Surgical Technique - synthes.vo.llnwd.net

1 ARCH Laminoplasty System. Dedica-ted System for Open-door TechniqueThis publication is not intended for distribution in the and implants approved by the AO intensifier controlWarningThis 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 , Reprocessing, Care and MaintenanceFor 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.

2 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: Laminoplasty System DePuy Synthes DePuy Synthes 1 Table of ContentsIntroduction Overview 2AO ASIF Principles 4 Indications and Contraindications 5 Product Information Implants 6 Instruments 8 Vario Case 10 Surgical Technique Laminotomy

3 11A. Arch Laminoplasty without Spacer 13B. Arch Laminoplasty with Spacer 162 DePuy Synthes ARCH Laminoplasty System DePuy SynthesBefore laminoplastyAfter laminoplastyAfter laminoplasty with spacerMiniplatesThe ARCH Laminoplasty System miniplates are: Pre-bent (single bend and double bend) to fit the anatomy of the dorsally elevated lamina Low profile to prevent tissue irritation Available in 5 sizes Made from pure titaniumThe aims of the ARCH Laminoplasty System are to.

4 Maintain an expanded spinal canal Secure spinal stability Preserve the protective function of the spine after a laminoplasty has been performedDouble bendSingle bendOverviewARCH Laminoplasty System DePuy Synthes DePuy Synthes 3 Also recommended for Laminoplasty procedure:Electric Pen Drive and Air Pen Drive*To ease the work and decrease Surgical time during lamino-plasty the use of an appropriate power tool can be helpful. The Electric Pen Drive and Air Pen Drive are pen shaped, high-speed systems, supporting surgeons for example in performing a laminoplasty.

5 A wide range of attachments and cutting tools further facilitates working with the Electric Pen Drive and Air Pen Drive.** Especially appropriate for performing a laminoplasty are the angled burr attachments, with steel or diamond burrs.* see also brochure Electric Pen Drive ( ) and Air Pen Drive ( )** see also brochure Cutting Tools for Electric Pen Drive and Air Pen Drive ( )4 DePuy Synthes ARCH Laminoplasty System DePuy SynthesIn 1958, the AO ASIF (Association for the Study of Internal Fixation) formulated four basic principles1, which have be-come the guidelines for internal fixation.

6 They are: Anatomical reduction Stable internal fixation Preservation of blood supply Early, active pain-free mobilizationThe 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 ASIF Principles as applied to the spine3 Anatomical alignmentIn the spine, this means reestablishing and maintaining the natural curvature and the protective function of the spine. By regaining this natural anatomy, the biomechanics of the spine can be improved, and a reduction of pain can be expe-rienced.

7 Stable internal fixationIn the spine, the goal of internal fixation is to maintain not only the integrity of a mobile segment, but also to maintain the balance and the physiologic three-dimensional form of the A stable spinal segment allows bony fusion at the junction of the lamina and of blood supplyThe proper atraumatic Technique enables minimal retraction or disturbance of the nerve roots and dura, and maintains the stability of the facet joints. The ideal Surgical Technique and implant design minimize damage to anatomical struc-tures, facet capsules and soft tissue attachments remain intact, and create a physiological environment that facilitates , pain-free mobilizationThe ability to restore normal spinal anatomy may permit the immediate reduction of pain, resulting in a more active, functional patient.

8 The reduction in pain and improved func-tion can result when a stable spine is achieved. 1 M ller ME, Allg wer M, Schneider R, Willenegger R (1991) AO Manual of Internal Fixation. 3rd ed. Berlin: Springer2 Aebi M, Thalgott JS, Webb JK (1998) AO ASIF Principles in Spine Surgery. Berlin: SpringerAO ASIF PrinciplesARCH Laminoplasty System DePuy Synthes DePuy Synthes 5 ContraindicationsThe ARCH Laminoplasty System is not to be used: For single- or two-level spondylosis without developmen-tal spinal canal stenosis The ARCH Laminoplasty System is not to be used when there is.

9 Focal anterior compression Established absolute kyphosis Isolated radiculopathy Loss of anterior column support resulting from tumor, trauma, or infectionIndications Ossi fication of the posterior longitudinal ligament (OPLL) over multiple levels with maintained cervical lordosis Congenital canal stenosis with maintained cervical lordo-sis Multilevel cervical spondylosis with maintained cervical lordosis Posterior compression from ligamentous hypertrophy with maintained cervical lordosisThe ARCH Laminoplasty System is intended for use in the lower cervical and upper thoracic spine (C3 T3)

10 After a lami-notomy has been and Contraindications6 DePuy Synthes ARCH Laminoplasty System DePuy SynthesDouble bendSingle bendMiniplatesThe ARCH Laminoplasty System miniplates are available single bend or double bend:Single mm MiniplatesArt. No. Laminar gap Overall 4 mm 27 6 mm 29 8 mm 31 10 mm 33 12 mm 35 mmDouble mm MiniplatesArt. No. Laminar gap Overall 4 mm 27 6 mm 29 8 mm 31 10 mm 33 12 mm 35 mmAdditional mm Adaption plateArt. No. Holes Overall 20 mmImplantsARCH Laminoplasty System DePuy Synthes DePuy Synthes 7 Screws with PlusDrive recess Excellent screw retention Flat head Easy to pick upThe PlusDrive screws are available as self-tapping or self-drilling cortex screws:Self-tapping, B mmArt.