Insert And Tighten Set Screw With Deformity Set Screw Driver; Tighten Set Screw Using Long Quick Tube; Tighten Set Screw Using Short Quick Tube; Tighten Set Screw Using Derotation Tube And Combo Pusher - B. Braun Aesculap Ennovate SZ334R Gebrauchsanweisung/Technische Beschreibung

3.11 Insert and tighten set screw with deformity set
screw driver
Note
The Ennovate deformity set screw driver 6 must be used when conducting
the final tightening of constructs utilizing the derotation tube 11 or the
long quick tube 1.
WARNING
Insufficient stabilization of the spinal column region to be treated due
to under tightening the set screw!
Risk of damage to the implant or instruments due to overtightening
of the set screw!
►
For the final tightening of the set screws and when activating
PolyLock®, only use the 10 N∙m torque handle SZ228R.
►
Check the recalibration/maintenance date on the torque wrench
handle maintenance label prior to each use.
►
When tightening or loosening the set screws, make sure that the
working end of the torque wrench handle shaft is positioned
entirely within the socket of the set screws.
►
Apply the torque slowly and without sudden movement until the
torque wrench handle release is audibly triggered.
WARNING
Injury to the patient from initiation of high torques on the spinal col-
umn!
►
Always use a counter torque for the tightening of the set screw and
when activating PolyLock®.
►
Always completely and correctly insert the counter torque in the
respective receptacle geometry. Check for the correct positioning.
►
Hold the counter torque in position and do not twist or lever
against the tube or the inserted rod.

3.11.1 Tighten set screw using long quick tube

►
Push the 10 N∙m torque handle a (SZ228R) onto the hex connection of
the set screw driver 6 up to the stop.
►
Insert the set screw driver 6 into the cannulation of the long quick
tube 1 and carefully push the set screw driver 6 down with light pres-
sure into the socket of the set screw up to the stop.
►
Engage the counter torque 5 (SZ335R) to the coupling geometry on the
long quick tubes 1 which require final tightening.
►
If needed, a segmental coupler 20 can be used as a counter torque
handle during the final tightening.
►
Screw in the set screw by turning the torque wrench SZ228R clockwise
while firmly holding the segmental coupler 20 or counter torque
handle 5 until the set screw SY001T/SY001TS engages with the screw
head and an acoustic signal sounds. The sound is an indicator that the
final tightening torque of 10 N∙m has been achieved.
►
Remove the set screw driver 6 and torque wrench SZ228R assembly
from the quick tube 1 by pulling the torque handle and shaft straight
out of the tube.
►
Repeat the procedure for additional screws.

3.11.2 Tighten set screw using short quick tube

►
Remove the short quick tube 2 from the screw construct by pushing
the two smaller gold buttons inward and pulling the gold knob until a
hard stop is felt and the inner shaft no longer moves away from the rest
of the instrument.
–or–
►
Remove the short quick tube 2 from the screw construct by rotating
the gold knob counter clockwise until a hard stop is felt and the inner
shaft no longer moves away from the rest of the instrument.
Fig. 22
►
Push the 10 N∙m torque handle a (SZ228R) on to hex connection b of
the deformity set screw driver 6 up to the stop.
►
Push the counter torque handle c (SZ282R) onto the top of the head of
the pedicle screw or hook completely.
Note
The Counter Torque Holder can be placed in four different positions in 90
degree increments.
►
Insert the torque handle assembly into the cannula of the counter
torque holder and carefully push down with light pressure up to the
stop.
►
Final tighten the set screw by turning the 10 N∙m torque handle a
clockwise. Hold the counter torque handle c (SZ282R) securely in posi-
tion until the acoustic signal of the triggering torque handle sounds.
The acoustic signal indicates that a torque of 10 N∙m has been reached.
►
Remove the torque handle assembly together with the counter torque
holder SZ282R.
►
Repeat the procedure for additional screws.

3.11.3 Tighten set screw using derotation tube and combo pusher

►
Push the 10 N∙m torque handle a (SZ228R) onto the hex connection b
of the set screw driver 6 up to the stop.
►
Insert the set screw driver 6 into the cannula of the combo pusher 9
and carefully push the set screw driver 6 down with light pressure into
the socket of the set screw up to the stop.
►
Engage the counter torque handle 5 (SZ335R) to the coupling geome-
try on the derotation tube 11 which require final tightening.
►
If needed, segmental couplers 20 can be used as counter torque han-
dles during final tightening.
►
Screw in the set screw by turning the torque wrench SZ228R clockwise
while firmly holding the segmental coupler 20 or counter torque
handle 5 until the set screw SY001T/SY001TS engages with the screw
head and an acoustic signal sounds. The sound is an indicator that the
final tightening torque of 10 N∙m has been achieved.
en
a
c
13