.602.735 7.0 mm 35 mm 604.602.745 7.0 mm 45 mm 804.602.750 7.0 mm 50 mm 804.602.755 7.0 mm 55 mm 404.602.760 7.0 mm 60 mm 204.602.765 7.0 mm 65 mm 204.602.770 7.0 mm 70 mm 2
Dual Core USS Screws continued
ThreadDiameter Length
Titanium (mm) (mm) Qty.04.602.775 7.0 mm 75 mm 204.602.780 7.0 mm 80 mm 204.602.790 7.0 mm 90 mm 204.602.799 7.0 mm 100 mm 204.602.825 8.0 mm 25 mm 204.602.830 8.0 mm 30 mm 204.602.835 8.0 mm 35 mm 204.602.840 8.0 mm 40 mm 204.602.845 8.0 mm 45 mm 204.602.850 8.0 mm 50 mm 204.602.855 8.0 mm 55 mm 204.602.860 8.0 mm 60 mm 204.602.865 8.0 mm 65 mm 204.602.870 8.0 mm 70 mm 204.602.875 8.0 mm 75 mm 204.602.880 8.0 mm 80 mm 204.602.890 8.0 mm 90 mm 204.602.899 8.0 mm 100 mm 204.602.930 9.0 mm 30 mm 2 04.602.935 9.0 mm 35 mm 2 04.602.940 9.0 mm 40 mm 204.602.945 9.0 mm 45 mm 204.602.950 9.0 mm 50 mm 204.602.955 9.0 mm 55 mm 204.602.960 9.0 mm 60 mm 204.602.965 9.0 mm 65 mm 204.602.970 9.0 mm 70 mm 204.602.975 9.0 mm 75 mm 204.602.980 9.0 mm 80 mm 204.602.990 9.0 mm 90 mm 204.602.999 9.0 mm 100 mm 2
Washers
For screw Outerdiameter diameter
Titanium (mm) (mm) Qty.498.035 5 16 2498.036 6 16 2498.037 7 16 2498.045 5 18 2498.046 6 18 2498.047 7 18 2
Small Staples
Titanium Description Qty.498.301 for 5 mm screws 4498.302 for 6 mm screws 4498.303 for 7 mm screws 4
Synthes Spine 51
52 Synthes Spine Universal Spinal System
Dual Core USS Screw and Hook Instrument Set (01.602.001)
Graphic Case 60.602.001 Graphic Case for USS Hook and
Screw Instruments
Instruments388.36 Holding Sleeve for 388.395
388.38 Holding Sleeve for 03.602.001
388.61 Hook or Screw Holder, 16 ea.
388.104 Small Lamina Finder
388.105 Medium Lamina Finder
388.106 Large Lamina Finder
388.110 Hook Positioner
388.334 Screwdriver Shaft, for side-opening implants
388.395 2.5 mm Hexagonal Screwdriver, long, 2 ea.
388.536 Pedicle Probe with Palm Handle, for 4.0 mm
and 4.2 mm screws
388.545 Straight Ball Tip Probe
388.546 Curved Ball Tip Probe
388.621 Handle, for Hook or Screw Holder, 2 ea.
388.652 Ratchet T-Handle
388.655 Probe with Palm Handle (for 5.0 mm – 9.0 mm screws)
388.656 Awl with Palm Handle (for 4.0 mm – 9.0 mm screws)
03.602.001 Screwdriver, for side-opening implants
03.622.005 Thoracic Pedicle Probe, 3 mm width at tip
03.622.012 Pedicle Finder
Taps for Dual Core Screws, single lead, 230 mm
03.602.004 for 4.0 mm screws
03.602.005 for 5.0 mm screws
03.602.006 for 6.0 mm screws
03.602.007 for 7.0 mm screws
03.620.108 for 8.0 mm screws
03.620.109 for 9.0 mm screws
Cannulated Taps for Dual Core Screws, single lead, 230 mm
03.602.034 for 4.0 mm screws
03.602.035 for 5.0 mm screws
03.602.036 for 6.0 mm screws
03.602.037 for 7.0 mm screws
311.615 for 8.0 mm screws
311.616 for 9.0 mm screws
Synthes Spine 53
Dual Core USS Rod Instrument Set (01.602.002)
