Misano
16Pages

CONCEPT & DESIGN Misano is the first thoracolumbar stabilization system using a single pedicle screw for the treatment of degenerative, traumatic, or deformative pathologies. The self-threading screws can be inserted without tapping and feature double threads for easy insertion and improved pedicle hold. The screws are also cannulated to allow insertion of the guide wire and fenestrated to allow cementing. The Misano thoracolumbosacral stabilization system from Clover Orthopedics consists of single and polyaxial pedicle screws, clamping nuts, straight and precurved bars, laminar and pedicle...

<• CLOVER INSTRUMENTS Clover has invested heavily in instrument design and care with the goal of creating ergonomic, functional, and compact instrumentation. Designed for the surgeon and his team. ^1 THORACIC AWL MSN-A0SS02510S ^7 RATCHETING HANDLE MSN-H0SS00100S ^3 NARROW GEAR SHIFT PROBE CURVED MSN-B1SS00000S |9 RATCHETING T-HANDLE MSN-H1SS00100S ^4 NARROW GEAR SHIFT PROBE STRAIGHT MSN-B0SS00000S (lo) ROD TEMPLATE L200 D5.5 MSN-M0AL00000S ^ GEAR SHIFT PROBE STRAIGHT MSN-B0SS00001S (l1SOUNDING 2MM MSN-C0SS00000S ^6 GEAR SHIFT PROBE CURVED MSN-B1SS00001S (l2 DOUBLE SOUNDING 2MM MSN-C1SS00000S

<• CLOVER INSTRUMENTS CASE 1 | TRAY 2 FREEHAND POLYAXIAL SCREWDRIVER ^21 FREEHAND POLYAXIAL SCREWDRIVER MSN-I1SS28520S TULIP ALIGNMENT ^3 CEMENT NEEDLE ADAPTER MSN-K0SS00200S ^4 COUNTER TORQUE HANDLE MSN-Q0SS00000S ^5 LOSCKSCREW GUIDE TOWER MSN-Q0SS00002S

INSTRUMENTS CASE 2 | TRAY 1

NARROW GEAR SHIFT PROBE CURVED NARROW GEAR SHIFT PROPED STRAIGHT GEAR SHIFT PROBE CURVED GEAR SHIFT PROBE STRAIGHT RATCHETING HANDLE

POLYAXIAL SCREWDRIVER FREEHAND POLYAXIAL SCREWDRIVER TULIP ALIGNMENT

COUNTER-TORQUE HANDLE LOCKSCREW GUIDE DEROTATION TOWER HEAXGONAL WRENCH

ROCKER FORCEPS AXIAL PERSUADER WITH FOLDING HANDLE CEMENT NEEDLE ADAPTER PARALLEL DISTRACTOR PARALLEL COMPRESSOR

misano titOPEN SURGICAL TECHNIQUE Preparation of the pedicle screw After determining the entry point proceed via thoracic or lumbar awl through the pedicle. Subsequently, open the pedicle canal with the curved or straight gear shift. Use the straight or curved sounding to assess the integrity of the pedicle walls. Although Misano pedicle screws are self-tapping, taps can be used to prepare the screw housing. Tapping undersized by one size relative to the selected screw size is recommended. The taps - available in diameters 4.5 mm, 5.5 mm, 6.5 mm, 7.5 mm and 8.5 mm - must be assembled to the...

OPEN SURGICAL TECHNIQUE 2— Inserting the screw Connect the polyaxial screwdriver to the ratcheting handle: - connect the screwdriver to the screw by inserting its tip inside the tulip until the thread reaches the head of the screw and then turn the screwdriver nut clockwise to make the final tightening; - proceed to implant the screw. Once the desired insertion depth is reached, the screwdriver is disengaged from the screw by turning the screwdriver nut counterclockwise. 3— Adjustment of the screw head If necessary, you can use the freehand screwdriver by placing the tip of the screwdriver...

OPEN SURGICAL TECHNIQUE 4— Rod preparation Once all screws are in place use the rod template to determine the length of the final bar. If necessary to bend and shape the bars you can use the rod bender. 5— Positioning the rod Place the previously selected bar inside the screw head with the rod holder

OPEN SURGICAL TECHNIQUE 6A — Positioning of the clamping nut — A To ensure proper positioning of the clamping nut on the screw, the lockscrew guide derotation tower can be used. The latter has a slightly larger distal end that is positioned over the head of the screw. At the same time, by exerting downward pressure, you properly seat the bar inside the screw. You can then proceed to position the clamping nut with the cap holder. If necessary, the rod pusher can be used. 6B — Positioning of the clamping nut — B As an alternative to the rod pusher, the rocker can be used. Grasp the waist head...

OPEN SURGICAL TECHNIQUE 6C — Positioning of the clamping nut — C Alternatively, it is possible to use the axial persuader with folding handle, which allows, with greater force, the bar to be brought closer to the head of the screw and the tightening nut then positioned. With the handles fully open, engage the persuader to the tulip of the screw. By then tightening the handles, the mechanism lowers the bar until it is inserted into the head of the screw. Next, introduce the clamping nut inside the persuader using the long clamping cap holder. Then release the persuader from the screw tulip...

OPEN SURGICAL TECHNIQUE 8— Compression and Distraction Once the bar has been fully inserted into all polyaxial screw heads and the clamping nuts are in place, distraction or compression can be performed using the distractor or compressor. 9— Final tightening Proceed to the final tightening of the system. Final tightening is carried out using the countertorque system, consisting of the countertorque handle connected to the lockscrew guide derotation tower, and the cap screwdriver previously assembled to the 9Nm dynamometric T-handle. Cementing Connect the cement needle adapter by inserting...

misano ft monza m evo d Clover Orthopedics s.r.l. Via Gadames n. 57/7, c.a.p. 20151 Milano M. info@cloverorthopedics.com W. cloverorthopedics.com SISTEMA Dl GESTIONE QUALITA CERTIFICATO ITALCERT