Content

IntroductionErisma®-LP Evolution is a posterior pedicle screw system designed for stabilizing the thoracic and lumbar spine.

The design team turned its attention to creating a top loading system that combines reduced implant volume with ergonomically designed instruments. Erisma®-LP Evolution has been developed to meet the needs of surgeons and their teams with regard to reliability, safety and ease of use in the course of surgical procedures. Erisma®-LP Evolution offers a comprehensive range intended for the treatment of thoracolumbar disorders. Erisma®-LP Evolution can be combined with Erisma®-Reduction Screw.

Introduction

Benefits & Features

Surgical Technique

Product Catalogue

Indications:Degenerative disordersSpinal deformitiesTumoursTrauma

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CLARIANCE18, Rue Robespierre62217 Beaurains - FRANCETel +33 (0)3 21 16 12 15Fax +33 (0)3 21 15 50 73 0434

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Safe construct The asymmetrical threading of the set

screw is designed to reduce head splay and improves the connection performance of the rod/screw couple.

Comprehensive and ergonomic instrumentsThe Erisma®-LP Evolution system’s intuitive

and ergonomic instrumentation allows surgeons to carry out precise, quick and safe maneuvers.

Benefits & Features

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Comprehensive rangeConsisting of polyaxial screws, rods and crosslinks Erisma®-LP Evolution

offers a wide range of implants allowing the treatment of many indications, while simplifying the surgical procedure.

Polyaxial screw headA screw head angulation of 50° provides great

flexibility in screw positioning and allows quick and easy insertion of the rod.

Pre-bent rods ø 5,5 mm, length 30 mm to 100 mm

Straight rodsø 5,5 mm, length 120 mm to 440 mm

Articulated crosslinks Sizes : S, M, L, XL, XXL

Polyaxial screws

3-Zone Thread improves bone purchase

and ease of insertion.

Cortical Zone

Cancellous Zone

Initiation Zone

Optimized implant volumeA less cumbersome screw head limits

any interference with nearby anatomical structures

Low Profile Head

Friction-fit design Maintains head position

facilitating rod insertion.

Enhanced resistance on flexion Constant external diameter Conical core

4.5mm x 25 - 50mm 5.5mm x 25 - 50mm 6.5mm x 25 - 50mm 7.5mm x 35 - 55mm

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Surgical Technique

A • Pedicle sighting

Pedicle preparationInsertion of pedicle screwsRod preparationRod insertionSet screw insertionCorrection maneuversFinal tighteningCrosslink placementAblation

In accordance with safety procedures in force, the patient is placed in the ventral position on the operating table. The surgical approach is based on the usual techniques used by the surgeon.

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Pedicle preparation1

B • Pedicle drilling and screw selection

C • Pedicle tapping

The pedicle path is carried out using the curved lumbar probe. The markings situated every 10 mm along the probe indicate the pedicle depth and therefore make possible the selection of the appropriate screw length.

The intactness of the pedicle canal is verified by probing the internal walls using the pedicle sounder.

Erisma®-LP Evolution screws are self-tapping and do not require use of a tap. Nevertheless, depending on the surgeon’s usual practice, optional tapping can be performed. The colour code identifies the diameter of the tap for the screw to be inserted.

After exposing the spine, the pedicle entry point is located and prepared by perforating the cortical bone with the bone awl.

99702002 BONE AWL

997014** TAP

99731001CURVED LUMBAR PROBE

99730001PEDICLE SOUNDER

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If necessary, the french bender is used to fit the desired rod contour. The bender of the Erisma®-LP Evolution system offers several bending ranges.

If the screw is over-inserted or insufficiently inserted, its depth can be modified by using the T20 wrench.

Radiological control is carried out to verify the position of the screws in the pedicles.

The screwdriver 18710001 is used for the monoaxial screws.The screwdriver 18710024 is used for the polyaxial screws.

The screw of appropriate diameter and length is selected from the implant set.

Insertion of pedicle screws2

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The Erisma®-LP Evolution system offers a range of pre-bent rods (30mm to 100mm). Longer rods are straight and require bending.

Rod preparation3

The screw is inserted into the pedicle.

The screwdriver is disengaged by unscrewing the upper black tightening wheel while the rotation of the screwdriver is blocked by maintaining the handle.

The screw head positioner is used to orientate and align the screw heads.

18710024SCREWDRIVER

18710001 SCREWDRIVER

18720000T20 WRENCH

18719002SCREW HEAD POSITIONER

99750003FRENCH BENDER

tightening wheel

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B • Rocker

A • Rod pusher

Rod insertion4

The rod is inserted using the straight rod holding forceps.

Erisma®-LP Evolution offers three rod introduction options:

The rod pusher is used to firmly insert the rod in the screw head.

The pongs of the rocker are engaged in the holes located on the external sides of the screw head. The instrument is tipped over to press on the rod such that the rod is positioned into the head of the screw.

99743003 ROD PUSHER

18742005 ROCKER

18742009PERSUADER

C • Persuader

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Insert the instrument over the head of the screw without manipulating the trigger. 1

Turn clockwise the handle to push the rod and position it into the head of the screw. Insert the set screw. 2

Turn counter clockwise the handle (2 turns) and press on the trigger to disconnect the persuader. 3

99715007 STRAIGHT ROD HOLDING

FORCEPS

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B • Compression and distraction

Final tightening7

B • With use of the persuader or the guiding tube

A • Rod rotation

Correction maneuvers 6

The set screw is placed on the snap fit T30 tightening wrench then placed on the screw head and screwed in by engaging the threads.

