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D E G E N E R A T I V E
L O W P R O F I L E P O LYA X I A L S P I N E S Y S T E M
A02100001 Straight ratchet handle A02100002 T ratchet handle A02100004 Malleable rod,
A01130250 T20 screwdriver shaft length 350 mm
A02100005
Palm ratchet handle A02110010 Squared awl A02110030 Lenke type Spatula A02110050 Depth gauge
A02110020 Squared awl reamer shaft
A02120000 Rod holder A02120002 Rod rotating wrench A02120020 Rod pusher shaft A02120100 French bender
A02120250 Compressor A02120350 Rod spreader A02120375 L-Shaped Jaws A02130160 Nutdriver
A02130170 Nutdriver shaft A02150020 Sacral screw gimlet A02150030 Sacral screw holder A02200010 Flexible guide
for T20 screwdriver
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I N S T R U M E N T A T I O N
A02230040 A02230250
A02250010 Sacral plate holder MS219 Pedicle probe
Counter-torque for rod-plate Nutdriver shaft for dismantling
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L O W P R O F I L E P O LYA X I A L S P I N E S Y S T E M
1. implant selection.................................................................5
2. screw fixation
on lumbar and/or thoracic vertebrae..............................6
1. implant selection...............................................................11
2. Rod contouring...................................................................11
5. tightening............................................................................14
6. final procedure...................................................................17
1. implant selection...............................................................18
2. insertion of crosslink....................................................18
1. implant selection...............................................................19
5. tightening............................................................................23
6. final procedure...................................................................23
1. implant selection...............................................................24
5. final procedure...................................................................25
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D E G E N E R A T I V E S U R G I C A L T E C H N I Q U E
1. implant selection
m
m
m
5
0
4.
5.
6.
7.
8.
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L O W P R O F I L E P O LYA X I A L S P I N E S Y S T E M
IMPORTANT:
For the superior end of the instrumentation, secure
the screw position outside of the facet joint.
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D E G E N E R A T I V E S U R G I C A L T E C H N I Q U E
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L O W P R O F I L E P O LYA X I A L S P I N E S Y S T E M
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D E G E N E R A T I V E S U R G I C A L T E C H N I Q U E
Determine the appropriate screw length using the laser marks on the
spatulas, or the depth gauge (A02110050).
RATCHET HANDLES:
The handles A02100001, A02100002 & A02100005 offer 3 settings:
F = Forward position for Screw insertion
0 = Neutral position to lock ratchet function
R = Reverse position for Screw removal
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L O W P R O F I L E P O LYA X I A L S P I N E S Y S T E M
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D E G E N E R A T I V E S U R G I C A L T E C H N I Q U E
1. Implant selection
m
e
ng
m
le
th L
is la L
ser marked
2. Rod contouring
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L O W P R O F I L E P O LYA X I A L S P I N E S Y S T E M
3. Connector setting
Implant selection :
The PASS LP system provides 2 types of connectors.
The compatible rod diameter is laser marked on the implant to ease identification.
IMPORTANT: When operating on patients with poor bone quality such as severe osteoporosis the use of
realignment connectors (Gold) is not recommended.
NOTES:
Other implants are available (offset, angulated).
In order to use those connectors, please refer to the additional implants leaflet of the PASS LP Surgical
Technique.
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D E G E N E R A T I V E S U R G I C A L T E C H N I Q U E
NOTES:
The threaded extensions are completely free during
this step and no stress is applied to the anchorage.
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L O W P R O F I L E P O LYA X I A L S P I N E S Y S T E M
5. Tightening
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D E G E N E R A T I V E S U R G I C A L T E C H N I Q U E
5.c.1. Distraction
5.c.2. Contraction
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L O W P R O F I L E P O LYA X I A L S P I N E S Y S T E M
If you wish to remove a broken nut, use the nutdriver for dismantling
(A02230250). Align the pins with the holes present on the remaining part of
the nut.
IMPORTANT:
If tightening must be re-executed, it is MANDATORY to re-execute the tightening procedure with a new unbroken nut.
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D E G E N E R A T I V E S U R G I C A L T E C H N I Q U E
6. final procedure
6.a. Checking
IMPORTANT: A count of all the broken parts is recommended to be certain no broken parts are
left in the incision.
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L O W P R O F I L E P O LYA X I A L S P I N E S Y S T E M
1. Implant Selection
2. Insertion of crosslink
Once the connector is on the rod, tighten the central axis using the T20
screwdriver until the instrument cannot be rotated any further.
The Crosslink can then slide freely along the rod without escaping, and a gentle
compression or distraction can be applied between the 2 rods.
Lock the crosslink by tightening the locking nuts using the Nutdriver
(A02130160).
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D E G E N E R A T I V E S U R G I C A L T E C H N I Q U E
1. Implant Selection
Identification of the S1 pedicle entry point which is in the inferior part of the
S1 articular surface.
NOTE: To check the correct positioning of the implant, we recommend the use
of a lateral view from an image intensifier (C-arm).
Create the pathway through the anterior cortex for a bicortical fixation of the S1 screw using the Straight
spatula A01110050.
Test the pathway with the Pedicle probe (MS219).
Enlarge the hole with a curette and perform a second test of the pathway with the pedicle probe (MS219).
Determine the appropriate screw length using the depth gauge (A02110050).
