B. Braun Aesculap Spine S4 User manual

Aesculap®
Aesculap Spine
Instructions for use
S4®Instruments - dynamic connecting rod
Gebrauchsanweisung
S4®Instrumente - dynamischer Verbindungsstab
Mode d'emploi
Instruments S4®- tige de jonction dynamique
Instrucciones de manejo
Instrumental S4®- varillas de unión dinámica
Istruzioni per l'uso
Strumenti S4®- barra di connessione dinamica
Instruções de utilização
Instrumentos S4®- barra de união dinâmica
Gebruiksaanwijzing
S4®-instrumenten - dynamisch verbindingsstaafje
Bruksanvisning
S4®instrument - dynamisk förbindelsestav
Инструкция по применению
S4®Динамический соединительный стержень
Návod k použití
Nástroje S4®- dynamická spojovací tyčka
Instrukcja użytkowania
Instrumenty S4®- dynamiczny pręt połączeniowy
Návod na používanie
S4®Nástroje - dynamická spojovacia tyč
Kullanım Kılavuzu
S4®Dinamik bağlantı çubuğuna sahip araçlar

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3
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Aesculap®
S4® Instruments - dynamic connecting rod
Aesculap® S4®Instruments - dynamic connecting rod
Legend
1Insertion pliers FW685R
2Sleeve FW686R
3Trial implant FW687R
Symbols on product and packages
Applicable to
►For item-specific instructions for use and informa-
tion on material compatibility, see also the
Aesculap Extranet at www.extranet.bbraun.com
Intended use
S4instruments - dynamic connecting rod are used for
the implantation of the S4dynamic connecting rods.
S4instruments - dynamic connecting rod comprise the
following components:
■Insertion pliers FW685R to securely hold and
implant the S4dynamic connecting rod.
■Sleeve FW686R in combination with counter
torque FW236R to counteract the torque at the
final locking of the locking screw, in particular if
there is little space between the spring element
and the pedicle screw head. If there is sufficient
space, alternative counter torque FW178R can be
used.
■Trial implant FW687R to gauge the space required
by the S4dynamic connecting rod.
Safe handling and preparation
CAUTION
Federal law restricts this device to sale by, or on
order of a physician!
►Ensure that the product and its accessories are
operated and used only by persons with the requi-
site training, knowledge, or experience.
►Read, follow, and keep the instructions for use.
►Use the product only in accordance with its
intended use, see Intended use.
►Remove the transport packaging and clean the new
product, either manually or mechanically, prior to
its initial sterilization.
►Store any new or unused products in a dry, clean,
and safe place.
►Prior to each use, inspect the product for loose,
bent, broken, cracked, worn, or fractured compo-
nents.
►Do not use the product if it is damaged or defec-
tive. Set aside the product if it is damaged.
►Replace any damaged components immediately
with original spare parts.
Safe operation
Caution, general warning symbol
Caution, see documentation sup-
plied with the product
Date of manufacture
WARNING
Risk of injury and/or malfunc-
tion!
►Always carry out a func-
tion check prior to using
the product.

3
Insertion pliers FW685R
►Insert the spring element of the S4dynamic con-
necting rod in the insertion pliers, see Fig. 1.
Fig. 1 Inserting the spring element in the insertion
pliers
►Ensure that the direction of the spring element
corresponds with the profile of the jaws.
►Close the insertion pliers and engage, see Fig. 2.
Fig. 2 Closing the insertion pliers
►Only remove the insertion pliers from the spring
element after the final locking of the locking
screws in the polyaxial screws.
CAUTION
Bending or twisting of the
implant due to implantation
with incorrect clamping in the
insertion pliers!
►Check the correct position-
ing of the implant in the
insertion pliers.
►Always insert the implant
with insertion pliers.
CAUTION
Bending or twisting of the
spring element when tighten-
ing the locking screws!
►Use the countering instru-
ment.
►Make certain the pedicle
screw heads are in parallel
alignment.
►Clamp the spring element
with the insertion pliers
when tightening.