Graphic Cases 60.602.002 Graphic Case for USS Deformity Correction
Instruments
60.602.005 Graphic Case for USS Rod Bending Instruments
60.602.007 Graphic Case for Additional USS Deformity
Instruments
Instruments in Graphic Case 60.602.002
388.13 Socket Wrench with L-Handle
388.49 Rod Crimping Pliers
388.50 Rod Introduction Pliers, 2 ea.
388.261 10 Nm Torque Wrench
388.262 Counter Torque Sleeve
388.263 Internal Counter Torque
388.605 Distraction Clip, 2 ea.
03.602.014 Socket Wrench with Straight Handle, 11 mm, 2 ea.
Instruments in Graphic Case 60.602.005
388.112 In Situ Bender, right
388.113 In Situ Bender, left
388.114 Rod Pusher for 6.0 mm rod
388.902 Coated Rod Template
388.905 Coated Rod Template
03.620.020 Rod Bender with radius adjustment and spring opening
03.622.061 Coronal Rod Bender for 6.0 mm Rod, left
03.622.062 Coronal Rod Bender for 6.0 mm Rod, right
03.622.081 Rod Holding Forceps with Clamp Grip, 2 ea.
03.622.082 Rod Rotation Wrench, for 6.0 mm hexagonal-end rods
Instruments in Graphic Case 60.602.007
388.118 Parallel Distraction Forceps
388.119 Parallel Compression Forceps
03.602.011 Staple Impactor
03.602.013 Socket Wrench with Straight Handle, 6 mm
03.602.016 Collar Impactor
Sterilization Parameters for Sets (01.602.001 and 01.602.002)These Synthes sets with all additionally available items, as marked in the case,can be sterilized by the following parameters. For more information, please referto graphic case package insert.
Method Cycle Temperature Exposure Time
Steam Prevacuum 132°–135°C 10 Minutes(Wrapped) (270°–275°F)
Steam Gravity Displacement 132°–135°C 28 Minutes(Wrapped) (270°–275°F)
54 Synthes Spine Universal Spinal System
Universal Spinal System Hook, Rod and Clamp SetsStainless Steel (105.855) and Titanium (145.855)
Graphic Case690.061 USS Hook and Rod Set Graphic Case
ImplantsSide-Opening Hooks
Stainless Steel Titanium Description Qty.
298.310 498.310 Lamina Hook, small, right 5
298.311 498.311 Lamina Hook, small, left 5
298.312 498.312 Lamina Hook, small, frontal 2
298.320 498.320 Lamina Hook, medium, right 5
298.321 498.321 Lamina Hook, medium, left 5
298.322 498.322 Lamina Hook, medium, frontal 2
298.330 498.330 Lamina Hook, large, right 5
298.331 498.331 Lamina Hook, large, left 5
298.332 498.332 Lamina Hook, large, frontal 2
298.340 498.340 Thoracic Lamina Hook, right 5
298.341 498.341 Thoracic Lamina Hook, left 5
298.342 498.342 Thoracic Lamina Hook, frontal 2
298.350 498.350 Pedicle Hook, right 5
298.351 498.351 Pedicle Hook, left 5
298.352 498.352 Pedicle Hook, frontal 2
298.380 498.380 Transverse Process Hook, right 4
298.381 498.381 Transverse Process Hook, left 4
298.382 498.382 Transverse Process Hook, 2frontal, right
298.383 498.383 Transverse Process Hook, 2frontal, left
6.0 mm Hard Rods
StainlessSteel Titanium Length (mm) Qty.
