Safe Operation - B. Braun Aesculap Spine S4 Gebrauchsanweisung/Technische Beschreibung

Safe operation

Risk of injury and/or malfunction!
Always carry out a function
check
WARNING product.
Screw placement
Note
Screw placement is critical. It is recommended to place
the screws parallel in the sagittal plane and to make
sure the screws are not too laterally deviated.
Within the limits of the patient's anatomy, place
the screws in the cephalad vertebral body parallel
to its superior endplate and as parallel to each
other as possible.
Place the caudal vertebra screws so that they are
parallel to the cephalad vertebra screws in both
planes (contrary to the standard convergent
manner).
Placement of screws in this way allows for optimal
operation of the reduction instrument and provides
for easier rod placement.
Preparation
Insert the cylinder piece 1 into the tulip of the
screw 2 and screw the thread on the mounting
post 3 into the thread in the tulip head of the
pedicular screw of the vertebra to be repositioned
using the outer T-handle 4.
Insert the inner T-handle 5 to apply counter torque
during tightening, see foldout page. Do not turn
the inner T-handle 5. The T-handle 5 is used just to
apply counter torque when tightening the outer
T-handle 4.
prior to using the
Position the mounting post 3 on the pedicle screw
of the other vertebra as described above.
Insert the distraction spindles 6 into the articular
head 7 of the mounting post. Make sure that the
articular heads of the traction spindles are
positioned inferiorly, see foldout page.
Note
Using the component marked "R" on the patients's right
and the component marked "L" on the patient's left will
result in placement of the SRI threaded distraction rod
lateral to the pedicle screws. For larger patients this
orientation may result in soft tissue impingement on
the SRI device. An alternative technique is to reverse
the system by placing the component marked "R" on
the left and the component marked "L" on the right. This
will place the threaded distraction rod medial to the
pedicle screws and will result in less soft tissue
impingement.
Distraction
Use any standard distracting instrument, such as a
cervical lamina spreader, and place it between the
screw attachments.
4
Slowly spread the S
Instrument (SRI) to achieve the desired distraction
and then lock the distraction in place on the
distraction spindle with the distraction nut.
Distract the bodies only enough to separate the
vertebral bodies as minimally as needed (in some
cases, distraction is not required).
For distraction turn the distraction spindle nuts 8
on both sides in the direction of the articular head,
if necessary with the aid of the tightening key 9.
Spondylolisthesis Reduction
3