Synthes SYNMESH User manual

Surgical Technique
Vertebral Body System for the Cervical, Thoracic and Lumbar Spine
SYNMESH™

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

SYNMESH™ Surgical Technique DePuy Synthes 1
AO Spine Principles 2
Indications and Contraindications 3
Round Implants 4
Oblong Implants 7
Locking Screws 10
Surgical Technique 11
Instruments 18
Bibliography 20
Table of Contents

2 DePuy Synthes Surgical Technique SYNMESH™
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 specific 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 et al (1998)
2Aebi et al (2007)

SYNMESH™ Surgical Technique DePuy Synthes 3
Indications and Containdications
Please refer to the corresponding Instructions for Use
for specific information on Intended use, Indications,
Contraindications, Warnings and Precautions, Potential
Adverse Events, Undesirable Side Effects and Residual
Risks. Instructions for Use are available at
www.depuysynthes.com/ifu

B 10 mm
4 DePuy Synthes Surgical Technique SYNMESH™
The round implants are designed to treat defects in
the cervical spine.
Round Implants
SYNMESH™, Corpectomy Device, Pure Titanium
Art. No. Bheight
495.341 10 mm 4 mm
495.441 10 mm 5 mm
495.342 10 mm 6 mm
495.442 10 mm 7 mm
495.443 10 mm 8 mm
495.444 10 mm 9 mm
495.343 10 mm 10 mm
495.445 10 mm 11 mm
495.446 10 mm 12 mm
495.601 10 mm 14 mm
495.602 10 mm 16 mm
495.344 10 mm 18 mm
495.603 10 mm 20 mm
495.604 10 mm 22 mm
495.605 10 mm 24 mm
495.447 10 mm 32 mm
04.817.448 10 mm 88 mm

B 12 mm
B 15 mm
SYNMESH™ Surgical Technique DePuy Synthes 5
Art. No. Bheight
495.346 12 mm 4 mm
495.347 12 mm 5 mm
495.348 12 mm 6 mm
495.349 12 mm 7 mm
495.351 12 mm 8 mm
495.352 12 mm 9 mm
495.353 12 mm 10 mm
495.354 12 mm 11 mm
495.355 12 mm 12 mm
495.611 12 mm 14 mm
495.612 12 mm 16 mm
495.451 12 mm 18 mm
495.613 12 mm 20 mm
495.614 12 mm 22 mm
495.615 12 mm 24 mm
495.356 12 mm 32 mm
495.357 12 mm 88 mm
495.361 15 mm 8 mm
495.362 15 mm 10 mm
495.363 15 mm 12 mm
495.364 15 mm 14 mm
495.455 15 mm 16 mm
495.621 15 mm 18 mm
495.622 15 mm 20 mm
495.623 15 mm 22 mm
495.624 15 mm 24 mm
495.365 15 mm 32 mm
495.366 15 mm 88 mm
Round Implants

12 mm 15 mm10 mm
12 mm 15 mm10 mm
6 DePuy Synthes Surgical Technique SYNMESH™
End Rings, round, with locking screw (convex)
Art. No. BAngle
495.411 10 mm 0°
495.414 10 mm 2.5°
495.412 12 mm 0°
495.415 12 mm 2.5°
495.413 15 mm 0°
495.416 15 mm 2.5°
End Rings, round, press fit*
Art. No. BAngle
495.384 10 mm 0°
495.387 10 mm 2.5°
495.385 12 mm 0°
495.388 12 mm 2.5°
495.386 15 mm 0°
495.389 15 mm 2.5°
End Rings, round
• Two fastening mechanisms available: press fit or with
locking screw
• Angles of 0° or 2.5°
• Each end ring increases the overall height of the
implant by 1.5 mm (see step 3 of the Surgical technique)
*No locking screw needed
Round Implants

17 × 22 mm
22 × 28 mm
26 × 33 mm
SYNMESH™ Surgical Technique DePuy Synthes 7
The oblong implants are designed to treat defects in
the thoracic and lumbar spine.
Oblong Implants
SYNMESH, Corpectomy Device, Pure Titanium
Art. No. Dimensions height
495.461 17 × 22 mm 6 mm
495.371 17 × 22 mm 8 mm
495.462 17 × 22 mm 10 mm
495.372 17 × 22 mm 12 mm
495.463 17 × 22 mm 14 mm
495.464 17 × 22 mm 20 mm
495.465 17 × 22 mm 22 mm
495.466 17 × 22 mm 24 mm
495.467 17 × 22 mm 26 mm
495.468 17 × 22 mm 28 mm
495.373 17 × 22 mm 32 mm
495.469 17 × 22 mm 52 mm
495.374 17 × 22 mm 88 mm
495.471 22 × 28 mm 6 mm
495.376 22 × 28 mm 8 mm
495.472 22 × 28 mm 10 mm
495.377 22 × 28 mm 12 mm
495.473 22 × 28 mm 14 mm
495.474 22 × 28 mm 28 mm
495.475 22 × 28 mm 30 mm
495.476 22 × 28 mm 32 mm
495.477 22 × 28 mm 34 mm
495.478 22 × 28 mm 36 mm
495.479 22 × 28 mm 52 mm
495.378 22 × 28 mm 64 mm
495.379 22 × 28 mm 88 mm
495.481 26 × 33 mm 6 mm
495.482 26 × 33 mm 8 mm
495.483 26 × 33 mm 10 mm
495.484 26 × 33 mm 12 mm
495.485 26 × 33 mm 14 mm
495.486 26 × 33 mm 44 mm
495.487 26 × 33 mm 46 mm
495.488 26 × 33 mm 48 mm
495.489 26 × 33 mm 50 mm
495.490 26 × 33 mm 52 mm
495.381 26 × 33 mm 64 mm
495.382 26 × 33 mm 88 mm

17 × 22 mm 22 × 28 mm 26 × 33 mm
17 × 22 mm 22 × 28 mm 26 × 33 mm
8 DePuy Synthes Surgical Technique SYNMESH™
End Rings, oblong, press fit*
Anterolateral end rings
Art. No. Dimensions Angle
495.391 17 × 22 mm 0°
495.393 17 × 22 mm 5°
495.395 22 × 28 mm 0°
495.397 22 × 28 mm 5°
495.399 26 × 33 mm 0°
495.402 26 × 33 mm 5°
End Rings, oblong
• Two fastening mechanisms available: press fit or with
locking screw
• Angles of 0° or 5°
• Different configurations feature slots for anterolateral,
lateral or anterior insertion under distraction
• Each end ring increases the overall height of the
implant by 3.5 mm (see step 3 of the Surgical technique)
Lateral or anterior end rings
Art. No. Dimensions Angle
495.392 17 × 22 mm 0°
495.394 17 × 22 mm 5°
495.396 22 × 28 mm 0°
495.398 22 × 28 mm 5°
495.401 26 × 33 mm 0°
495.403 26 × 33 mm 5°
*No locking screw needed
Oblong Implants