CD HORIZON® LEGACY™ Spinal System Advanced ... - Arcos

CD HORIZON ® LEGACY Spinal SystemAdvanced Deformity CorrectionConfidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Thoracic Pedicle Screwing1. Superior Facet Rule2. Thoracic Pedicle (TP) Screw Starting Points3. Ventral Laminar Concept4. Four types of PedicleConfidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Pedicle Screw Starting Points For The Straight-Forward Trajectory• Superior Facet RuleColor Reference ChartUnsafeSafeNote: Do not start medial to the midpoint of thesuperior facet.CD HORIZON ® LEGACY Spinal SystemAdvanced Deformity CorrectionConfidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Pedicle Screw Starting Points For The Straight-Forward Trajectory• Cephalo-Caudal Starting PointsColor Reference ChartT9, T8, T7T10, T6T11, T5, T4T12, T3, T2, T1CD HORIZON ® LEGACY Spinal SystemAdvanced Deformity CorrectionConfidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Thoracic Pedicle (TP) Screw Starting Points• Use Fixed Angle or MultiAxial Screws for thestraightforward approach(Blue Pins)• Use Multi Axial Screws forthe anatomic approach(Green Pins)CD HORIZON ® LEGACY Spinal SystemAdvanced Deformity CorrectionConfidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Ventral Lamina ConceptVentral laminaConfidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Confidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

4 Types of PedicleA type B type C type D typeCancellousCortical65% 25% 7%3%Confidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

C typeTry intra-osseous insertionChoose a tap one size smaller than a screwConfidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

D typeTry extra-pedicular insertionChoose a tap one size smaller than a screwConfidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Thoracic Bilateral Apical Vertebral Derotation (BAVD)Surgical TechniqueCD HORIZON ® LEGACY Spinal SystemAdvanced Deformity CorrectionConfidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Thoracic Bilateral Apical Vertebral Derotation (BAVD)Surgical Technique (continued)CD HORIZON ® LEGACY Spinal SystemAdvanced Deformity CorrectionConfidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Thoracic Bilateral Apical Vertebral Derotation (BAVD)Surgical Technique (continued)Confidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Thoracic Bilateral Apical Vertebral Derotation (BAVD)Surgical Technique (continued)APEXConfidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Thoracic Bilateral Apical Vertebral Derotation (BAVD)Surgical Technique (continued)Confidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Case PresentationConfidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Case PresentationConfidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

OptionsApexSpinal CordConfidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

OptionsTranslation( Sublaminar Wiring)Confidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

OptionsHookTransverseFacet ( Pedicle )Confidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Thoracic Adolescent Idiopathic Scoliosis Curves 70-100 PSF; Hook vs. Hybrid vs. Pedicle Screw OnlySpine 2005; 30: 2061-2067Confidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Thoracic Adolescent Idiopathic Scoliosis Curves 70-100 APSF vs. PSF with Pedicle Screw OnlyAPSFPSF Pedicle Screw OnlyMain thoracic curve overall change 47.2 (58.5%) 45.9 (58.3%) NS(preop. to last follow-up)Sagittal T5-T12 surgical change -2.2 -16.5 NS(preop. to last follow-up)SRS pain (postop.) 21.4 21.8 NSSRS self-image (postop.) 22.4 24.8 NSSRS function (postop.) 21.1 21.8 NSSRS satisfaction (postop.) 8.4 8.6 NSSpine 2005; 30: 2061-2067Confidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Confidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only

Lenke Type I Adolescent Idiopathic Scoliosis CurvesASF vs. PSF / TPSASFPSF / TPS% Correction of Rib Hump 26% 51% p=0.005(preop. to last follow-up)% Correction of Apical VertebralBody-Rib (AVB-R) Ratio 32% 73% p

Lenke Type I Adolescent Idiopathic Scoliosis CurvesASF vs. PSF / TPSConfidential, Do Not Copy, Do Not Circulate, Do Not Distribute, For Internal Use Only