4
Aesculap®
S4® Instruments - dynamic connecting rod
Sleeve FW686R
►Use sleeve in combination with counter torque
FW236R.
►Push the sleeve onto the pedicle screw until the
lower opening of the sleeve is positioned on the
rod.
Trial implant FW687R
►Use the trial implant with handle FW165R as
required.
►Apply the first K-wire.
►Thread the trial implant through the hole in the rod
piece via the K-wire, see Fig. 3, Step 1.
►Gauge the entry point of the second K-wire using
the slotted hole, see Fig. 3, Step 2.
Fig. 3 Using the trial implant
►Apply the pedicle screws.
►Using the trial implant, gauge the required space
for the spring element and clear.
CAUTION
Damage to the rod due to an
incorrectly positioned sleeve!
►Ensure the sleeve is cor-
rectly positioned on the
rod.
CAUTION
Distance between the pedicle
screws too narrow for the
spring element!
►Determine the distance
between the pedicle screws
pre-operatively.
►Use the trial implant when
applying the K-wire.
12

5
Disassembling
Insertion pliers FW685R
►Detach the jaws from the insertion pliers in the
direction of the arrow, see Fig. 4.
Fig. 4 Disassembling the insertion pliers
Assembling
Insertion pliers FW685R
►Attach the jaws to the corresponding plier piece in
the direction of the arrow. The markings (down or
up) on the plier piece and jaw piece must
correspond, see Fig. 5.
Fig. 5 Assembling the insertion pliers
►Push on the jaw pieces as far as they will go.

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Aesculap®
S4® Instruments - dynamic connecting rod
Validated reprocessing procedure
General safety instructions
Note
Adhere to national statutory regulations, national and
international standards and directives, and local, clini-
cal hygiene instructions for sterile processing.
Note
For patients with Creutzfeldt-Jakob disease (CJD), sus-
pected CJD or possible variants of CJD, observe the rel-
evant national regulations concerning the reprocessing
of products.
Note
Mechanical reprocessing should be favored over man-
ual cleaning as it gives better and more reliable results.
Note
Successful processing of this medical device can only
be ensured if the processing method is first validated.
The operator/sterile processing technician is responsi-
ble for this.
The recommended chemistry was used for validation.
Note
If there is no final sterilization, then a virucidal disin-
fectant must be used.
Note
For the latest information on reprocessing and material
compatibility see also the Aesculap extranet at
www.extranet.bbraun.com
The validated steam sterilization procedure was carried
out in the Aesculap sterile container system.
General information
Dried or affixed surgical residues can make cleaning
more difficult or ineffective and lead to corrosion.
Therefore the time interval between application and
processing should not exceed 6 h; also, neither fixating
pre-cleaning temperatures >45 °C nor fixating disin-
fecting agents (active ingredient: aldehydes/alcohols)
should be used.
Excessive measures of neutralizing agents or basic
cleaners may result in a chemical attack and/or to fad-
ing and the laser marking becoming unreadable visu-
ally or by machine for stainless steel.
Residues containing chlorine or chlorides e.g. in surgi-
cal residues, medicines, saline solutions and in the ser-
vice water used for cleaning, disinfection and steriliza-
tion will cause corrosion damage (pitting, stress
corrosion) and result in the destruction of stainless
steel products. These must be removed by rinsing thor-
oughly with demineralized water and then drying.
Additional drying, if necessary.

7
Only process chemicals that have been tested and
approved (e.g. VAH or FDA approval or CE mark) and
which are compatible with the product’s materials
according to the chemical manufacturers’ recommen-
dations may be used for processing the product. All the
chemical manufacturer's application specifications
must be strictly observed. Failure to do so can result in
the following problems:
■Optical changes of materials, e.g. fading or discol-
oration of titanium or aluminum. For aluminum,
the application/process solution only needs to be
of pH >8 to cause visible surface changes.
■Material damage such as corrosion, cracks, fractur-
ing, premature aging or swelling.
►Do not use metal cleaning brushes or other abra-
sives that would damage the product surfaces and
could cause corrosion.
►Further detailed advice on hygienically safe and
material-/value-preserving reprocessing can be
found at www.a-k-i.org, link to Publications, Red
Brochure – Proper maintenance of instruments.
Disassembling the product before carry-
ing out the reprocessing procedure
►Disassemble the product immediately after use, as
described in the respective instructions for use.
►Open up instruments with hinges.
Preparations at the place of use
►If applicable, rinse non-visible surfaces preferably
with deionized water, with a disposable syringe for
example.
►Remove any visible surgical residues to the extent
possible with a damp, lint-free cloth.
►Transport the dry product in a sealed waste con-
tainer for cleaning and disinfection within 6 hours.
Preparation before cleaning
►Dismantle the product prior to cleaning, see Disas-
sembling.
Cleaning/disinfection
Product-specific safety notes on the repro-
cessing procedure
CAUTION
Damage to the product due to
inappropriate cleaning/disin-
fecting agents and/or exces-
sive temperatures!
►Use cleaning and disinfect-
ing agents according to the
manufacturer’s instruc-
tions which
–are approved for use
e.g. on aluminum, plas-
tic materials and stain-
less steel,
–do not attack softeners
(e.g. in silicone).
►Observe specifications
regarding concentration,
temperature and exposure
time.

