IDYS®-C ZP 3DTI

SECURED CERVICAL CAGE

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 PRODUCT PRESENTATION

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 PRODUCT FEATURES
Integrated Fixation – 2 screws
In-Built Lordosis
2 self-tapping and self-drilling screws
6° Angle + locking mechanism
Anatomical Profile
Superior convexity in sagittal plane and inferior convexity in frontal
plane to perfectly adapt to the superior endplate and to the uncinate
processes and allow to implant wider cages

Cage in 3DTi
Porosity et Roughness

In Top view trapezoidal shape to adapt to the uncinate processes

1 big graft space

Maximize graft volume
Easy to fill-in

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 ADDITIONAL INFOS ON IMPLANTS

SCREW ANGLE
RULE FOR SCREW LENGTH Vs CAGE HEIGHT
cranio-caudal angle: 35.5°
Medio latéral angle : 5° - The entry point of our screws is fixed whatever the cage’s height is ,
and that is why we have one single unique cage holder for all cages.
Angular Variability: angle cone of 3° in total But is means as well that higher is the cage, less the screw will go
(±1.5° in all directions) over the cage’s limit to penetrate into the endplate. This rule must
then be respected to ensure proper mechanical resistance to pull
out.

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 IMPLANT RANGE
w

Idys-C ZP 3DTi Screw Ø3.5mm

Idys-C ZP 3DTi Screw Ø4.0mm

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 INSTRUMENTS SET

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 SURGICAL TECHNIQUE

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 SURGICAL TECHNIQUE

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 SURGICAL TECHNIQUE

Discectomy & Endplate Preparation Trial Selection and Preparation

The Cage Holder has a fixed depth stop located

at 2 mm from the anterior wall of the vertebra
Check under fluoroscopic control:
The posterior side of the cage trial should
be a minimum of 1 mm from the posterior
edge of the vertebra. If it is not the case,
choose a cage trial of inferior depth
The trial implant should be as large as
possible, while allowing stable seating on
the vertebral endplate

the consistency between the selected trial

and the disc heights of the adjacent levels.

Trial insertion and Choice of size

Cage Preparation 9
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 SURGICAL TECHNIQUE
Insert progressively the cage centered laterally in the IMPORTANT: For cages with height of 9mm, the minimum screw length
intersomatic space taking care to orientate the laser mark allowed is 16 mm. Do not use shorter screws on H9 mm cages.
“TOP” toward the cranial side of the patient and under
fluoroscopy in order to check its correct positioning. We recommend to start by implanting the screw that will be inserted in the
cranial vertebra.
The posterior side of the cage should be a
minimum of 1 mm from the posterior
edge of the vertebra
Remove the Distractor (and the Distractions
Pins if not at 6 mm from endplate and fully
centered) to avoid any conflict during the
bone screw pathway preparation
The Cage Holder has a fixed depth stop located
at 2 mm from the anterior wall of the vertebra

Cage Insertion Insertion of the drill guide on the hole for cranial screw

Insert the screw into the previously prepared pathway but do not
screw it fully. Leave the head of the screws a bit out from the cage.
Preparation of 1st cranial hole Insertion of the 1st screw
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 SURGICAL TECHNIQUE

Insertion of the drill guide on the hole Preparation of the 2nd hole
for caudal screw

Insertion of the 2nd screw

Screw Locking 11
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 SURGICAL TECHNIQUE – REVISION

Screw Unlocking

Note : If the connection between the Cage Holder and the cage is difficult,
you can use the internal part of the Cage Holder alone to remove the
cage by screwing it into the thread present on the locking mechanism
Screw Removal and by pulling the cage out.

Cage Removal 12
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 TIPS & TRICKS
- Color Code on Trials : 1 color per footprint

16x14 18x15
Sky Blue Gold

- Check good assembly of the cage on the cage-holder

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 TIPS & TRICKS
- Start preparation of screw pathway on cranial side and drill
through the guide prior to screw insertion.

Insert the Guide on the cage-holder on the

opposite side of the Laser Mark TOP to prepare
the pathway in the cranial vertebrae

- Do not prepare both pathways at the same time ! Prepare first the
1st hole and then screw the cranial screw before preparing the 2nd
hole and inserting the caudal screw.
Reinsert the
Insert the Guide on the
Guide on the other hole
Hole heading heading
toward cranial towards caudal
vertebra and vertebra this
then drill time and then
drill. 14
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 TIPS & TRICKS
- Warning : no short screws on high cages

- How to remove the cage in case of revision if the cage holder cannot
be reinserted.
Note : If the connection between the Cage Holder and the cage is difficult, you can use the internal part of the Cage Holder alone to
remove the cage by screwing it into the thread present on the locking mechanism and by pulling the cage out.

