8
Avenue
®
T TLIF Cage—Surgical Technique Guide
IMPLANT SIZE SELECTION
STEP 5
Paddle distractors or trials are used to select implant
size (height, length, and lordosis) best suited to the
patient's anatomy. Paddle distractors and trials are
available for each implant height and lordosis
(Figures
5a/5b)
. Markers present on the paddle distractors
and trials allow for the surgeon to determine the
appropriate implant length (30mm or 34mm), under
fluoroscopy
(Figure 5c)
.
Position the paddle distractor or trial in the desired
position. The paddle distractor or trial should fit
securely within the disc space, but care should be taken
to avoid oversizing the implant.
Confirm the position of the paddle distractor or trial
using fluoroscopy.
•
A/P View:
Lateral coverage and rotational position
(the more visible the paddle hole, the more rotation
in the axial plane)
(Figure 5d)
.
•
Lateral View
: Length, height, lordosis, and
anteroposterior positioning (the posterior edge of
the cage should end 2 to 5mm away from the
posterior vertebral walls).
Once the proper size is determined, remove the paddle
distractor or trial from the intervertebral space.
Example:
The best cage length here is 34mm. Paddle
distractors and trials can also be used to determine the
appropriate lordosis and height
(Figure 5e)
.
Figure 5a
5° H12mm paddle distractor
Figure 5b
5° trial
Figure 5c
Axial View
Figure 5d
A/P View
Figure 5e
Lateral View
30mm
34mm
This side points
to the left side
of collar
2 to 5mm
34
mm
30
mm