298.102 498.102 50 2
298.103 498.103 75 2
298.104 498.104 100 2
298.105 498.105 125 2
298.106 498.106 150 2
298.108 498.108 200 2
298.112 498.112 300 2
298.116 498.116 400 2
298.119 498.119 500 2
Sterilization Parameters for Sets (105.855 and 145.855)These Synthes sets with all additionally available items, as marked in the case,can be sterilized by the following parameters. For more information, please referto graphic case package insert.
Method Cycle Temperature Exposure Time
Steam Prevacuum 132° – 135°C 10 Minutes(Wrapped) (270° – 275°F)
Steam Gravity Displacement 132° – 135°C 28 Minutes(Wrapped) (270° – 275°F)
Synthes Spine 55
Implants continued
Collar, Nut
Stainless Steel Titanium Description Qty.
298.011 498.011 Collar with grooves 20
298.003 498.003 Nut, 11 mm 20
Half Ring
Stainless Steel Titanium Description Qty.
298.910 498.910 Half Ring 4
Low Profile Transconnectors for 6.0 mm Rods
Stainless Steel Titanium Length (mm) Qty.
297.791 497.791 15 2
297.792 497.792 18 2 297.793 497.793 21 3 297.794 497.794 24 3 297.795 497.795 25.5 – 30.5 4 297.796 497.796 31.5 – 34.0 3 297.797 497.797 35.0 – 41.0 3 297.798 497.798 42.0 – 55.0 2 297.799 497.799 56.0 – 83.0 2
3.5 mm Bars, for Transconnector
Stainless Steel Titanium Length (mm) Qty.
298.120 498.120 80 2
298.125 498.125 120 2
Instrument388.365 Measuring Template
Clamps
Stainless Steel Titanium Description Qty.
298.250 498.250 Clamp for Open Transverse Bars 4
298.813 498.813 USS Preassembled Transconnector Clamp 4
Parallel Connectors
Stainless Steel Titanium Diameters (mm/mm) Qty.
498.960 3.5/6.0 2
298.160 498.160 6.0/6.0 2
298.162 498.162 5.0/6.0 2
Closed Transverse Bars
Stainless Steel Titanium Diameter (mm) Qty.
298.215 498.215 15 2
298.220 498.220 20 2
298.225 498.225 25 2
Open Transverse Bars
Stainless Steel Titanium Diameter (mm) Qty.
298.251 498.251 15 2
298.252 498.252 20 2
298.253 498.253 25 2
56 Synthes Spine Universal Spinal System
Universal Spinal System Screw Sets Stainless Steel (105.856) and Titanium (145.856)
Graphic Case690.060 USS Screw Set Graphic Case
ImplantsSide-Opening Screws
Stainless Diameter Length Steel Titanium (mm) (mm) Qty.
298.630 498.630 6.0 30 4
298.635 498.635 6.0 35 6
298.640 498.640 6.0 40 8
298.645 498.645 6.0 45 8
298.650 498.650 6.0 50 6
298.655 498.655 6.0 55 4
298.660 498.660 6.0 60 4
298.730 498.730 7.0 30 4
298.735 498.735 7.0 35 6
298.740 498.740 7.0 40 8
298.745 498.745 7.0 45 8
298.750 498.750 7.0 50 6
298.755 498.755 7.0 55 4
298.760 498.760 7.0 60 4
WashersFor screw Outer
Stainless diameter diameter Steel Titanium (mm) (mm) Qty.
298.035 498.035 5 16 4
298.036 498.036 6 16 4
298.037 498.037 7 16 4
298.045 498.045 5 18 4
298.046 498.046 6 18 4
298.047 498.047 7 18 4
Small Staples
Stainless Steel Titanium Description Qty.
298.301 498.301 for 5 mm screws 4
298.302 498.302 for 6 mm screws 4
298.303 498.303 for 7 mm screws 4
Sterilization Parameters for Sets (105.856 and 145.856)These Synthes sets with all additionally available items, as marked in the case,can be sterilized by the following parameters. For more information, please referto graphic case package insert.