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 Differentiating Instruments
1 SINGLE UNIQUE CAGE HOLDER FOR ALL SIZES
1 CAGE HOLDER VERY THIN FOR A VERY GOOD VISIBILITY
1 CAGE HOLDER SECURED WITH A FIXED DEPTH STOP AT 2MM

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 SALES SUPPORT

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 Confidential – For Internal use Only

Sales Pitch - CAB

CHARACTERISTICS IMAGE ADVANTAGE BENEFITS PATIENT/SURGEON
- Perfect fit with
Concavity of the - Better endplate coverage
- Better primary stability
ANATOMICAL PROFILE Inferior endplate - Better congruence with endplates to enhance
- Adaptation to the concavity fusion
of Superior vertebra

ZERO PROFILE - Immediate stability in the disc

- Indicated in multi-level Stand Alone cases (no
space
INTEGRATED FIXATION - Nothing protrudes outside the disc
plate to be added)
- Reduce the risk of dysphagia/Dysphonia
WITH 2 SECURED SCREWS space
- Excellent Biocompatibility
- Porous titanium matrix structure for bone
3DTi / POROUS TITANIUM - Porous structure with rough growth and x-ray visibility.
surface
- Reduce impaction force on cervical spine
- Easy Insertion (better for narrow canal/myélopathy).
INTEGRATED LORDOSIS - Adaptation to natural disc space - Restore « anatomical » sagittal balance for the
patient especially on multi-levels.
- Better adaptation of the size and graft volume
- 2 footprints (16x14 / 18x15) for for the patient.
- Adaptation to different anatomies
WIDE RANGE LUR
- Suitability to different markets
- Comfort of choice for the surgeon for a
- 5 Heights (5 to 9 mm) diversified practice on several patient’s types
- Reduced risk of subsidence on the endplates.
- Traceability
STERILE IMPLANTS - 5 years Gamma Sterilization - Easiest Logistics handling (patient labels,…)
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Sales Pitch - CAB

CHARACTERISTICS IMAGE ADVANTAGE BENEFITS PATIENT/SURGEON
- Trial holder = Cage holder
- 1 single unique cage holder for all
sizes - Simple Technique (no change of instruments
between screw insertion and locking)
SIMPLE - 1 graft compactor/ Filling block for
- Reproducible technique
INSTRUMENTATION all sizes - Simplified Sterilization process (only 1
- Screwriver for locking mechanism container)
= Screwdriver for screws insertion

- Secured Insertion while leaving the possibility

CAGE HOLDER to the surgeon to insert a bit more posteriorly
his cage than flush with the anterior wall for a
Very thin with fixed depth - Very good visibility upon insertion
perfect zero profile implantation according to
stop at 2 mm from cage - Reduce risk of canal impingment the anatomy.
edge. - Guarantee to be able to screw in without
conflict with anterior walls.

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 FAQ

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 FAQ

- Whay a cage in 3DTi ?

See Slides on materials located above in this presentation

- Why did you choose an anatomical profiles and not a wedge profile?
Less invasive for the patient / Less risk of endplate fracture because less endplate preparation needed
Less preparation for the surgeon
All options remais opened in case of revision because the anatomy has been kept as natural as possible
and not « modified »

- Why a drilling guide?

To guarantee that the screw will remain in the limit of polyaxiality of the system and that the head of the
screw will be entirely drown into the the cage’s hole and thus really locked when the mechanism will
cover the head.

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 FAQ
- Why do you recommand to start with the cranial screw ?
To avoid that the tip of the screw slipps on the concavity located on the inferior endplate of the
superior vertebra creating a space due to distraction effect in between the cage and the endplate that
coud lead to pseudarthrosis. If the cage is not attached yet on the inferior vertebra when you implant
the cranial screw, the cage will be « pressed » against the superior vertebra due to screwing reducing
the risk to have a void remaining. Our conceptors have mentioned this problem with competitive
products.

- Why not to prepare the 2 pre-holes with the guide at the same time/step
and to screw both screws after ?
When the 1st screw is screwed in, the cage could be a bit pushed posteriorly due to the screwing effect, and in this
case, the surgeon would have lost of sight the entry point of the 2nd pre-hole if he had prepared it before the 1st screw
insertion. He would be then oblideg to prepare a 2nd pre-hole in the same vertebra which could fragilize the vertebral
body or would enlarge the pre-hole prepared anteriorly and thus reducing the stability/pull-out strength of the 2nd screw.

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 TAKE HOME MESSAGE

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 TAKE HOME MESSAGE IMPLANTS

- Anatomical Cage: The cage adapts to the patient’s anatomy and

not the reverse (no need to drill the endplates to flatten them –
just remove the cartilagenous layer / save time)
- 3DTi Cage: Biocompatible Material more favorable to fusion than
PEEK that is inert.
- Secured Cage : Stand-Alone indications for multi-level surgeries
- Wide Range: Adaptation to patient anatomies

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 TAKE HOME MESSAGE INSTRUMENTS

A simple and unobstrusive instrumentation for good

visibility in the incision and a safe and reproductible
surgical technique

- Simple and thin Secured Cage Holder : Very good

visibility during the insertion that is safe
- Surgical Technique : simple & reproducible

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Clariance SAS Clariance, Inc.
International Headquarter

18 Rue Robespierre 4809 N Ravenswood Avenue

62217 Beaurains, France Suite 119, Chicago, IL 60640
+33 3 21 16 12 15 +1 773 868 7041
[email protected] [email protected]

www.clariance-spine.com