Escalate Laminoplasty System Surgical Technique TM • Expandable Laminoplasty Plate • Streamlined Procedur

Escalate Laminoplasty System TM Surgical Technique Table of Contents System Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4 Surgical Procedure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-12 Expandable Laminoplasty Plate Technique. . . . . . . . . . . . . . . . . . . . . . . . . . . 6-11 Base Laminoplasty Plate Technique. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Implant Removal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....

Escalate Laminoplasty System TM Surgical Technique System Overview The Escalate™ System is a comprehensive set of implants and instruments designed for a systematic approach to cervical laminoplasty procedures. The system features an Expandable Laminoplasty Plate, a Base Laminoplasty Plate, Bone Screws for fixation, and a set of instruments to assist in implantation and removal of the device, if necessary. Expandable Laminoplasty Plate The open end of the Expandable Laminoplasty Plate attaches to the open lamina while the straight end of the plate corresponds to the lateral mass. The plate can...

Escalate Laminoplasty System TM Surgical Technique Base Laminoplasty Plate The Base Laminoplasty Plate can be used to reinforce an unstable hinge after a laminoplasty procedure. It can be attached directly to the lamina above and to the lateral mass beneath the hinge. Base Laminoplasty Plate (48570301) The Base Laminoplasty Plate features two screw holes which can be used to secure the plate to the laminar hinge and two holes which can be used to attach the plate to the lateral mass. Bone Screws The Escalate™ Laminoplasty System features a 2.0mm diameter self-drilling screw in lengths of 4-10mm...

Escalate Laminoplasty System TM Surgical Technique Surgical Procedure Patient Positioning and Exposure The patient is placed in the prone position with the head and neck adequately secured. A midline incision is made sub-periosteally, exposing the spinous processes and lamina at the desired levels. To perform an open-door laminoplasty procedure, create a vertical trough completely through the lamina on one side of the posterior arch (the “open side”) and a unicortical trough on the contralateral side (the “hinge”). Care must be taken not to remove an excessive amount of bone when creating the...

Escalate Laminoplasty System TM Surgical Technique Expandable Laminoplasty Plate Technique Lifting the Lamina After the laminar trough and hinge have been prepared, the Lamina Elevator can be used to lift the fully-cut lamina. This instrument is designed such that the Expandable Laminoplasty Plate can fit between the prongs of the Lamina Elevator. The Lamina Elevator can remain attached to the lamina during plate placement. Lamina Elevator (48570100) Note: Care should be taken not to use excessive force when lifting the lamina as this may result in hinge loosening.

Escalate Laminoplasty System TM Surgical Technique Attach the Plate Holder to the plate by clamping the Plate Holder onto the top half of the plate (green side). To insert the plate, hold the Plate Holder / Expandable Laminoplasty Plate assembly with the green side facing up. Insert the mouth of the plate around the lifted lamina and place the foot of the plate (grey side) against the lateral mass of the open side. If necessary, lift the lamina using the plate, with a “scooping action” so that the foot can be placed. Tip: The Lamina Elevator can be left in place during this step, as the plate...

Escalate Laminoplasty System TM Surgical Technique Screw Hole Preparation Note the recommended steps for screw hole preparation and screw insertion: a) Prepare / insert lateral mass side screws b) Expand plate c) Insert laminar screw This order is recommended to allow the plate to be positioned in the desired location before it is locked down. Keeping the Plate Holder attached, prepare the screw hole on the lateral mass side of the plate using either the Awl or a Drill Bit. Preparing / Inserting Lateral Mass Side Screw To use the Awl, align the pointed tip in the center of the plate screw hole...

Escalate Laminoplasty System TM Surgical Technique Screw Insertion The self-retaining Screwdriver features a square split tip to hold the screw head securely. To load bone screws, fully insert the tip of the Screwdriver into a screw head while the screw is in the screw caddy. Use the gauge in the screw caddy to confirm screw length. Screwdriver (48570104) Note: Following either technique for screw preparation (Awl or Drill), use the 2.0mm self-drilling screws (magenta). The 2.4mm self-tapping screws should only be used as a rescue screw after a 2.0mm screw has been inserted into (and removed...

Escalate Laminoplasty System TM Surgical Technique Plate Expansion Expander Knob If the Expandable Laminoplasty Plate is at a desired height, the laminar screw hole can be prepared. If more opening is required, use the Expander to expand the plate. Position the Expander so that the bottom (flat side) pin engages the hole on the bottom (grey) half of the plate, then engage the top (angled side) pin in the hole at the top (green side) of the plate. Tip: To set the Expander in the “Start” position, rotate the handle counterclockwise until it stops. Then rotate clockwise for one full revolution....

Escalate Laminoplasty System TM Surgical Technique Prepare Laminar Screw Pathway and Insert Screw With the plate in its expanded position, prepare the laminar screw pathway using either the Awl or Drill Bit (as described previously). Then insert the appropriate screw using the Screwdriver. Note: Care should be taken while inserting the laminar screw as the Plate Holder is no longer attached for use as a guide. Note: In cases where the hinge is loose or unstable, the Lamina Elevator may be used to lift the lamina to the top of the plate to facilitate drilling or screw insertion. Insert Laminar...