6
Universal Clamp—Surgical Technique Guide
STEP 2, OPTION 1A
Standard Band Passage: Laminar Fixation
•
Prior to band passage, the ligamentum flavum and the
inferior edge of the lamina may be partially resected to
facilitate insertion of the band.
•
Shape the band’s malleable leader to facilitate band
passage under the lamina. Pass the band from the
caudal margin of the lamina toward the cephalad
laminar margin.
•
The band should be inserted under the lamina in a
caudal-to-cephalad direction and preferably near
the midline under the spinous process.
Caution:
During band passage, maintain
upward pressure on the malleable leader to ensure
the band stays in contact with the anterior aspect of
the lamina and does not push or bow into the dura.
Warning:
Additional fixation is required at the
cephalad and caudal ends of the construct in
scoliosis surgery, especially in case of obesity,
extreme kyphosis or muscular weakness, except
where additional fixation would increase the risk
to the patient.
Warning:
Elevators
and
band passers
should not
be used for sublaminar passage. They should only be
used for passage around the transverse process.
IMPLANT PREASSEMBLY (continued)
