Handling Technique

Spine Cable System.

Indications/Features 2

Instruments 3

Handling technique: double-lead cable 4

Handling technique: single-lead cable 8

Table of contents

WarningThis description is not sufficient for immediate application of the instrumentation. Instruction by a surgeon experienced inhandling this instrumentation is highly recommended.

Synthes Spine Cable System Handling Technique 1

Indications/Features

2 Synthes Spine Cable System Handling Technique

Indications

As with monofilament wire, the Spine Cable System is indicated for the following spinal applications:

– Spinal trauma: for sublaminar, interspinous, or facet wiring– Spinal reconstruction: to correct spinal deformities,

scoliosis, kyphosis, and spondylolisthesis– Spinal degenerative surgery: as an adjunct to spinal fusions

Features

– 1.0 mm diameter cable fabricated with an (8�7)�(1�19)weave designed for flexibility and control

– Cable assemblies available in Ti-6Al-7Nb alloy (TAN) andstainless steel

– Retrieval loop at the end of the cable facilitates passing thecable sublaminarly

– Available in single- and double-lead configurations– Crimp is an integral part of the cable

Crimp integral to the cable

Double-lead cable

Single-lead cable

Cable retrieval loops

Cross-sectional view of cable

8 outer bundlesof 7 strands

One centralbundle of 19 strands

3

Instruments

Cable Retriever (321.745)

– Facilitates sublaminar cable passage

Cable Cutter, standard (391.905)

– Cuts cable flush with head of crimp

Tensioner/Crimper for Spine Cable (321.131)

– Automatically releases when the crimp is fully secured– Single instrument applies tension and crimps

Pretensioner for Spine Cable (321.744)

– Holds cable tension prior to crimping

Torque-Limiting Handle (321.132)

– For setting the tension level

4 Synthes Spine Cable System Handling Technique

In the following handling technique, sublaminar wiring isdescribed using the example of a C1/C2 wiring procedure. Theprocedure of sublaminar wiring for other indications is similar.

1Pass leader

Pass the leader of the double-lead cable under the lamina anduse the Cable Retriever (321.745) to catch the retrieval loop onthe tip of the leader. Gently pull the cable through until theleader is completely exposed.

2Cut leader tip

Using the Cable Cutter (391.905), remove only the tip of theleader. Separate the cable leaders.

Handling technique:double-lead cable

5

3Thread cable through crimp

Thread the cable leader through the crimp sleeve and pull upthe slack in each cable.

4Attach pretensioners

Gently pull each cable sequentially for provisional tightening.Next, depress the button on the Pretensioner (321.744) andpass the cable in the direction indicated on the pretensioner.Releasing the button automatically locks the cable.

Note: Align the button on the pretensioner in such a way thatit will not hinder the use of the tensioner/crimper.

5Attach tensioner/crimper

Align the jaws of the Tensioner/Crimper (321.131) to grasp thecrimp sleeve on the cylindrical barrel. Gently squeeze the handleuntil a single, audible click is heard.

Note: One click only is required to securely fasten the crimp.The second and the third click will definitely crimp the cable.

6 Synthes Spine Cable System Handling Technique

6Provisionally tighten cable

Pass the cable end through the spool at the end of thetensioner/crimper handle and pull any excess slack out of thecable.

Note: The holes in the spool must be aligned with the lineetched on the spool.

7Adjust torque setting

Select the desired torque by adjusting the setting on the Torque-Limiting Handle (321.132). Grasp the knurled wheel on the han-dle and pull it toward the working tip. Rotate the wheel to thedesired torque setting and release.

Note: The torque indications are marked in inch-pounds.

Torque TorqueInch-pounds Nm (approx.)4 0.56 0.78 0.9

10 1.112 1.414 1.616 1.8

8Tension cable

Attach the torque-limiting handle to the tensioner/crimper.Apply tension by rotating the torque-limiting handle in the direc-tion noted on the shaft until it slips. Slide the pretensionerforward to maintain tension if the tensioner/crimper is to beremoved.

7

9Tension second cable

Repeat steps 5–8 for the second cable. Remove the torque- lim-iting handle and the tensioner/crimper from the construct whentensioning is complete.

Notes: The tension in each cable can be rechecked or increasedsequentially a number of times.

Alternatively, two tensioner/crimpers may be used in place oftwo pretensioners.

10Secure crimps

Secure each crimp by grasping the crimp sleeve in the jaws ofthe tensioner/crimper and squeezing the handles until theyautomatically release. (This is a safety mechanism to ensure thesleeve is fully crimped.)

Remove the tensioner/crimper and pretensioners.

11Remove excess cable

Cut the cables flush with the tip of the crimp sleeves using thecable cutter.

Handling technique:single-lead cable

In the following handling technique, sublaminar wiring is de-scribed using the example of a C1/C2 wiring procedure. Theprocedure of sublaminar wiring for other indications is similar.

1Pass leader

Pass the leader of the single-lead cable under the lamina anduse the Cable Retriever (321.745) to catch the retrieval loop onthe tip of the leader. Gently pull the cable through until theleader is completely exposed.

2Cut leader tip

Using the Cable Cutter (391.905), remove only the tip of theleader.

3Thread cable through crimp

Thread the cable leader through the crimp sleeve and pull upthe slack in the cable.

8 Synthes Spine Cable System Handling Technique

4Attach tensioner/crimper

Grasp the crimp sleeve with the jaws of the Tensioner/Crimper(321.131). Gently squeeze the handles until a single, audibleclick is heard.

Note: One click only is required to securely fasten the crimp.The second and the third click will definitely crimp the cable.

5Provisionally tighten cable

Pass the cable end through the spool at the end of thetensioner/crimper handle and pull any excess slack out of thecable.

Note: The holes in the spool must be aligned with the lineetched on the spool.

6Adjust torque setting

Select the desired torque by adjusting the setting on the Torque-Limiting Handle (321.132). Grasp the knurled wheel on thehandle and pull it toward the working tip. Rotate the wheel tothe desired torque setting and release.

Notes: The torque indications are marked in inch-pounds.

Torque TorqueInch-pounds Nm (approx.)4 0.56 0.78 0.9

10 1.112 1.414 1.616 1.8

9

10 Synthes Spine Cable System Handling Technique

7Tension cable

Attach the torque-limiting handle to the tensioner/crimper.Apply tension by rotating the torque-limiting handle in the direc-tion noted on the shaft until it slips. Remove the torque-limitinghandle.

8Secure crimp

Secure the crimp by squeezing the handles until they automati-cally release. (This is a safty mechanism to ensure the sleeve isfully crimped.) Remove the tensioner/crimper.

9Remove excess cable

Cut the cable flush with the tip of the crimp sleeve using thecable cutter.

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Synthes GmbH Eimattstrasse 3, CH-4436 Oberdorfwww.synthes.com

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