8
Aesculap®
S4® Instruments - dynamic connecting rod
Validated cleaning and disinfection procedure
Validated procedure Specific requirements Reference
Manual cleaning with
immersion disinfection
■Cleaning brush:
– for FW685R e.g. TE654202
– for FW686R e.g. TA007747
■20 ml disposable syringe
■Keep working ends open for
cleaning.
■When cleaning instruments with
movable hinges, ensure that these
are in an open position and, if
applicable, move the joint while
cleaning.
■Dryingphase: Use a lint-free cloth
or medical compressed air
Chapter Manual cleaning/disinfection and
sub-chapter:
■Chapter Manual cleaning with immer-
sion disinfection
Manual pre-cleaning
with brush and subse-
quent mechanical alka-
line cleaning and ther-
mal disinfection
■Cleaning brush:
– for FW685R e.g. TE654202
– for FW686R e.g. TA007747
■20 ml disposable syringe
■Place the instrument in a tray
that is suitable for cleaning
(avoiding rinsing blind spots).
■Connect components with lumens
and channels directly to the rins-
ing port of the injector carriage.
■Keep working ends open for
cleaning.
■Place instruments in the tray with
their hinges open.
Chapter Mechanical cleaning/disinfection
with manual pre-cleaning and sub-chap-
ter:
■Chapter Manual pre-cleaning with a
brush
■Chapter Mechanical alkaline cleaning
and thermal disinfecting

9
Manual cleaning/disinfection
►Prior to manual disinfecting, allow water to drip off for a sufficient length of time to prevent dilution of the
disinfecting solution.
►After manual cleaning/disinfection, check visible surfaces visually for residues.
►Repeat the cleaning /disinfection process if necessary.
Manual cleaning with immersion disinfection
D–W: Drinking water
FD–W: Fully desalinated water (demineralized, low microbiological contamination: drinking water
quality at least)
RT: Room temperature
*Recommended: BBraun Stabimed
►Note the information on appropriate cleaning
brushes and disposable syringes, see Validated
cleaning and disinfection procedure.
Phase Step T
[°C/°F]
t
[min]
Conc.
[%]
Water
quality
Chemical
I Disinfecting
cleaning
RT (cold) >15 2 D–W Aldehyde-free, phenol-free,
and QUAT-free concentrate,
pH ~ 9*
II Intermediate rinse RT (cold) 1 - D–W -
III Disinfection RT (cold) 15 2 D–W Aldehyde-free, phenol-free,
and QUAT-free concentrate,
pH ~ 9*
IV Final rinse RT (cold) 1 - FD-W -
VDrying RT - - - -

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Aesculap®
S4® Instruments - dynamic connecting rod
Phase I
►Fully immerse the product in the cleaning/disinfec-
tant for at least 15 min. Ensure that all accessible
surfaces are moistened.
►Clean the product with a suitable cleaning brush in
the solution until all discernible residues have been
removed from the surface.
►If applicable, brush through non-visible surfaces
with an appropriate cleaning brush for at least
1min.
►Mobilize non-rigid components, such as set screws,
links, etc. during cleaning.
►Thoroughly rinse through these components with
the cleaning disinfectant solution (at least five
times), using a disposable syringe.
Phase II
►Rinse/flush the product thoroughly (all accessible
surfaces) under running water.
►Mobilize non-rigid components, such as set screws,
joints, etc. during rinsing.
►Drain any remaining water fully.
Phase III
►Fully immerse the product in the disinfectant solu-
tion.
►Mobilize non-rigid components, such as set screws,
joints, etc. during rinsing.
►Rinse lumens at least 5 times at the beginning of
the exposure time using an appropriate disposable
syringe. Ensure that all accessible surfaces are
moistened.
Phase IV
►Rinse/flush the product thoroughly (all accessible
surfaces).
►Mobilize non-rigid components, such as set screws,
joints, etc. during final rinse.
►Rinse lumens with an appropriate disposable
syringe at least five times.
►Drain any remaining water fully.
Phase V
►Dry the product in the drying phase with suitable
equipment (e.g. cloth, compressed air), see Vali-
dated cleaning and disinfection procedure.

