Johnson & Johnson DePuy Synthes MATRIX Surgical Technique Download Page 84

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Synthes GmbH
Eimattstrasse 3
4436 Oberdorf
Switzerland
Tel: +41 61 965 61 11
Fax: +41 61 965 66 00
www.depuysynthes.com

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Not all products are available in all markets.

This publication is not intended for distribution in the USA.

All surgical techniques are available as PDF files at
www.depuysynthes.com/ifu

Summary of Contents for DePuy Synthes MATRIX

Page 1: ...A Solution for Simple and Complex Spine Pathology MATRIX Spine System Degenerative Surgical Technique...

Page 2: ...mantling 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...

Page 3: ...nal 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...

Page 4: ...e 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 Desig...

Page 5: ...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...

Page 6: ...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 Lea...

Page 7: ...the risk of damage at high loads 1 step locking cap designed to allow for complete xation in one step polyaxiality and run on rod Available at or with guidance Transverse Connector The snap on transve...

Page 8: ...1 2 Stability Stabilization to achieve a speci c therapeutic outcome Biology Etiology pathogenesis neural protection and tissue healing Alignment Balancing the spine in three dimensions Function Prese...

Page 9: ...ntal 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 pr...

Page 10: ...h 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 p...

Page 11: ...mm length 275 mm 388 549 Feeler straight with rounded tip 388 551 Pedicle Awl B 3 0 mm length 230 mm for Screws B 4 0 and 4 2 mm 03 632 103 Tap for Pedicle Screws B 3 5 mm length 180 mm 03 632 104 Ta...

Page 12: ...aft and attach the ratchet handle Optional instruments 03 616 043 Retaining Sleeve locking long 03 632 074 Screwdriver Stardrive T25 long with T Handle for Matrix 03 632 075 Screwdriver Stardrive T25...

Page 13: ...sleeve is firmly attached to the pedicle screw Verify the screw length with the template provided in the screw module Note Set the ratchet to the neutral position before picking up a screw Optional in...

Page 14: ...he green knob counterclockwise and remove the screwdriver Notes Do not grasp the green knob during screw inser tion as this will cause the retaining sleeve to dis engage from the screw Ensure that the...

Page 15: ...Matrix 03 632 075 Screwdriver Stardrive T25 long with straight handle for Matrix 03 616 042 Retaining Sleeve locking 03 632 001 Retaining Sleeve standard for Matrix 5 5 03 632 002 Screwdriver Shaft S...

Page 16: ...d or use rod bender to form rod according to the template Notes The screw height must be adjusted to the rod If necessary adjust the screw height using a screw driver without retaining sleeve To resto...

Page 17: ...th Silicone Handle 388 750 USS Rod Cutting and Bending Device 388 720 Bolt Cutter Precautions The USS rod cutting and bending device must be used to cut cobalt chromium rods Do not reverse bend rods R...

Page 18: ...Instrument 03 632 081 Rod Holding Forceps for Rods B 5 5 mm Insert the rod using the rod holding forceps Optional instrument 03 632 202 Holding Forceps for Rods B 5 5 and B 6 0 mm Note When using a co...

Page 19: ...ct detachable handle to the octagonal end of the rod pusher counter torque Advance rod into the screw head using the rod pusher countertorque Optional instruments 03 632 076 Rod Pusher Counter Torque...

Page 20: ...1 Rocker Fork footed for Matrix 5 5 Use a rocker fork to lever the rod into the head of the pedicle screw Reduction travels Small Rocker Fork 8 5 mm Medium Rocker Fork 13 5 mm Footed Rocker Fork 7 5 m...

Page 21: ...rew head Press down firmly until the tips engage the head of the screw Squeeze the handle to seat the rod into the head of the pedicle screw Reduction travel 15 mm Note The rod persuader can be used a...

Page 22: ...he black nut and turn the black nut clockwise until the black line is visible at the 30 line Place the reduction instrument over the screw head Press down firmly until the tips engage Load the hexag o...

Page 23: ...vertebral body Note The reduction instrument for spondylolisthe sis can be used as counter torque for final tightening of the locking cap Optional instrument 03 632 409 Reduction Instrument for Spond...

Page 24: ...061 T Handle with Ratchet Wrench and with Torque Limiter 10 Nm Insert the tip of the screwdriver shaft into the T25 recess of the locking cap Press down firmly The screwdriver shaft is self retaining...

Page 25: ...aligned to the polyaxial head Improper alignment of the rod with respect to the MATRIX implant heads could lead to construct loosening 1 Examples of misalignment The rod is sitting high in the polyaxi...

Page 26: ...re all locking caps are fully re duced and provisionally tightened see Insert 1 step locking cap Failure to do so could poten tially lead to a misalignment Finally tighten one locking cap completely t...