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L O W P R O F I L E P O LYA X I A L S P I N E S Y S T E M
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D E G E N E R A T I V E S U R G I C A L T E C H N I Q U E
Position the plate with its lower end lying on the sacral ala, lateral to
the first posterior sacral foramen.
Use the drilling guide of the sacral plate holder to determine the entry
point of the inferior screw (S2) located lateral to the first sacral hole
(hole R for a right plate and hole L for a left plate).
IMPORTANT: If you wish to use an electric drill, the drilling guide is compatible with up to a 3.2 mm size drill.
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L O W P R O F I L E P O LYA X I A L S P I N E S Y S T E M
Move the drilling guide onto its side by pulling and rotating
the tie to release access to the plate.
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D E G E N E R A T I V E S U R G I C A L T E C H N I Q U E
The sacral screws have intersected trajectories in all 3 planes in order to obtain optimal pull-out resistance.
5.tightening
Please refer to Section 2 paragraph 5 (page 14).
6.final procedure
Please refer to Section 2 paragraph 6 (page 17).
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L O W P R O F I L E P O LYA X I A L S P I N E S Y S T E M
Section 5 ROD-PLATE
1. Implant selection
IMPORTANT: The Rod-plate can be used with standard and offset polyaxial screws, as well as with sacral
plates.
Measure the distance between the threaded extensions of the anchorages and choose the implant that will fit.
2. Bending of rod-plate
3. Insertion of rod-plate
The flexible guide can be loaded on the threaded extension of the anchorages prior to rod-plate insertion.
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D E G E N E R A T I V E S U R G I C A L T E C H N I Q U E
The Counter-torque for rod-plate (A02230040) can be used to stabilize the construct
during tightening.
5. final procedure
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L O W P R O F I L E P O LYA X I A L S P I N E S Y S T E M
B02216555 POLYAXIAL PEDICLE SCREW 6.5 mm x 55 mm* NON STERILE REF. DESIGNATION
B02216560 POLYAXIAL PEDICLE SCREW 6.5 mm x 60 mm* B02270010 ROD-PLATE 1 LEVEL SMALL
B02217525 POLYAXIAL PEDICLE SCREW 7.5 mm x 25 mm* B02270015 ROD-PLATE 1 LEVEL LARGE
B02217530 POLYAXIAL PEDICLE SCREW 7.5 mm x 30 mm* B02270020 ROD-PLATE 2 LEVELS SMALL
B02218025 POLYAXIAL PEDICLE SCREW 8.0 mm x 25 mm* ** NOTE : Non Sterile polyaxial screws and sacral plates are delivered
WITHOUT the nut .
B02218030 POLYAXIAL PEDICLE SCREW 8.0 mm x 30 mm*
Nuts need to be ordered separately.
B02218035 POLYAXIAL PEDICLE SCREW 8.0 mm x 35 mm*
B02185545 OFFSET PEDICLE SCREW 5.5 X 45mm IMPORTANT : The PASS LP system is also available
B02186535 OFFSET PEDICLE SCREW 6.5 X 35mm in STERILE version- simply add a S at the end of each
B02186540 OFFSET PEDICLE SCREW 6.5 X 40mm reference in your order.
B02186545 OFFSET PEDICLE SCREW 6.5 X 45mm Sterile Polyaxial Screws and Sacral Plates are delivered
*other lengths available upon special request directly assembled with the nut.
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IMPLANTS
B02235501 STANDARD CONNECTING CLAMP FOR 5.5 mm ROD B02236001 STANDARD CONNECTING CLAMP FOR 6mm ROD
B02235510 REALIGNMENT CONNECTOR FOR 5.5mm ROD B02236010 REALIGNMENT CONNECTOR FOR 6mm ROD
ROD ROD
B02175510 PRE BENT ROD 5.5 X 100 mm B02176010 PRE BENT ROD 6 X 100 mm
CROSSLNKS CROSSLNKS
B02265534 CROSSLINK FOR 5.5mm ROD. 22 TO 34mm DISTANCE B02266034 CROSSLINK SYSTEM for 6mm rod. Distances 22 to 34mm
B02265548 CROSSLINK FOR 5.5mm ROD. 34 TO 48mm DISTANCE B02266048 CROSSLINK SYSTEM for 6mm rod. Distances 34 to 48mm
B02265562 CROSSLINK FOR 5.5mm ROD. 48 TO 62mm DISTANCE B02266062 CROSSLINK SYSTEM for 6mm rod. Distances 48 to 62mm
IMPORTANT : The PASS LP system is also available in STERILE version- simply add a S at the end of each
reference in your order.
Sterile Polyaxial Screws and Sacral Plates are delivered directly assembled with the nut.
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FDA cleared. Ref. C02D02002 V02 Sept 2009 Medicrea. All rights reserved. Patented products. MEDICREA and PASS are Medicrea registered trademarks
Headquarters:
MEDICREA
24 porte du Grand Lyon
01700 NEYRON - FRANCE
Tl. +33 (0)4 72 01 87 87
Fax +33 (0)4 72 01 87 88
customerservice@medicrea.com
Manufacturer:
MEDICREA Technologies
Z.I. Chef de Baie
17000 LA ROCHELLE - FRANCE
Tel. +33 (0)5 46 00 55 55
Fax +33 (0)5 46 00 55 77
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