11
Mechanical cleaning/disinfection with manual pre-cleaning
Note
The cleaning and disinfection device must be of tested and approved effectiveness (e.g. FDA approval or CE mark
according to DIN EN ISO 15883).
Note
The cleaning and disinfection device used for processing must be serviced and checked at regular intervals.
Manual pre-cleaning with a brush
D–W: Drinking water
RT: Room temperature
*Recommended: BBraun Stabimed
►Note the information on appropriate cleaning
brushes and disposable syringes, see Validated
cleaning and disinfection procedure.
Phase I
►Fully immerse the product in the cleaning/disinfec-
tant for at least 15 min. Ensure that all accessible
surfaces are moistened.
►Clean the product with a suitable cleaning brush in
the solution until all discernible residues have been
removed from the surface.
►If applicable, brush through non-visible surfaces
with an appropriate cleaning brush for at least
1min.
►Mobilize non-rigid components, such as set screws,
links, etc. during cleaning.
►Thoroughly rinse through these components with
the cleaning disinfectant solution (at least five
times), using a disposable syringe.
Phase II
►Rinse/flush the product thoroughly (all accessible
surfaces) under running water.
►Mobilize non-rigid components, such as set screws,
joints, etc. during rinsing.
Phase Step T
[°C/°F]
t
[min]
Conc.
[%]
Water
quality
Chemical
I Disinfec-
tant
cleaning
RT (cold) >15 2 D–W Aldehyde-free, phenol-free, and
QUAT-free concentrate, pH ~ 9*
II Rinsing RT (cold) 1 - D–W -

12
Aesculap®
S4® Instruments - dynamic connecting rod
Mechanical alkaline cleaning and thermal disinfecting
Machine type: single-chamber cleaning/disinfection device without ultrasound
D–W: Drinking water
FD–W: Fully desalinated water (demineralized, low microbiological contamination: drinking water
quality at least)
*Recommended: BBraun Helimatic Cleaner alkaline
►Check visible surfaces for residues after mechani-
cal cleaning/disinfecting.
Phase Step T
[°C/°F]
t
[min]
Water
quality
Chemical
I Prerinse <25/77 3 D–W -
II Cleaning 55/131 10 FD-W ■Concentrate, alkaline:
–pH=13
– <5 % anionic surfactant
■0.5 % working solution
– pH = 11*
III Intermediate rinse >10/50 1 FD-W -
IV Thermal disinfect-
ing
90/194 5 FD-W -
VDrying - - - According to the program for cleaning
and disinfection device

13
Inspection, maintenance and checks
►Allow the product to cool down to room tempera-
ture.
►After each complete cleaning, disinfecting and dry-
ing cycle, check that the instrument is dry, clean,
operational, and free of damage (e.g. broken insu-
lation or corroded, loose, bent, broken, cracked,
worn, or fractured components).
►Dry the product if it is wet or damp.
►Repeat cleaning and disinfection of products that
still show impurities or contamination.
►Check that the product functions correctly.
►Immediately put aside damaged or inoperative
products and send them to Aesculap Technical Ser-
vice, see Technical Service.
►Assemble dismountable products, see Assembling.
►Check for compatibility with associated products.
Packaging
►Store products with ratchet locks fully opened or
locked no further than in the first notch.
►Place the product in its holder or on a suitable tray.
Ensure that all cutting edges are protected.
►Pack trays appropriately for the intended steriliza-
tion process (e.g. in sterile Aesculap containers).
►Ensure that the packaging provides sufficient pro-
tection against recontamination of the product
during storage.
Steam sterilization
Note
The product may only be sterilized when dismantled.
Note
To avoid breakage due to stress crack corrosion, steril-
ize the instruments with the lock fully open or locked no
further than on the first ratchet tooth.
►Check to ensure that the sterilizing agent will come
into contact with all external and internal surfaces
(e.g. by opening any valves and faucets).
►Validated sterilization process
– Disassemble the instrument
– Steam sterilization through fractionated vac-
uum process
– Steam sterilizer according to DIN EN 285 and
validated according to DIN EN ISO 17665
– Sterilization using fractionated vacuum pro-
cess at 134 °C/holding time 5 min
►When sterilizing several instruments at the same
time in a steam sterilizer, ensure that the maxi-
mum load capacity of the steam sterilizer specified
by the manufacturer is not exceeded.
CAUTION
Damage (metal seizure/fric-
tion corrosion) to the product
caused by insufficient lubrica-
tion!
►Prior to function checks,
lubricate moving parts (e.g.
joints, pusher components
and threaded rods) with
maintenance oil suitable
for the respective steriliza-
tion process (e.g. for steam
sterilization: Aesculap
STERILIT® I oil spray JG600
or STERILIT® I drip lubrica-
tor JG598).

