hofer-medical.com HISS - HOFER IMPROVED SPINE SYSTEM

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Implant Specific InformationHISS - Cage cervicalIndicationsMultisegmental cervical interbody fusion to treat disc related disorders• Degenerative spinal disorders• Instability• Unsuccessful spondylolisthesisAdditional instrumentation has to be considered according to the situation.Contra Indications• Active systemic infections or local infections around the implantation area• Allergies or contaminant reactions caused by one of the implant materials• Severe osteoporosis• Instable burst or compression fractures• Overweight, osteopenia or degenerative disorders• Destructive tumors• Limiting, since the probability for fusion can be reduced: Radiation- or chemotherapy,renal dialysis• Limiting due to a possible overload leading to a potential implant failure: Toohigh level of activity, limited mental abilities, mental disorders, alcoholism, drugabuse, non-compliance of post-operative instructionsPosition of Patient and ApproachesPatient Positioning:• StandardApproach:• StandardImplant Specific Details• 3 sizes in 1 mm steps for an optimal disc height and lordosis restoration• Toothed upper and lower side for reducing implant migration• Smooth edges• Radiolucent cage material for bone formation determination• X-ray markers for determination of implant position• Large central compartment for bone materialX-Ray markersMarks pointing in cranial directionCage size refers to the height of the frontal wallHISS-CC-ST-3
Surgical Technique - Preparation, Implant Size Determination4 - Implantation of the HISS Cage cervicalPreparatory measures for the use of HOFER implants require a preparation as thorough as possible of theoperation field. Nearby nerve fibers and blood vessels require a special caution.4.1 - Preparation and Implant Size Determination4.1.1 - Preparation of Implant Location: Preparation of Disc and EndplatesDistraction may be necessary for a proper access to ensure a thorough discectomy.For a thorough discectomy the application of currettes and rongeurs is recommended. In addition, to remove remainingcartilage and disc material from the bony endplates, a rasp can be used carefully.IMPORTANT: The integrity of the endplates has to be maintained.4.1.2 - Segment DistractionFurther distraction of the disc space prior to cage insertion is achieved by an appropriate distraction set-up.IMPORTANT: An already correct alignment of the segments has to be considered at this stage since the cage size is determinedwithin the next steps.4.1.3 - Determination of Implant SizePrior to the insertion of the implant the required cage size can be determined and verified by a define cage. The definecages are available in the same sizes and variants as the implants.IMPORTANT: The define cages have smooth surfaces and are made of steel. These define cages are not for implantationand have to be removed again!NOTE: The concave endplate shape of the inferior vertebra is considered by the convex upper side of the define cages andcages. Therefore, the total height of the define cages and implantable cages is approximately 1 mm higher than as referedto. For more information refer to the implant specific details on the previous page.Fig. 1: Determination of implant size with define cageHISS-CC-ST-4.1
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Page 5: IntroductionAll implants for cervic
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hofer-medical.com HISS - HOFER IMPROVED SPINE SYSTEM

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