Page 27: ...ve T25 long for Matrix 03 632 074 Screwdriver Stardrive T25 long with T Handle for Matrix 03 632 075 Screwdriver Stardrive T25 long with straight handle for Matrix 03 632 400 Screwdriver Shaft Stardri...

Page 28: ...ailure to do so could poten tially lead to a misalignment Finally tighten one locking cap completely to create a fixed point for distraction see Perform final tighten ing Reverse the locking cap of th...

Page 29: ...ignment of the rod with the implant Place the counter torque over the head of the screw At tach the screwdriver shaft to the T handle with torque limiter Insert the instrument through the counter torq...

Page 30: ...must be perpendicular to the rod during final tightening Optional instruments 03 632 006 Rod Pusher Counter Torque standard for Matrix 5 5 03 632 008 Reduction Instrument for Spondylolis thesis stand...

Page 31: ...043 Retaining Sleeve locking long To assemble the screwdriver and the retaining sleeve depress the loading collar on the proximal end of the retaining sleeve 1 Then slide the sleeve toward the handle...

Page 32: ...tate the silver knob counterclockwise and remove the screw driver 8 Notes Polyaxial screwheads need to remain free and mo bile after insertion to allow accurate alignment to the rod during locking cap...

Page 33: ...iver in the unassembled pedicle screw Ream until the black line is visible on the shaft This indi cates that there is enough room for the implant head Note When reaming the most superior and inferior...

Page 34: ...s down Position the placement tool with the polyaxial head over the unassembled pedicle screw and press down To en sure the polyaxial head is securely attached to the unas sembled pedicle screw gently...

Page 35: ...removal tool Ensure that the black line is visible on the inner shaft of the head removal tool Press the tip of the head removal tool into the polyaxial head A tactile feedback may be felt as the tip...

Page 36: ...ial screw page 10 or unassembled pedicle screw page 31 to in sert screw Pick up a locking cap from the screw module with a T25 screwdriver shaft The screwdriver shaft is self retaining Place the rod p...

Page 37: ...handle over the screw head Gently rock the tab removal tool medial then lateral to break the tab wall free from the polyaxial head Alternative technique for locking cap insertion Instrument 03 632 02...

Page 38: ...indicator note the size of the appropriate transverse connector 1 8 The transverse connectors are marked with sizes 1 8 matching the figures on the length indicator Select the appropriate transverse c...

Page 39: ...of the connector to ensure the correct rod size is attached to each opening Precaution Parallel connectors with one set screw should be used in pairs on each side of the con struct Connectors with tw...

Page 40: ...used in patients with nickel sensitivities or allergies The retaining sleeve for transverse connectors cannot be used when tightening parallel with two set screws Precautions Care should be taken not...

Page 41: ...the distractor tip over the screwdriver tip and press firmly into the detachable retaining sleeve Insert the tip of the screwdriver shaft into the screw head Make sure that the tip of the screwdriver...

Page 42: ...er 2 to the distraction position D and rotate the wing nut screw clockwise until the desired distraction is achieved Perform discectomy and interbody fusion Turn the rocker lever 2 to neutral N to unl...

Page 43: ...pedicle polyaxial and polyaxial reduction screws Parallel distrac tion can be performed The distractor tip with screw heads 2 can be used with polyaxial polyaxial reduction and monoaxial screws They a...

Page 44: ...32 080 Handle detachable for Matrix To remove a locking cap slide the counter torque with detachable handle over the screwhead Place the ratchet of the torque limiting handle in the neutral position e...

Page 45: ...nique always use the torque limiting handle 03 620 061 to reduce risk of damage to the T25 screwdriver shaft If this method does not produce the desired result follow the technique according to Option...

Page 46: ...r Matrix 5 5 03 632 006 Rod Pusher Counter Torque standard for Matrix 5 5 03 632 080 Handle detachable for Matrix Place the rod pusher counter torque with detachable handle over an adjacent screw on t...

Page 47: ...rque consisting of rod pusher counter torque and handle with a rod persuader If this method does not produce the desired result follow the technique according to Option B page 46 Optional instruments...

Page 48: ...on With the reduction load applied begin to sequentially turn clockwise and then immediately counter clockwise Turn until tactile or audible feedback from the implant is experienced Repeat the steps u...

Page 49: ...4 2 2 5 3 3 MATRIX Spine System Degenerative Surgical Technique DePuy Synthes 44 How to Disassemble Instruments for Cleaning Screwdriver with retaining sleeve Screwdriver with detachable retaining sle...

Page 50: ...1 1 2 2 1 2 44 DePuy Synthes MATRIX Spine System Degenerative Surgical Technique How to Disassemble Instruments for Cleaning Counter torque Positioning instrument for polyaxial screw heads...

Page 51: ...1 1 2 2 1 2 MATRIX Spine System Degenerative Surgical Technique DePuy Synthes 44 Head removal tool Torque limiting handle...