14
Aesculap®
S4® Instruments - dynamic connecting rod
Sterilization for the US market
■Aesculap advises against sterilizing the device by
flash sterilization or chemical sterilization.
■Sterilization may be accomplished by a standard
prevacuum cycle in a steam autoclave.
To achieve a sterility assurance level of 10-6, Aesculap
recommends the following parameters:
*Aesculap has validated the above sterilization cycle
and has the data on file. The validation was accom-
plished in an Aesculap sterile container cleared by FDA
for the sterilization and storage of these products.
Other sterilization cycles may also be suitable, how-
ever individuals or hospitals not using the recom-
mended method are advised to validate any alternative
method using appropriate laboratory techniques. Use
an FDA cleared accessory to maintain sterility after
processing, such as a wrap, pouch, etc.
WARNING for the US market
If this device is/was used in a patient with, or sus-
pected of having Creutzfeldt-Jakob Disease (CJD),
the device cannot be reused and must be destroyed
due to the inability to reprocess or sterilize to elim-
inate the risk of crosscontamination.
Storage
►Store sterile products in germ-proof packaging,
protected from dust, in a dry, dark, temperature-
controlled area.
Technical Service
►For service and repairs, please contact your
national B. Braun/Aesculap agency.
Modifications carried out on medical technical equip-
ment may result in loss of guarantee/warranty rights
and forfeiture of applicable licenses.
Service addresses
Aesculap Technischer Service
Am Aesculap-Platz
78532 Tuttlingen / Germany
Phone: [phone]
Fax: [phone]
E-Mail: [email protected]
Or in the US:
Aesculap Implant Systems LLC
Attn. Aesculap Technical Services
615 Lambert Pointe Drive
Hazelwood
MO, 63042
Aesculap Repair Hotline
Phone: [phone]
Fax: [phone]
Other service addresses can be obtained from the
address indicated above.
Aesculap Orga Tray/Sterile container (perforated
bottom)
Minimum cycle parameters*
Steriliza-
tion method
Temp. Time Minimum
drying
time
Prevacuum 270 °F/
275 °F
4 min 20 min
WARNING
Risk of injury and/or malfunc-
tion!
►Do not modify the product.

15
Disposal
►Adhere to national regulations when disposing of
or recycling the product, its components and its
packaging!
Incineration of the product, its components and its
packaging produces harmless residues.
►Comply with national regulations for incineration
under all circumstances!
To avoid the release of toxic incineration products, the
incineration of the product, its components and its
packaging must be carried out in an appropriate incin-
erator (>1 000 °C).
►Comply with national regulations for incineration
under all circumstances!
Distributor in the US/Contact in
Canada for product information
and complaints
Aesculap Implant Systems LLC
3773 Corporate Parkway
Center Valley, PA, 18034,
USA

