Johnson & Johnson DePuy Synthes MATRIX User manual

A Solution for Simple and Complex Spine Pathology
MATRIX Spine System–
Degenerative
Surgical Technique

Image intensifier control
This 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 recommended.
Processing, Reprocessing, Care and Maintenance
For 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:
http://emea.depuysynthes.com/hcp/reprocessing-care-maintenance
For 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:
http://emea.depuysynthes.com/hcp/reprocessing-care-maintenance

MATRIX Spine System – Degenerative Surgical Technique DePuy Synthes 1
Introduction MATRIX Spine System – Degenerative 2
AO Spine Principles 6
Indications and Contraindications 7
Surgical Technique Surgical Technique 8
Optional Technique 29
• Screw Insertion with Retaining Sleeve, Locking 29
• Unassembled Pedicle Screw Insertion 31
• Polyaxial Head Removal 33
• Reduction Screws 34
• Adding Transverse Connectors 36
• Adding Rod-to-Rod Connectors 37
• Distraction for Posterior Interbody Fusion 39
• Locking Cap Removal 42
Product Information How to Disassemble Instruments for Cleaning 47
Implants 51
Instruments 67
Biomaterial Implants 81
Table of Contents

2 DePuy Synthes MATRIX Spine System – Degenerative Surgical Technique
MATRIX Spine System – Degenerative
The Synthes MATRIX Spine System is a set ofinstruments
and implants that cover degenerative disorders (open
or minimally invasive access), deformities and trauma
indications.
Dual Core / Double Lead Screw Design
• Designed for fast and controlled insertion
• Designed for increased pull-out resistance due to
enhanced bone purchase
• Designed for improved handling thanks to atraumatic
tip and self tappingthread
PrimeLock – Screwdriver – ScrewInterlock
• Toggle free screw insertion
• Designed for precise and controlled screw placement
• Direction of screw insertion possible

MATRIX Spine System – Degenerative Surgical Technique DePuy Synthes 3
Modularity – Click-on and
Preassembled Screws
• Designed for better visualization of the
anatomical structure
• Multiple screw head removal and
replacement without removing the
bone screw from the pedicle
• Customized inventory possible
Snap-on Swiveling Transverse
Connector
• Designed to provide fast in-situ
placement
• Anatomical adjustment possible

15 mm
50° 50°
4 DePuy Synthes MATRIX Spine System – Degenerative Surgical Technique
MATRIX Spine System – Degenerative
Preassembled Polyaxial and Reduction Pedicle
Screw
• Allows up to 50° of angulation to ease in situ connec-
tion to the longitudinal rod
• The rod reduction features are located at the top of
the polyaxial head
• Dual Core/Double Lead thread designed to securely
anchor the screw in cortical and cancellous bone
• Threaded T25 Stardrive recess designed to deliver
torque effectively
Pedicle Screw
• Designed for increased visual access to the anatomical
structures
• Designed to allow for improved access to the surgical
field
• Dual Core/Double Lead thread designed to securely
anchor the screw in cortical and cancellous bone
• Threaded T25 Stardrive recess designed to deliver
torque effectively
Click-on Polyaxial and Reduction Screw Head
• The polyaxial head of the implant is designed for rod
reduction
• To ease intraoperative planning, the polyaxial heads
can be removed and replaced without removing the
pedicle screw from the pedicle
• The reduction head allows for 15 mm rod reduction
Implants

MATRIX Spine System – Degenerative Surgical Technique DePuy Synthes 5
Rods
• Available in three material strengths: Hard pure tita-
nium, extra-hard titanium alloy (TAN), and extra-hard
cobalt-chromium alloy, diameter 5.5 mm
• A choice of straight and curved rods to facilitate intra-
operative construct assembly and technique maneuvers
Locking Cap
• Square thread design reduces cross threading under
high reduction loads
• T25 Stardrive recess designed to reduce the risk of
damage at high loads
• 1-step locking cap designed to allow for complete
fi xation in one step (polyaxiality and run on rod)
• Available fl at or with guidance
Transverse Connector
• The snap-on transverse connector is preassembled and
requires only fi nal positioning and tightening
• The jaws of the transverse connector swivel and are
springloaded
• Telescoping body is arched to accommodate grafts and
anatomical structures and is available in a range of
lengths
• The locking screws use a T15 Stardrive which reduces
drive stripping while fi nal tightening
Instruments
• Ergonomically designed handles
• Intuitive, ease of use
• Convenient, interchangeable options

coronal
axial
sagittal
6 DePuy Synthes MATRIX Spine System – Degenerative Surgical Technique
The four principles to be considered as the foundation for
proper spine patient management underpin the design
and delivery of the Curriculum: Stability – Alignment–
Biology – Function.1,2
Stability
Stabilization to achieve
a specifi c therapeutic
outcome
Biology
Etiology, pathogenesis,
neural protection,
and tissue healing
Alignment
Balancing the spine in
three dimensions
Function
Preservations and resto-
ration of function to
prevent disability
AO Spine Principles
Copyright © 2012 by AOSpine
1Aebi M, Arlet V, Webb JK, (2007): AOSPINE Manual
(2 vols), Stuttgart, New York: Thieme.
2Aebi M, Thalgott JS, Webb JK (1998): AO ASIF Principles
in Spine Surgery. Berlin: Springer.

MATRIX Spine System – Degenerative Surgical Technique DePuy Synthes 7
Indications and Contraindications
Intended use
The MATRIX Spine System is a posterior pedicle screw
and hook fixation system (T1–S2) intended to provide
precise and segmental stabilization of the spine for use
in skeletally mature patients.
Indications
• Degenerative disc disease
• Spondylolisthesis
• Trauma (i.e. fracture or dislocation)
• Tumor
• Stenosis
• Pseudarthrosis
• Failed previous fusion
• Deformities (i.e. scoliosis, kyphosis and/or lordosis)
Contraindications
• Osteoporosis
• In fractures and tumors with severe anterior vertebral
body disruption, an additional anterior support or
column reconstruction is required

8 DePuy Synthes MATRIX Spine System – Degenerative Surgical Technique
Surgical Technique
1. Prepare pedicles and determine
screw lengths
Instruments
388.656 Pedicle Awl B4.0 mm with Silicone
Handle, length 255 mm, for Pedicle
Screws B5.0 to 7.0 mm
388.655 Pedicle Probe B 3.7 mm
with Silicone Handle, length 240 mm,
for Pedicle Screws B 5.0 to 7.0 mm
Locate pedicles and use the awl to perforate the cortex.
Use the probe to open the pedicle canal. Using radio-
graphic imaging, confirm pedicle location, orientation
and depth by inserting the probe. When selecting the
appropriate length screw, use the markings on the probe
to determine the pedicle depth.
All MATRIX pedicle screws are self-tapping; however, if
tapping is preferred, use the appropriate tap and tap
handle.