Synthes USS II Polyaxial User manual

USS II Polyaxial. The Versatile Polyaxial
Solution for the Universal Spine Systems.
Technique Guide
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Synthes USS II Polyaxial Technique Guide
Contents
Image intensifier control
Warning
This description is not sufficient for immediate application of
the instrumentation. Instruction by a surgeon experienced in
handling this instrumentation is highly recommended.
AO/ASIF Principles of Internal Fixation 4
Indications and Contraindications 5
Implants 6
Instruments 7
Surgical Technique 10
Dismantling Instructions 19
Bibliography 24
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USS II Polyaxial. The Versatile Polyaxial
Solution for the Universal Spine Systems.
USS II Polyaxial combined with USS II Ilio-Sa-
cral enables a construction to be fabricated
from the thoracolumbar spine to the pelvis.
It is suitable for the treatment of degenera-
4.2 5.2 6.2 7.0 8.0 6.2 7.0 8.0
tive diseases as well as for correcting defor-
mities. The implants are compatible with all
5 mm and 6 mm rod systems.
USS II Polyaxial
– Versatile
– Polyaxial
– Low Profile
First the screws are inserted and
then the polyaxial heads are clicked on
the screw. This enables free screw
placement.
Using the remobilization instrument
the polyaxial heads can be remobilized
even with the rod in place.
Easy handling
Pedicle screws
Cancellous
bone screws
USS II nut
Sleeve
3-D head
– Click-on head for various
combinations
– Side opening for 5 mm or 6 mm rods
– 25° deflection
Dual-core pedicle and cancellous
bone screws
– Various diameters and lengths
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AO/ASIF Principles of Internal Fixation
AO/ASIF Principles of internal fixation
In 1958 the Association for the Study of Internal Fixation
AO/ASIF formulated four basic principles which have become
the guidelines for internal fixation.
They are:
– Anatomic reduction
– Stable internal fixation
– Preservation of blood supply
– Early, active pain-free mobilization
The fundamental aims of fracture treatment are the same
for the limbs and spinal fusion. A specific goal in the spine is to
restore as much function as possible to the injured neural
elements.
AO/ASIF Principles as applied to the spine
Anatomical 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, pain-free mobilisation
Minimization of damage to the spinal vasculature, dura and
neural elements, which may contribute to pain reduction and
improved function for the patient.
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Indications and Contraindications
Indications
USS II Polyaxial is indicated for use in the thoracic and lumbar
spine, as well as for ilio-sacral fixations (T1–S2). It is indicated
for the posterior treatment of:
– Degenerative diseases
– Deformities in combination with USS II or USS Low Profile
pedicle screws
– Fractures and tumours with sufficient anterior support
when using USS II Polyaxial as a stand-alone device for
posterior fixation
Contraindications
– In fractures with severe anterior vertebral body disruption,
an additional anterior support or column reconstruction is
required.
Precautions
For patients with osteoporosis, the use of cancellous bone
screws is recommended.
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6Synthes USS II Polyaxial Technique Guide
Implants
The USS II Polyaxial system consists of the
following implants:
– Pedicle screws
– Cancellous bone screws
– Polyaxial 3-D heads
– Sleeves
Pedicle screws with dual core, titanium alloy (TAN)
Art. Nos. ⭋Lengths Colour
04.607.010 – 014* 4.2 mm 20 – 40 mm gold
04.607.021 – 027* 5.2 mm 25 – 55 mm purple
04.607.032 – 039* 6.2 mm 30 – 65 mm dark blue
04.607.052 – 059* 7.0 mm 30 – 65 mm green
04.607.072 – 079* 8.0 mm 30 – 65 mm pink
* All implants are also available sterile packed. Add suffix "S"
to article number.
Cancellous bone screws with dual core,
titanium alloy (TAN)
Art. Nos. ⭋Lengths Colour
04.607.232 – 239* 6.2 mm 30 – 65 mm light blue
04.607.252 – 259* 7.0 mm 30 – 65 mm turquoise
04.607.260 – 269* 7.0 mm 70 – 140 mm turquoise
04.607.272 – 279* 8.0 mm 30 – 65 mm dark blue
04.607.280 – 289* 8.0 mm 70 – 140 mm dark blue
Polyaxial 3-D heads, titanium alloy (TAN)
Art. No. For rod ⭋Colour
04.607.401* 5.0 mm light blue
04.607.402* 6.0 mm green
Sleeves, titanium alloy (TAN)
Art. No. For rod ⭋Colour
04.607.411* 5.0 mm light blue
04.607.412* 6.0 mm green
USS II nut, titanium alloy (TAN)
Art. No. Colour
499.294* green
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The basic instrument set for USS II (187.200) should be used as
basic instruments for USS II Polyaxial.
Instruments specific for USS II Polyaxial
Instruments
03.607.000 USS II Polyaxial Reamer
03.607.001 Screwdriver, bihexagonal, ⭋3.0 mm,
with T-Handle
03.607.002 Screwdriver Shaft for USS II Polyaxial cancel-
lous bone screws with lengths ≥ 70 mm
03.607.003 USS II Polyaxial Holding Sleeve for
No. 03.607.001
03.607.006 USS II Polyaxial Handle for Screw Holder
03.607.005
03.607.005 USS II Polyaxial Screw Holder
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8Synthes USS II Polyaxial Technique Guide
03.607.004 USS II Polyaxial Positioning Pliers for
3-D Heads
03.607.007 Positioner for Screw Holder 03.607.005
03.607.008 Socket Wrench, bihexagonal, ⭋11.0 mm,
self-holding, with straight handle
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