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Facet Preparation Instruments.To facilitate the preparation and filling of voids in facet joints.

Technique Guide

10369B Facet Prep Inst TG_- 8/31/11 12:20 PM Page 2

Table of Contents

Facet Preparation Instruments Technique Guide Synthes

Image intensifier control

Introduction

Surgical Technique

Product Information

Facet Preparation Instruments 2

Surgical Technique 3

Instruments 9

Set List 11


Facet Preparation Instruments. To facilitate the preparation and filling of voids infacet joints.

The Facet Preparation Instruments allow users to localize alumbosacral facet joint and to create or prepare a bony voidin the plane of that joint during facet fusion procedures.These instruments also facilitate insertion of the ThreadedFacet Dowel into the prepared void.

Features− Antirotation teeth on the guide tube, tap and driver shaft

to limit rotation after threads have been created− Helical flutes on the tap for thread creation− Trocar and spade tipped guide pins offer alternatives

when localizing the facet joint− Drills and taps in two sizes accommodate varying anatomy− Reamer to prepare facet joint

2 Synthes Facet Preparation Instruments Technique Guide


Facet Preparation Instruments Technique Guide Synthes 3

Surgical Technique

1Localize and prepare facet joint

Instruments

03.630.901 4.0 mm Guide Pin, trocar tip

03.630.912 4.0 mm Guide Pin, spade tip

03.820.113 Slotted Mallet

Use the appropriate surgical approach and instruments to expose the facet joint. Preoperative imaging may be useful to plan the type (open or MIS) and trajectory of approach,and to estimate graft sizing.

Technique tip: If using an MIS approach, the instruments are compatible with the Synthes Insight Access Tube Set(01.615.101).

If necessary, use a ronguer to remove any osteophytes. Elec-trocautery may be used to denude the facet capsule. Mobilizethe segment to visually identify the plane of the facet joint.

Insert the trocar- or spade-tipped guide pin into the plane ofthe joint. The outer diameter of the guide pin is 4.0 mm. Thiscorresponds to the minor diameter of the 5.5 mm dowel andcan be used to evaluate appropriate graft size based on facetjoint spacing. Depending on facet level and morphology,oblique imaging may be necessary to confirm the orientationof the facet plane. Lateral imaging may be used to establishthe trajectory in the sagittal plane.


Optional technique: Prepare site for joint finder andguide tube

Instrument

03.630.902 Reamer

If the joint surface is uneven, the reamer can be used to levelthe site.

Place the reamer over the guide pin and rotate to remove allinterfering bone. Hold the proximal end of the guide pin duringreaming to prevent migration and to maintain trajectory.


Guide pin

Surgical Technique



2Insert joint finder and guide tube

Instruments

03.630.903 Joint Finder

03.630.904 Guide Tube

03.630.910 Impaction Cap


Note: The axial grooves on the proximal end of the spade-tipped guide pin, joint finder, and guide tube are alignedwith the tines on the distal end.

Joint finder

Joint finder with impaction cap

Guide tube

Guide tube with impaction cap

Cross-section of impaction cap with guide tube

Axial groove

Axial groove

Tines

Tines


Surgical Technique


Place the joint finder over the guide pin, ensuring that the tinesare in line with the plane of the facet joint. The impactioncap and slotted mallet can be used to fully seat the jointfinder. The outer diameter of the joint finder is 6.5 mm. Thiscorresponds to the major diameter of the 6.5 mm ThreadedFacet Dowel and can be used to evaluate the appropriategraft size based on the morphology of the facet joint.

Note: Use the largest graft that the anatomy can safely accommodate. Consider bone quality, distance between articular surfaces and the medial and lateral facet borderswhen making this assessment.

Insert the guide tube over the joint finder, placing the tines in the plane of the joint. Ensure that the guide tube is fullyseated, as this will control the depth and trajectory of thevoid that will be created. The impaction cap and slotted mallet can be used to seat the guide tube as needed.

Once the guide tube is fully seated, remove the guide pinand joint finder, keeping the guide tube in place.



3Drill and tap

Instruments

03.630.905 4.0 mm Drill Bit with stop, quick coupling


03.630.907 Tap for 5.5 mm Threaded Dowel, quickcoupling


324.107 Quick Coupling Handle, with swivel cap

Select the appropriate drill, corresponding to the graft sizedetermined in Step 2. Advance the drill until the stop contactsthe proximal end of the guide tube.