Method Cycle Temperature Exposure Time
Steam Prevacuum 132°–135°C 10 Minutes(Wrapped) (270°–275°F)
Steam Gravity Displacement 132°–135°C 28 Minutes(Wrapped) (270°–275°F)
Synthes Spine 57
Universal Spinal System Hook and Screw Instrument Set (105.852)
Graphic Case690.059 USS Hook and Screw Instrument Set
Graphic Case
Instruments388.31 Long Small Hexagonal Screwdriver, 2 ea.388.33 Screwdriver, for side-opening implants388.334 Screwdriver Shaft, for side-opening screws388.36 Holding Sleeve for 388.31, 2 ea.388.38 Holding Sleeve for 388.33388.539 Pedicle Probe, for 7.0 mm, 8.0 mm and
9.0 mm screws388.54 Probe (for 5.0 mm and 6.0 mm screws)388.544 Pedicle Probe, for 4.0 mm and 4.2 mm screws388.545 Straight Ball Tip Probe388.546 Curved Ball Tip Probe388.51 Pedicle Finder388.52 Lamina Finder388.55 Awl (for 5.0 mm – 9.0 mm screws)388.551 Awl for 4.0 mm and 4.2 mm screws388.61 Hook or Screw Holder, 16 ea.388.621 Handle, for Hook or Screw Holder, 2 ea.388.63 Hook Positioner388.652 Ratchet T-Handle, 6 mm hex coupling389.80 Ball Tip Probe
Sterilization Parameters for Sets (105.851 and 105.852)These Synthes sets with all additionally available items, as marked in the case, can be sterilized by the following parameters. For more information, please referto graphic case package insert.
Method Cycle Temperature Exposure Time
Steam Prevacuum 132°–135°C 10 Minutes(Wrapped) (270°–275°F)
Steam Gravity Displacement 132°–135°C 28 Minutes(Wrapped) (270°–275°F)
58 Synthes Spine Universal Spinal System
Universal Spinal System Rod Instrument Set (105.851)
Graphic Case690.058 USS Rod Instrument Set Graphic Case
Instruments385.805 Staple Impactor388.13 Socket Wrench with L-handle, 11 mm388.14 Socket Wrench with straight handle, 6 mm388.15 Socket Wrench with straight handle,
11 mm, 2 ea.388.261 10 Nm Torque Wrench, 11 mm388.262 Counter Torque Sleeve388.263 Internal Counter Torque388.410 Distraction Forceps, curved388.42 Compression Forceps388.44 Rod Holding Forceps, for 6.0 mm rod, 2 ea.388.45 Bar Holding Forceps, for 3.5 mm bar388.49 Rod Crimping Pliers, for side-opening implants388.50 Rod Introduction Pliers, for side-opening
implants388.605 Distraction Clip388.902 Coated Rod Template for 6.0 mm rod, 150 mm388.905 Coated Rod Template for 6.0 mm rod, 500 mm388.91 Bending Iron, left388.92 Bending Iron, right388.94 Rod Pusher, for 6.0 mm Rods388.961 Rod Bender, with bend radius adjustment389.225 Collar Impactor
Synthes Spine 59
6.0 mm Hard Rods
Titanium Length (mm)
498.110 250498.114 350498.118 450
6.0 mm Soft Rods
498.150 50498.151 75498.152 100498.153 125498.154 150498.158 500
6.0 mm Rods (Ti-6Al-7Nb)
498.290 200498.292 300498.294 400498.296 500
Transconnector Implants
Titanium Description
498.810 Transconnector Clamp Body498.811 Transconnector Collar
For set 01.602.013
Washers
For screw Outerdiameter diameter
Titanium (mm) (mm)498.038 8 16498.039 9 16498.048 8 16498.049 9 18
Staples
Titanium Description
498.041 for 5 mm screws498.042 for 6 mm screws498.043 for 7 mm screws498.044 for 8 mm screws
Tall Body Lamina Hooks
Titanium Description