Page 52: ...1 2 3 1 2 3 55 DePuy Synthes MATRIX Spine System Degenerative Surgical Technique How to Disassemble Instruments for Cleaning Reduction instrument for spondylolisthesis MATRIX Rod persuader MATRIX...

Page 53: ...5 5 Polyaxial B 5 0 mm preassembled Titanium Alloy TAN length mm 04 632 520 20 04 632 525 25 04 632 530 30 04 632 535 35 04 632 540 40 04 632 545 45 04 632 550 50 04 632 555 55 Pedicle Screw Matrix 5...

Page 54: ...4 632 630 30 04 632 635 35 04 632 640 40 04 632 645 45 04 632 650 50 04 632 655 55 04 632 660 60 04 632 665 65 Pedicle Screw Matrix 5 5 Polyaxial B 7 0 mm preassembled Titanium Alloy TAN length mm 04...

Page 55: ...04 632 845 45 04 632 850 50 04 632 855 55 04 632 860 60 04 632 865 65 04 632 870 70 04 632 875 75 04 632 880 80 04 632 890 90 04 632 899 100 Pedicle Screw Matrix 5 5 Polyaxial B 9 0 mm preassembled T...

Page 56: ...4 440 40 04 634 445 45 Reduction Screw Matrix 5 5 B 5 0 mm preassembled Titanium Alloy TAN length mm 04 634 520 20 04 634 525 25 04 634 530 30 04 634 535 35 04 634 540 40 04 634 545 45 04 634 550 50 0...

Page 57: ...m 04 634 620 20 04 634 625 25 04 634 630 30 04 634 635 35 04 634 640 40 04 634 645 45 04 634 650 50 04 634 655 55 04 634 660 60 04 634 665 65 Reduction Screw Matrix 5 5 B 7 0 mm preassembled Titanium...

Page 58: ...uy Synthes MATRIX Spine System Degenerative Surgical Technique Implants Reduction Screw Matrix 5 5 B 8 0 mm preassembled Titanium Alloy TAN length mm 04 634 825 25 04 634 830 30 04 634 835 35 04 634 8...

Page 59: ...639 440 40 04 639 445 45 Pedicle Screw Matrix 5 5 B 5 0 mm Titanium Alloy TAN length mm 04 639 520 20 04 639 525 25 04 639 530 30 04 639 535 35 04 639 540 40 04 639 545 45 04 639 550 50 04 639 555 55...

Page 60: ...4 639 630 30 04 639 635 35 04 639 640 40 04 639 645 45 04 639 650 50 04 639 655 55 04 639 660 60 04 639 665 65 Pedicle Screw Matrix 5 5 B 7 0 mm Titanium Alloy TAN length mm 04 639 725 25 04 639 730 3...

Page 61: ...s 55 Pedicle Screw Matrix 5 5 B 8 0 mm Titanium Alloy TAN length mm 04 639 825 25 04 639 830 30 04 639 835 35 04 639 840 40 04 639 845 45 04 639 850 50 04 639 855 55 04 639 860 60 04 639 865 65 04 639...

Page 62: ...0 50 04 639 955 55 04 639 960 60 04 639 965 65 04 639 970 70 04 639 975 75 04 639 980 80 04 639 990 90 04 639 999 100 Also available Pedicle Screw Matrix 5 5 polyaxial cannulated Pedicle Screw Matrix...

Page 63: ...6 045 45 04 636 050 50 04 636 055 55 04 636 060 60 04 636 065 65 04 636 070 70 04 636 075 75 04 636 080 80 04 636 085 85 04 636 125 125 Rods B 5 5 mm prebent Cobalt Chrome Alloy CoCrMo length mm 09 63...

Page 64: ...04 634 230 30 04 634 235 35 04 634 240 40 04 634 245 45 04 634 250 50 04 634 255 55 04 634 260 60 04 634 265 65 04 634 270 70 04 634 275 75 04 634 280 80 04 634 285 85 04 634 290 90 04 634 295 95 04 6...

Page 65: ...0 30 04 616 135 35 04 616 140 40 04 616 145 45 04 616 150 50 04 616 155 55 04 616 160 60 04 616 165 65 04 616 170 70 04 616 175 75 04 616 180 80 04 616 185 85 04 616 190 90 04 616 195 95 04 633 279 10...

Page 66: ...09 631 030 30 09 631 035 35 09 631 040 40 09 631 045 45 09 631 050 50 09 631 055 55 09 631 060 60 09 631 065 65 09 631 070 70 09 631 075 75 09 631 080 80 09 631 085 85 09 631 090 90 09 631 095 95 09 6...