The rod gripper or the hexagonal wrench can be used to apply a rod rotation movement and restore appropriate curvature along the sagittal plane.

Set screw insertion

A • Without the use of the persuader5

The set screw is placed on the set screw holder then placed on the screw head and screwed in by engaging the threads.

The counter torque is placed on the screw where final locking is carried out. The snap fit T30 tightening wrench connected to the torque limited T handle is inserted into the counter torque until contact with the set screw. Final tightening is carried out.

18714000 SET SCREW HOLDER

01720006 SNAP FIT

T30 TIGHTENING WRENCH

99715011 ROD GRIPPER

18721005 GUIDING TUBE

99740005COMPRESSOR

18721002COUNTER TORQUE

99781212TORQUE LIMITED T HANDLE

99741003DISTRACTOR

Segmental compression or distraction maneuvers can be performed by using the compressor or the distractor.18742009

PERSUADER

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A crosslink can be added to enhance the stability of the construct.

A • Measurement of the crosslink

Using the crosslink holder, the transverse connectors of the crosslink are placed on the rods and the set screws are tightened using the T20 wrench. Once the lateral set screws are locked, the central set screw can then be tightened.

The appropriate size (S, M, L, XL, XXL) is established using the crosslink template. The straight rod holding forceps can be used as gripper for the crosslink template.

Crosslink placement8

B • Positioning of the crosslink

18733001 CROSSLINK TEMPLATE

18720000 T20 WRENCH

99715007 STRAIGHT ROD HOLDING

FORCEPS

18713001 CROSSLINK HOLDER

The surgical technique shown is for illustrative purposes only. The technique actually employed in each case will always depend upon the medical judgment of the surgeon exercised before and during surgery as to the best mode of treatment for each patient. It is recommended to see the package insert for the complete list of indications, warnings, precautions, and other medical information.

Ablation9

If you plan a surgery including the ablation of the Erisma®-LP Evolution system, please contact our customer service. We will provide you a complete kit specially design for the ablation of our products.This kit will be provided non sterile.

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PERSUADER 18742009

GUIDING TUBE 18721005

ROD HOLDING FORCEPS Angled 99715002Straight 99715007

ROD GRIPPER 99715011

ROD PUSHER 99743003

SET SCREW HOLDER 18714000

Product Catalogue

TAP Ø 4,5 MM 99701445 Ø 5,5 MM 99701455 Ø 6,5 MM 99701465 Ø 7,5 MM 99701475

HEXAGONAL WRENCH 99719000

SCREWDRIVER 18710024

SCREW HEAD POSITIONER 18719002 FRENCH BENDER 99750003

SNAP FIT T30 01720006TIGHTENING WRENCH

ROCKER 18742005

BONE AWL 99702002 CURVED PROBE Lumbar 99731001Thoracic 99731002

DOUBLE PEDICLE SOUNDER 99730001

COMPRESSOR 99740005T20 WRENCH 18720000

HANDLES Cylindrical Handle Medium 99782002T Handle 99781001Ratcheting T Handle 99781101Torque Limited T Handle 99781212

DISTRACTOR 99741003

COUNTER TORQUE 18721002

CROSSLINK HOLDER 18713001

CROSSLINK TEMPLATE 18733001

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POLYAXIAL SCREWS L. (MM) Ø4,5 Ø5,5 Ø6,5 Ø7,5 25 18154525 18155525 18156525* _

30 18154530 18155530 18156530 _

35 18154535 18155535 18156535 18157535 40 18154540 18155540 18156540 18157540 45 18154545* 18155545 18156545 18157545 50 18154550* 18155550* 18156550 18157550 55 _ _ _ 18157555*

* Available upon special request

STRAIGHT RODS L. 120 MM 18455512 L. 140 MM 18455514 L. 160 MM 18455516L. 180 MM 18455518L. 200 MM 18455520L. 220 MM 18455522L. 240 MM 18455524L. 400 MM 18455540L. 440 MM 18455544

ARTICULATED CROSSLINK S (27-31 MM) 18442731M (30-37 MM) 18443037L (35-47 MM) 18443547XL (45-67 MM) 18444567XXL (58-93 MM) 18445893

PRE-BENT RODS L. 30 MM 18505030L. 35 MM 18505035 L. 40 MM 18505040L. 45 MM 18505045L. 50 MM 18505050L. 60 MM 18505060L. 70 MM 18505070L. 80 MM 18505080L. 90 MM 18505090L. 100 MM 18505100

SET SCREW 13620009

INSTRUMENTS TRAY #1 18991012LID FOR INSTRUMENTS TRAY 18991005

INSTRUMENTS TRAY #2 18991013INSTRUMENTS TRAY #3 18991014

IMPLANTS TRAYS 18991024LID FOR IMPLANTS TRAYS 18991004SCREW RACK 18991026CROSSLINK TRAY 18991006/1

STRAIGHT PROBE Lumbar 99731004Thoracic 99731003

BONE AWL 99702005 PEDICLE SOUNDER 99730000

SCREWDRIVER 18710001 CYLINDRICAL HANDLE LARGE 99782003SCREWDRIVER 18710026

Product Catalogue (optional)*

* Available upon special request

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