498.171 Small, left498.172 Small, right498.173 Small, frontal498.174 Medium, left498.175 Medium, right498.176 Medium, frontal498.177 Large, left498.178 Large, right498.179 Large, frontal
Extended Blade Lamina Hooks
498.181 Small, left498.182 Small, right498.183 Small, frontal498.184 Medium, left498.185 Medium, right498.186 Medium, frontal498.187 Large, left498.188 Large, right498.189 Large, frontal
Tall Body Extended Blade Lamina Hooks
498.191 Small, left498.192 Small, right498.193 Small, frontal498.194 Medium, left498.195 Medium, right498.196 Medium, frontal498.197 Large, left498.198 Large, right498.199 Large, frontal
Rectangular Opening Lamina Hooks
498.390 6.5 mm, right498.391 6.5 mm, left498.392 8 mm, right498.393 8 mm, left498.394 9.5 mm, right498.395 9.5 mm, left 498.396 11 mm, right498.397 11 mm, left
For set 01.602.014
Also Available (Dual Core)
60 Synthes Spine Universal Spinal System
6.0 mm Hard Rods
Stainless Steel Titanium Length (mm)
298.110 498.110 250298.114 498.114 350298.118 498.118 450
6.0 mm Soft Rods
298.150 498.150 50 298.151 498.151 75298.152 498.152 100298.153 498.153 125298.154 498.154 150
498.158 500
6.0 mm Rods (Ti-6Al-7Nb)
498.290 200498.292 300498.294 400498.296 500
Transconnector Implants
Stainless Steel Titanium Description
298.810 498.810 Transconnector Clamp Body298.811 498.811 Transconnector Collar
Low Profile Transconnectors for 6.0 mm Rods
Titanium Length (mm)
04.620.203 33.0 – 36.504.620.204 38.5 – 48.004.620.205 49.0 – 69.0
Closed Transverse Bars
04.602.001 30
Open Transverse Bars
04.602.002 30
Graphic Case Trays and Lids
690.181 Hook Tray690.182 Hook Tray Lid690.183 Implant Tray690.184 Implant Tray Left Lid690.185 Implant Tray Right Lid690.186 Transverse Bar Tray690.187 Transverse Bar Tray Lid
Tall Body Lamina Hooks
Stainless Steel Titanium Description
298.171 498.171 Small, left298.172 498.172 Small, right298.173 498.173 Small, frontal298.174 498.174 Medium, left298.175 498.175 Medium, right298.176 498.176 Medium, frontal298.177 498.177 Large, left298.178 498.178 Large, right298.179 498.179 Large, frontal
Extended Blade Lamina Hooks
298.181 498.181 Small, left298.182 498.182 Small, right298.183 498.183 Small, frontal298.184 498.184 Medium, left298.185 498.185 Medium, right298.186 498.186 Medium, frontal298.187 498.187 Large, left298.188 498.188 Large, right298.189 498.189 Large, frontal
Tall Body Extended Blade Lamina Hooks
298.191 498.191 Small, left298.192 498.192 Small, right298.193 498.193 Small, frontal298.194 498.194 Medium, left298.195 498.195 Medium, right298.196 498.196 Medium, frontal298.197 498.197 Large, left298.198 498.198 Large, right298.199 498.199 Large, frontal
Rectangular Opening Lamina Hooks
498.390 6.5 mm, right498.391 6.5 mm, left498.392 8 mm, right498.393 8 mm, left498.394 9.5 mm, right498.395 9.5 mm, left 498.396 11 mm, right498.397 11 mm, left
Also Available continued
For sets 105.855 and 145.855
Synthes Spine 61
Side-Opening Screws
Stainless Diameter Length Steel Titanium (mm) (mm)
298.451 498.451 4.2 25
298.452 498.452 4.2 28