Page 67: ...mm mm 04 633 187 5 5 6 0 Connecting Rods length 500 mm Titanium Alloy TAN diameter mm mm 04 633 190 5 5 3 5 04 633 191 5 5 4 0 04 633 188 5 5 6 0 Connecting Rod length 500 mm Cobalt chrome alloy CoCr...

Page 68: ...Snap On Transverse Connectors length size 04 633 317 17 22 mm 1 04 633 321 21 26 mm 2 04 633 326 26 31 mm 3 04 633 330 30 33 mm 4 04 633 333 33 38 mm 5 04 633 338 38 47 mm 6 04 633 347 47 62 mm 7 04...

Page 69: ...56 Pedicle Awl B 4 0 mm with Silicone Handle length 255 mm for Pedicle Screws B 5 0 to 7 0 mm 388 536 Pedicle Probe for Screws B 4 2 mm length 240 mm 388 655 Pedicle Probe B 3 7 mm with Silicone Handl...

Page 70: ...traight B 2 3 mm length 275 mm 388 546 Feeler for Screw Channel curved B 2 3 mm length 275 mm 388 549 Feeler straight with rounded tip Tap for Pedicle Screws length 180 mm 03 632 103 B 3 5 mm 03 632 1...

Page 71: ...ive T25 03 632 002 Screwdriver Shaft Stardrive T25 standard for Matrix 5 5 03 632 072 Screwdriver Shaft Stardrive T25 long for Matrix 03 632 400 Screwdriver Shaft Stardrive T25 standard straight tip w...

Page 72: ...le standard for Matrix 5 5 03 632 075 Screwdriver Stardrive T25 long with straight handle for Matrix 03 620 019 Torque limiting Handle 10 Nm for Pangea 03 636 008 T Handle with Hexagonal Coupling 6 0...

Page 73: ...yaxial Screw Heads for Matrix 5 5 03 632 045 Removal Instrument for Polyaxial Screw Heads for Matrix 5 5 03 632 046 Reamer for Pedicle Screws for Matrix 68 632 125 Loading Station for Matrix 5 5 For a...

Page 74: ...e System Degenerative Surgical Technique Instruments For rod cutting and bending 388 906 Trial Rod B 5 0 mm length 150 mm 03 632 017 Rod Bender with Silicone Handle 388 750 USS Rod Cutting and Bending...

Page 75: ...enerative Surgical Technique DePuy Synthes 71 For rod insertion 03 632 202 Holding Forceps for Rods B 5 5 and B 6 0 mm 03 632 081 Rod Holding Forceps for Rods B 5 5 mm 03 632 169 Rod Pusher for Rods B...

Page 76: ...ts 388 422 Compression Forceps length 335 mm for Pedicle Screws 03 620 017 Compression Forceps for Lumbar Spine 03 620 018 Distraction Forceps for Lumbar Spine 388 410 Spreader Forceps for Pedicle Scr...

Page 77: ...oothed rack retractor 03 632 083 Distractor Tip for Bone Screws for Matrix 5 5 03 632 084 Distractor Tip for Screw Heads for Matrix 5 5 03 632 085 Retaining Sleeve detachable for Matrix 5 5 03 632 087...

Page 78: ...le with Ratchet Wrench and with Torque Limiter 10 Nm Rod Pusher Counter Torques 03 632 049 Counter Torque standard for Matrix 5 5 03 632 080 Handle detachable for Matrix 03 632 006 Rod Pusher Counter...

Page 79: ...nnectors 03 632 050 Retaining Sleeve for Transverse Connectors Snap on for Matrix 03 632 052 Screwdriver Stardrive T15 short for Matrix 03 632 055 Screwdriver Shaft Stardrive T15 standard 03 632 053 L...

Page 80: ...d reduction Reduction instruments 03 632 408 Reduction Instrument for Spondylolis thesis standard for Matrix 5 5 03 620 091 Socket hexagonal 6 0 mm 388 654 Ratchet with Handle with Hexagonal Quick Cou...

Page 81: ...ks 03 632 010 Rocker Fork small for Matrix 5 5 Rod persuader Rod introduction pliers 03 632 009 Rod Persuader standard for Matrix 5 5 03 632 079 Rod Introduction Pliers long for Matrix 5 5 03 632 012...

Page 82: ...for Reduction Screw for Matrix 5 5 03 632 026 Rod Pusher Counter Torque for Reduction Screws for Matrix 5 5 03 632 029 Holding Crown for Reduction Screws for Matrix 5 5 03 632 030 Tab Remover for Redu...

Page 83: ...y be used by itself or in combination with autograft The construct shown is complemented with chronOS Strip precast which optimally integrates with patient anatomy and implanted hardware Perfusion of...

Page 84: ...es com 0123 DePuy Synthes Spine a division of Synthes GmbH 2017 All rights reserved 036 001 185 DSEM SPN 0115 0266 2 11 17 Not all products are available in all markets This publication is not intende...

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