Synthes
19
Overview Surgical Technique
Primary procedure
1. Patient positioning
20
2. Cranial exposure
20
3. Insertion cranial implants
21
3.1 Identify cranial rib
3.2 Prepare rib for implants
3.3 Select proper Cranial Rib Support angulation
and radius
3.4 Seat Cranial Rib Support
3.5 Select proper Closing Half-Ring size
3.6 Insert Closing Half-Ring
3.7 Insert Lock for Rib Support
4. Distract chest wall if necessary
26
5. Select appropriate Extension Bar
27
6. Determine appropriate matching implants and
construct assemble
A
Lumbar extension
28
Lamina Hook for rib-to-lumbar lamina construct
Ala Hook for rib-to-ilium constructs
6.1 Select the appropriate lumbar extension
6.2 Determine contour and cut to length, if necessary
6.3 Insert caudal Distraction Lock
6.4 Insert caudal implants
– Lamina Hook
– Ala Hook
6.5 Align the lumbar extension to the caudal implant
– Lamina Hook
– Ala Hook
6.6 Align Extension Bar to Cranial Rib Support
6.7 Insert Closure for Extension Bar
6.8 If using a Lamina Hook, distract if necessary and
tighten
B
Rib-to-rib
35
6.1 Choose the appropriate caudal rib
6.2 Select the appropriate Caudal Rib Support
6.3 Insert the caudal implants
6.4 Assemble the construct
6.5 Lock the construct
Expansion procedure
1. Patient positioning
38
2. Exposure
38
3. Remove the lock
38
4. Distraction
39
5. Final locking
39
Replacement procedure
Replacement
40