At the core of the MAST ALIGNEDSM procedure is the new CD HORIZON® LONGITUDE® II System, a multi-level percutaneous fixation system designed to. Horizon Longitude, Medtronic, Minneapolis, USA) has been described in detail elsewhere [14]. For minimally invasive thoracic instrumentation. experience and Medtronic expertise. Profile. Performance. Efficiency. 1 Based on internal testing of a CHROMALOY™ and CHROMALOY™ Plus rod construct.

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Place Suction Trephine down the shaft and rotate to remove blood and tissue that could be impeding the start of the Set Screw Figure Initially, if the hex spins freely with no advancement of the Inner Sleeve, apply slight upward pressure on the Inner Sleeve to engage the internal threads.

Figure 5 Figure 6 Figure 7a Figure 7b.

Unreduce the Extender one-half turn to relieve any possible pressure placed on the tulip of the Screw. Fluoroscopic guidance of screw insertion at the targeted levels through the small incisions is useful.

The described techniques have acceptable intra- and postoperative complication rates, and overall sufficient pain control with early mobilization of emdtronic. The cable is fabricated from a 7×7 filament yarn made from titanium alloy, with a cylinder rotary-swaged to the end, made from the same material. The PathFinder system consists of polyaxial cannulated screws, with screw extenders guiding the rod into the screw head utilizing a paramedian approach designed to accommodate three or four vertebral levels.

The proximal and distal rod components are manufactured from commercially pure titanium. The system includes screws, various More information.

CD HORIZON LONGITUDE. Multi-Level Percutaneous Fixation System – PDF

Figure 45b Figure 45a To pass a kyphotic Rod, the handle may be used to rotate the Rod in the patient. Whenever possible, use pre-cut rods of the length needed. Utilize an imaging system to facilitate surgery. Advances In Spine Care. The ports needed to be removed in a blind procedure to pass the rod between the screws.


There were no cases of newly developed neurological injury. Compression fracture, spondylolisthesis, and chronic discogenic pain were the main indications. Only three studies have involved the Sextant and PathFinder percutaneous fixation systems for lumbar instability [ 101112 ].

To use this website, you must agree to our Privacy Policyincluding cookie policy. Insertion is confirmed fluoroscopically.

Patient Positioning and Approach 2 2. Fractures of the Thoracic and Lumbar Spine. Journal List Asian Spine J v. If using a PAK Needle, the inner stylet of the needle is then removed. Pass the tip of the driver into the head of the Multi-Axial Screw until the driver fully engages the Screw.

Bracing for standalone rods and screws is controversial, especially in trauma cases. Table 4 Degree of screw displacement. As all percutaneous transpedicular placement steps were fluoroscopy-guided, the quality of fluoroscopy imaging of the spine was anticipated to be very good.

Like the Muller technique, the Sextant procedure involves blind tunneling for the rod passage with no provision for hemostasis in the muscle.

The surgical field is limited with the Pathfinder technique, similar to working through the early Kambin straight cannula. The needle is positioned on the skin directly over the pedicle on an AP image. Correlation between clinical symptoms and radiological results were also reported.

Percutaneous Transpedicular Fixation: Technical tips and Pitfalls of Sextant and Pathfinder Systems

National Center for Biotechnology InformationU. Multi-Level Percutaneous Fixation System. Operative techniques, technical tips, and pitfalls were recorded for both systems. Figure 48a Figure 48b The Inserter can pass through the first Extender. The goal is to develop treatment methods that are less painful, more cost effective, and longer lasting, and which improve the quality of life and allow a rapid return to daily activities [ 4671314 ].


CD HORIZON LONGITUDE. Multi-Level Percutaneous Fixation System

We had to repeat all steps of screw introduction from the beginning. AP and lateral fluoroscopy should be used to confirm the needle is within pedicle confines when the NIM PAK Needle is at the base of the pedicle on lateral fluoroscopy. Reduction and compression can then be performed. Some tables have pedestals that make it difficult to get a true AP view of the pedicles. If difficulties arise seating the Screwdriver, use the Ball End Screwdriver in the set to align the Screw head to the shaft and remove.


Exclusion criteria also included inadequate identification of bone anatomy on image intensification, extensive disruption of bone anatomy, prior posterolateral fusion, vertebral rotation-scoliosis, high grade spondylolithesis, severe osteoporosis, and tumor or infection at the instrumented level.

It is important that immobilization of the spinal surgical site be maintained until firm bony union is established and confirmed by roentgenographic examination. During Sextant rod insertion, although a palpable engagement is confirmed with the rod tester, the optimal placement of the rods through the screw heads should be verified by both AP and lateral fluoroscopic images before tightening.

Introduction Percutaneous pedicle screw insertion is novel and recently reported technique. Additional surgery may be necessary to correct some of these potential adverse events. Complications of minimally invasive posterior fixation reported in the literature included screw misplacement requiring revision, neurological injury, radicular pain, instrumentation prominence, and wound infection [ 710131519 ].

The incision should be sufficient to accommodate the screw extender used with the system. Health Care Authorities recommend sterilization according to these parameters so as to minimize the potential risk of transmission of Creutzfeldt-Jakob disease, especially of surgical instruments that could come into contact with the central nervous system. Implants and disposable instruments single use only.

Recent developments have allowed for the preservation of normal spinal anatomical structures when performing spinal longitudw and instrumentation. These images were inspected for evidence of pedicle violation.