Synthes Spine Cable System Quick start guide

Instruments and implants
approved by the AO Foundation
Spine Cable System. Implants and
instruments for use when stabilizing
and reconstructing spinal structures.
Technique Guide

Introduction
Surgical Technique
Product Information
Table of Contents
Spine Cable System 2
AO Principles 3
Indications 4
Double-Lead Cable 5
Single-Lead Cable 11
Instruments 15
Set List 16
Synthes Spine

Cable retrieval loops
Spine Cable System
– 1.0 mm diameter cable fabricated with an (8 x 7) + (1 x 19)
weave designed for flexibility and control
– Cable assemblies available in Ti-6Al-7Nb alloy and
stainless steel
– Retrieval loop at the end of the cable facilitates passing
the cable sublaminarly
– Available in single- and double-lead configurations
2Synthes Spine Spine Cable System
Cross-sectional view of cable
8 outer bundles
of 7 strands
One central
bundle of
19 strands
Crimp integral to the cable
Double-lead cable
Single-lead cable

AO Principles
Synthes Spine 3
In 1958, the AO formulated four basic principles which have
become the guidelines for internal fixation.1They are:
– Anatomic reduction
– Stable internal fixation
– Preservation of blood supply
– Early, active mobilization
The fundamental aims of fracture treatment in the limbs and
fusion of the spine are the same. A specific goal is returning
as much function as possible to the injured neural elements.2
AO Principles as Applied to the Spine3
Anatomic Alignment
Restoration of normal spinal alignment to improve the
biomechanics of the spine.
Stable Internal Fixation
Stabilization of the spinal segment to promote bony fusion.
Preservation of Blood Supply
Creation of an optimal environment for fusion.
Early, Active Mobilization
Minimization of damage to the spinal vasculature, dura, and
neural elements, which may contribute to pain reduction and
improved function for the patient.
1. M.E. Müller, M. Allgöwer, R. Schneider, H. Willenegger: Manual of Internal
Fixation, 3rd Edition. Berlin; Springer-Verlag. 1991.
2. Ibid.
3. M. Aebi, J.S. Thalgott, J.K. Webb. AO ASIF Principles in Spine Surgery. Berlin;
Springer-Verlag. 1998.

Indications
As with monofilament wire, the Spine Cable System is indicated
for the following spinal applications:
– Spinal trauma for sublaminar, interspinous, or facet wiring;
– Spinal reconstruction to correct spinal deformities, scoliosis,
kyphosis, and spondylolisthesis; and
– Spinal degenerative surgery as an adjunct to spinal fusions.
Note: See package insert for intended use/indications, device
description, contraindications, precautions, warnings, and
potential risks associated with the Spine Cable System.
4Synthes Spine Spine Cable System

Technique — Double-Lead Cable
Required Set
105.803 Spine Cable System Instrument Set
1
Pass the leader
Instrument
321.745 Cable Retriever
Pass the leader of the double-lead cable under the lamina
and use the Cable Retriever to catch the retrieval loop on
the tip of the leader. Gently pull the cable through until
the leader is completely exposed.
2
Cut the leader tip
Instrument
391.905.99 Cable Cutter
Using the Cable Cutter, remove only the tip of the leader.
Separate the cable leaders.
Synthes Spine 5

Technique — Double-Lead Cable continued
3
Thread cable through the crimp
Thread the cable leader through the crimp sleeve and
pull up the slack in each cable.
4
Attach Pretensioner
Instrument
321.744 Pretensioner
Gently pull each cable sequentially for provisional tightening.
Next, depress the button on the side of the Pretensioner
and pass the cable in the indicated direction. Releasing the
button automatically locks the cable.
6Synthes Spine Spine Cable System

5
Attach Tensioner/Crimper
Instrument
321.131 Tensioner/Crimper
Align the jaws of the Tensioner/Crimper to grasp the crimp
sleeve on the cylindrical barrel. Gently squeeze the handle
until a single click is heard.
Note: Typically, one click only is required to securely fasten
the crimp.
6
Provisionally tighten the cable
Pass the cable end through the spool at the end of the
Tensioner/Crimper handle and pull any excess slack out
of the cable.
Note: The holes in the spool must be aligned with the line
etched on the spool.
Synthes Spine 7

Technique — Double-Lead Cable continued
7
Adjust the torque setting
Instrument
321.132 Torque Limiting Handle
Select the desired torque by adjusting the setting on the
Torque Limiting Handle. Grasp the knurled wheel on the
handle and pull it toward the working tip. Rotate the wheel
to the desired torque setting and release.
Note: It is recommended to start at a lower torque setting;
the setting can be increased as needed.
8
Tension the cable
Attach the Torque Limiting Handle to the Tensioner/Crimper.
Apply tension by rotating the Torque Limiting Handle in a
clockwise direction until it slips. Slide the Pretensioner forward
to maintain tension if the Tensioner/Crimper is to be removed.
Note: Rotate the handle in the direction noted on the shaft
of the Torque Limiting Handle.
8Synthes Spine Spine Cable System