298.453 498.453 4.2 30
298.454 498.454 4.2 32
298.455 498.455 4.2 35
298.456 498.456 4.2 38
298.457 498.457 4.2 40
498.525 5.0 25
298.530 498.530 5.0 30
298.535 498.535 5.0 35
298.540 498.540 5.0 40
298.545 498.545 5.0 45
298.765 498.765 7.0 65
298.770 498.770 7.0 70
298.771 498.771 7.0 75
298.772 498.772 7.0 80
498.773 7.0 85
498.774 7.0 90
498.775 7.0 95
498.776 7.0 100
499.101 7.0 110
499.102 7.0 120
499.103 7.0 130
499.104 7.0 140
298.860 498.860 8.0 30
298.861 498.861 8.0 35
298.862 498.862 8.0 40
298.863 498.863 8.0 45
298.864 498.864 8.0 50
298.865 498.865 8.0 55
298.866 498.866 8.0 60
298.867 498.867 8.0 65
298.868 498.868 8.0 70
298.869 498.869 8.0 75
298.870 498.870 8.0 80
498.871 8.0 85
498.872 8.0 90
498.873 8.0 95
For sets 105.856 and 145.856
Stainless Diameter Length Steel Titanium (mm) (mm)
498.874 8.0 100
498.106 8.0 110
498.107 8.0 120
498.108 8.0 130
498.109 8.0 140
298.875 498.875 9.0 35
298.876 498.876 9.0 40
298.877 498.877 9.0 45
298.878 498.878 9.0 50
298.879 498.879 9.0 55
298.880 498.880 9.0 60
298.881 498.881 9.0 65
298.882 498.882 9.0 70
298.883 498.883 9.0 75
298.884 498.884 9.0 80
499.111 9.0 85
499.112 9.0 90
499.113 9.0 95
499.114 9.0 100
499.115 9.0 110
499.116 9.0 120
499.117 9.0 130
499.118 9.0 140
WashersFor screw Outer
Stainless diameter diameterSteel Titanium (mm) (mm)
298.038 498.038 8 16
298.039 498.039 9 16
298.048 498.048 8 18
298.049 498.049 9 18
Staples
Stainless Steel Titanium Description
298.041 498.041 for 5 mm screws
298.042 498.042 for 6 mm screws
298.043 498.043 for 7 mm screws
298.044 498.044 for 8 mm screws
62 Synthes Spine Universal Spinal System
For set 01.602.001388.52 Lamina Finder
For set 01.602.002 (in Graphic Case 60.602.002)388.42 Compression Forceps
388.44 Rod Holding Forceps
388.45 Bar Holding Forceps
388.410 Distraction Forceps
388.91 Bending Iron, Left
388.92 Bending Iron, Right
For set 01.602.002 (in Graphic Case 60.602.007)03.622.006 Parallel Compressor with Extended Travel
For set 105.852Taps, hex coupling, for side opening screws
388.267 for 4.2 mm screws, 180 mm
388.268 for 5.0 mm screws, 180 mm
388.269 for 6.0 mm screws, 230 mm
388.270 for 7.0 mm screws, 230 mm
388.271 for 8.0 mm screws, 230 mm
388.272 for 9.0 mm screws, 230 mm
Cannulated Taps, hex coupling, for side opening screws
388.284 for 4.2 mm screws, 180 mm
388.285 for 5.0 mm screws, 180 mm
388.286 for 6.0 mm screws, 230 mm
388.287 for 7.0 mm screws, 230 mm
388.288 for 8.0 mm screws, 230 mm
388.289 for 9.0 mm screws, 230 mm
388.274 Tap Handle
Additional Instruments
388.72 Rod Cutter
388.750 Table Top Rod Cutter
388.751 Handheld Rod Cutter
Also Available continued
Synthes Spine1302 Wrights Lane EastWest Chester, PA 19380Telephone: (610) 719-5000To order: (800) 523-0322Fax: (610) 251-9056
Synthes (Canada) Ltd.2566 Meadowpine BoulevardMississauga, Ontario L5N 6P9Telephone: (905) 567-0440To order: (800) 668-1119Fax: (905) 567-3185
© 2006 Synthes Spine CerviFix, Synthes and ASIF are trademarks of Synthes (USA). Printed in U.S.A. 10/06 J4437-A
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