16
Aesculap®
S4® Instrumente - dynamischer Verbindungsstab
Aesculap® S4®Instrumente - dynami scher Verbindung sstab
Legende
1Einsetzzange FW685R
2Hülse FW686R
3Probeimplantat FW687R
Symbole an Produkt und
Verpackung
Geltungsbereich
►Für artikelspezifische Gebrauchsanweisungen und
Informationen zur Materialverträglichkeit siehe
auch Aesculap Extranet unter
www.extranet.bbraun.com
Verwendungszweck
S4Instrumente - dynamischer Verbindungsstab wer-
den zur Implantation der S4dynamischen Verbin-
dungsstäbe verwendet.
S4Instrumente - dynamischer Verbindungsstab
umfasst folgende Komponenten:
■Einsetzzange FW685R zum sicheren Halten und
Implantieren des S4dynamischen Verbindungs-
stabs.
■Hülse FW686R in Verbindung mit Gegenhalter
FW236R zur Aufnahme des Drehmoments beim
finalen Verriegeln der Verriegelungsschraube, ins-
besondere bei wenig Platz zwischen Federelement
und Pedikelschraubenkopf. Bei ausreichend Platz
kann alternativ Gegenhalter FW178R verwendet
werden.
■Probeimplantat FW687R zum Abschätzen des vom
S4dynamischen Verbindungsstab benötigten Plat-
zes.
Sichere Handhabung und Bereit-
stellung
►Produkt und Zubehör nur von Personen betreiben
und anwenden lassen, die die erforderliche Ausbil-
dung, Kenntnis oder Erfahrung haben.
►Gebrauchsanweisung lesen, einhalten und aufbe-
wahren.
►Produkt nur bestimmungsgemäß verwenden, siehe
Verwendungszweck.
►Fabrikneues Produkt nach Entfernung der Trans-
portverpackung und vor der ersten Sterilisation rei-
nigen (manuell oder maschinell).
►Fabrikneues oder unbenutztes Produkt an einem
trockenen, sauberen und geschützten Platz aufbe-
wahren.
►Produkt vor jeder Verwendung visuell prüfen auf:
lose, verbogene, zerbrochene, rissige, abgenutzte
und abgebrochene Teile.
►Kein beschädigtes oder defektes Produkt verwen-
den. Beschädigtes Produkt sofort aussortieren.
►Beschädigte Einzelteile sofort durch Originaler-
satzteile ersetzen.
Bedienung
Achtung, allgemeines Warnzei-
chen
Achtung, Begleitdokumente
beachten
Herstelldatum
WARNUNG
Verletzungsgefahr und/oder
Fehlfunktion!
►Vor jedem Gebrauch Funk-
tionsprüfung durchführen.

17
Einsetzzange FW685R
►Federelement des S4dynamischen Verbindungs-
stabs in Einsetzzange einsetzen, siehe Abb. 1.
Abb. 1 Federelement in Einsetzzange einsetzen
►Sicherstellen, dass die Ausrichtung des Federele-
ments dem Profil der Maulteile entspricht.
►Einsetzzange schließen und einrasten, siehe Abb. 2.
Abb. 2 Einsetzzange schließen
►Einsetzzange erst nach dem finalen Verriegeln der
Verriegelungsschrauben in den Polyaxialschrauben
vom Federelement entfernen.
VORSICHT
Verbiegen oder Verdrehen des
Implantats beim Implantieren
durch falsches Klemmen in
Einsetzzange!
►Korrekten Sitz des Implan-
tats in der Einsetzzange
kontrollieren.
►Implantat immer mit Ein-
setzzange einsetzen.
VORSICHT
Verbiegen oder Verdrehen des
Federelements beim Anziehen
der Verriegelungsschrauben!
►Gegenhalteinstrument ver-
wenden.
►Auf parallele Ausrichtung
der Pedikelschrauben-
köpfe achten.
►Federelement beim Anzie-
hen mit Einsetzzange
klemmen.

18
Aesculap®
S4® Instrumente - dynamischer Verbindungsstab
Hülse FW686R
►Hülse in Kombination mit Gegenhalter FW236R
verwenden.
►Hülse auf Pedikelschraube aufschieben, bis untere
Öffnung der Hülse am Stab aufsitzt.
Probeimplantat FW687R
►Probeimplantat nach Bedarf mit Handgriff
FW165R verwenden.
►Ersten K-Draht setzen.
►Probeimplantat durch das Loch am Stabstück über
den K-Draht einfädeln, siehe Abb. 3, Schritt 1.
►Eintrittspunkt des zweiten K-Drahts mit Hilfe des
Langlochs abschätzen, siehe Abb. 3, Schritt 2.
Abb. 3 Verwendung des Probeimplantats
►Pedikelschrauben setzen.
►Benötigten Platz für das Federelement mit dem
Probeimplantat abschätzen und freiräumen.
VORSICHT
Beschädigung des Stabs durch
nicht korrekt sitzende Hülse!
►Auf korrekten Sitz der
Hülse am Stab achten.
VORSICHT
Abstand der Pedikelschrauben
zu eng für Federelement!
►Pedikelschraubenabstand
präoperativ ermitteln.
►Probeimplantat bereits
beim Setzen der K-Drähte
verwenden.
12