Note: There are three etched bands around the larger drilland the larger tap, and no bands around the smaller drill andsmaller tap.

Remove the drill and select the tap that corresponds to thedrilled hole. Attach the selected tap to the quick couplinghandle.

Warning: Only tap by hand; do not use power to tap.

Advance the tap until the antirotation feature on the tap engages with the antirotation feature on the guide tube.These are designed to prevent damage to the tapped holeonce the threads have been formed.

Warning: Hold the guide tube in place to prevent excesstorque from being transmitted to the supporting bonyanatomy.

Rotate the tap counterclockwise to remove.

Three etched bands

Three etched bands

4.0 mm drill bit 5.0 mm drill bit Tap for 5.5 mmdowel

Tap for 6.5 mmdowel

Drills (with stop)

Taps (with antirotation features)


Surgical Technique


4Insert graft

Instruments

03.630.909 4.0 mm Hexagonal Driver Shaft, female,quick coupling

03.630.911 Loading Station


Attach driver shaft to the quick coupling handle. Select thegraft size as determined in Step 2 and load it onto the driver.Insert through the guide tube.

Technique tip: The loading station may be used to facilitatethe engagement of the driver onto the graft.

Manually rotate the driver to advance the graft until the antiro-tation feature on the driver engages with the antirotationfeature on the guide tube. These are designed to preventdamage to the tapped hole and/or the graft once the graft is fully seated.

Warning: Hold the guide tube in place to prevent excesstorque from being transmitted to the supporting bony anatomy.

Remove the driver and guide tube.

Notes: The drive mechanism of the graft will remain exposedin a properly seated graft. If threads are visible, the graft may be rotated up to one additional turn to fully engage the threads.

To limit excessive bending following surgery, use of a brace isrecommended for 6–8 weeks.



Instruments

03.630.901 4.0 mm Guide Pin, trocar tip

03.630.902 Reamer

03.630.903 Joint Finder

03.630.904 Guide Tube





Instruments


03.630.909 4.0 mm Hexagonal Driver shaft, female,quick coupling

03.630.910 Impaction Cap

03.630.912 4.0 mm Guide Pin, spade tip






Facet Preparation Instrument Set (01.630.901)

Graphic Case60.630.900 Graphic Case, for Facet Preparation

Instruments

Instruments03.630.901 4.0 mm Guide Pin, trocar tip, 2 ea.

03.630.902 Reamer, 1 ea.

03.630.903 Joint Finder, 2 ea.

03.630.904 Guide Tube, 2 ea.

03.630.905 4.0 mm Drill Bit with stop, quick coupling, 2 ea.

03.630.906 5.0 mm Drill Bit with stop, quick coupling, 2 ea.

03.630.907 Tap for 5.5 mm Threaded Dowel, quickcoupling, 2 ea.

03.630.908 Tap for 6.5 mm Threaded Dowel, quickcoupling, 2 ea.

03.630.909 4.0 mm Hexagonal Driver shaft, female,quick coupling, 2 ea.

03.630.910 Impaction Cap, 2 ea.

03.630.911 Loading Station

03.630.912 4.0 mm Guide Pin, spade tip, 2 ea.


324.107 Quick Coupling Handle, with swivel cap, 2 ea.

Case shown fully loaded.

Note: For additional information, please refer to package insert. For detailed cleaning and sterilization instructions, please refer tohttp://www.synthes.com/sites/NA/MedicalCommunity/Pages/Cleaning_and_Sterilization.aspx or to the below listed inserts, which will be included in the shipping container:– Processing Synthes Reusable Medical Devices—Instruments, Instrument Trays

and Graphic Cases—DJ1305– Processing Non-sterile Synthes Implants—DJ1304


Synthes Spine1302 Wrights Lane EastWest Chester, PA 19380Telephone: (610) 719-5000To order: (800) 523-0322Fax: (610) 251-9056

Synthes (Canada) Ltd.2566 Meadowpine BoulevardMississauga, Ontario L5N 6P9Telephone: (905) 567-0440To order: (800) 668-1119Fax: (905) 567-3185

© 2011 Synthes, Inc. or its affiliates. All rights reserved. Synthes is a trademark of Synthes, Inc. or its affiliates. Printed in U.S.A. 9/11 J10369-B

www.synthes.com


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