Depuy腰Cage Mesh

1、Interbody Fusion Products,Brad Moore Group Product Director, US Ben Stungo Product Manager, International,Why Interbody Fusion?,Anterior Column Support is Necessary to Avoid Pedicle Screw Breakage避免断钉 80% of Loads in Spine Carried in Anterior Column80承载力在前拄 Large Surface Area for Fusion要提供足够大面积,Load

2、 Sharing,A Load Sharing Construct Closely Matches Load Distribution in Normal Spine Anterior Column (Cage) and Posterior Tension Band (Pedicle Screws),DePuy AcroMed Philosophy,Flat-Sided Vertical Cages increased stability增加稳定性 increase graft surface area增加植骨面积 minimize damage to surrounding structur

3、es减少周围组织的破坏 reduce the likelihood of graft subsidence减少内植物下沉,DePuy AcroMed Philosophy,Load Sharing应力承载 stiffness similar to human cortical bone与人皮质骨相似 reduces stress shielding减少压力屏蔽 loads bone graft inside of cage可在cage中加入植骨 Wolffs Law states that bone grows when loaded,PLIF (Posterior Lumbar Interb

4、ody Fusion),PLIF uses a posterior approach to the interbody space. very stable, bilateral construct稳定有双面结构 direct visualization of graft site.直视内植物的位置 great surface area for graft incorporation.只顾面积很多,TLIF (Transforaminal Lumbar Interbody Fusion),TLIF uses a Posterio-Lateral approach to the interbod

5、y space. Preserve most of the Posterior Elements and helps to ensure stability.保护更多的后路结构，帮助稳定 Eliminate the need to retract the Dura.减少牵拉神经脊髓 Operate on the side that is problematic. 操作困难,ALIF (Anterior Lumbar Interbody Fusion),ALIF uses an anterior approach to the disc space. Leaves posterior eleme

6、nts Tall Round,Features & Benefits,Load Sharing 应力承载 Diamond Pattern 1mm Wall Teeth (Resist Retropulsion & Encourage Settling) Versatility 种类多 Multiple Sizes & Geometries Trimmable Strength (CP Titanium)坚固,Maximizes Graft Surface Area提供最大植骨面积 Optimum Wall Thickness More Bone / Less Metal,Accessories

7、附件,Rings and Screws环和钉 Increases Resistance to Axial Loads Standard (3 Screws) Angled 17x22, 22x28, 26x33 (Oval),Endplates终板 Maximizes Surface Area STM Weak, Osteoporotic Bone / Tumor Patients 17x22, 22x28, 26x33 Non-Locking Design,Accessories,Endcaps终帽 Split Ring Design (no screws)开口环 Recessed Plat

8、form (1mm) Short and Tall Mesh,Increased Implant Surface Area,Endcaps provide 100 - 150% Greater Implant Surface Area in Axial Loading 终帽增加100150矢状表面压力,Resistance to Side Loads阻抗周围的压力,Up to 230% Greater Resistance to Side Load增加230,Addressing: Deformation,1. Technique Adequate Graft Site Distraction

9、 Endrings 2. Instrumentation KeystoneTM Graft Instruments,Addressing: Subsidence,56% Greater Implant Surface Area than Pyramesh Recessed Platform Design,Lumbar I/F Cage,Lumbar I/F Cage (also known as “Brantigan Cage”),Developed by John Brantigan, MD. Made of Carbon Fiber Reinforced Polymer - “CFRP”

10、12 years and thousands of patients in its clinical history,Lumbar I/F Cage Features,Stiffness Closely Matches Human Cortical Bone Wolffs Law states bone grows when loaded,Strength 2.3 Times as Strong as a Vertebral Body,Lumbar I/F Cage Features,Lumbar I/F Cage Features,Radiolucency Assess Fusion on

11、Plain X-Ray MRI/CT Compatible Tantalum Beads to Mark Position,Lumbar I/F Cage Features,Parallel and Wedged Available Match Curvature of Spine (Lordosis),Lumbar I/F Cage Features,Open Design Area for Bone Graft Inside and Outside Cage Cover up to 72% of Surface Area with Bone Graft,11mm Disc Space,Us

12、ing.,Lateral Width Required,4mm,x2 15mm Threaded Cages 30mm Drill Tube Requirement 4mm TOTAL WIDTH 34m,x2 9x11mm I/F Cages 18mm TOTAL WIDTH 18mm,Lumbar I/F Cage Features,Width Required to Place Rectangular Cage Less Retraction of Dura and Nerve Roots Does not Destroy Pedicles No limit to Cage Height

13、,4mm,Lumbar I/F Cage Features,Anterior I/F Cage,Anterior I/F Cage (also known as “Brantigan ALIF Cage”),Developed by John Brantigan, MD. Made of Carbon Fiber Reinforced Polymer - “CFRP” 8 years of clinical history,Anterior Lumbar Interbody Fusion Most Commonly Used at L4-L5 and L5-S1,Anterior I/F Ca

14、ge Indications,Anterior I/F Cage Approach,Most Commonly Left Retroperitoneal Complete Discectomy Do Not Perforate Endplates,Anterior I/F Cage Features,Radiolucency Assess Fusion on Plain X-Ray MRI/CT Compatible Tantalum Beads to Mark Position,Anterior I/F Cage Features,Teeth to Resist Migration Midd

15、le Strut for Added Stability Wedge Shape to Restore Lordosis,Cervical I/F Cage,Anterior I/F Cage (also known as “Brantigan Cervical Cage”),Developed by John Brantigan, MD. Made of Carbon Fiber Reinforced Polymer - “CFRP” 5 years of clinical history,Anterior Cervical Discectomy and Fusion (ACDF) Most

16、 Commonly Used at C4-C5, C5-C6 and C6-C7,Cervical I/F Cage Indications,Cervical I/F Cage Technique,Complete Discectomy Trial to Size Insert Cage Filled with Bone Graft,Cervical I/F Cage Features,Radiolucency Assess Fusion on Plain X-Ray MRI/CT Compatible Tantalum Beads to Mark Position,Cervical I/F

17、Cage Features,Teeth to Resist Migration 7 degree Wedge Shape to Restore Lordosis,I/F Ramps,I/F Ramps (also known as “Steffee Ramps”),Developed by Arthur Steffee, MD. Made of Carbon Fiber Reinforced Polymer - “CFRP” 5 years of clinical history,Posterior Lumbar Interbody Fusion (PLIF) Always Used with

18、 Pedicle Screw Fixation,I/F Ramps Indications,I/F Ramps Technique,Insert Parallel to Endplates Flip 90 degrees Pack Bone Graft in Disc Space and Compress Pedicle Screw Instrumentation,I/F Ramp Features,Radiolucency Wedge Shape to Restore Lordosis Minimal Retraction of Soft Tissue for Insertion,Cervical ACD/F Cervical Tumor / Trauma Posterior PLIF TLIF Anterior ALIF Thoracolumbar Tumor / Trauma,Keystone Graft Instruments,Keystone Graft Instruments,Surgical Titanium Mesh Improved Mes