ECD Expandable Corpectomy Device. Continuously Expandable Vertebral Body Replacement for Tumour Cases.Technique GuideSynthes1WarningThis description is not sufficient for immediate application of the instrumentation. Instruction by a surgeon experienced in handling this instrumentation is highly recommended.Cleaning of instruments For detailed information please refer to Reprocessing, Care and Maintenance of Synthes Instruments“, Article No. 035.000.090.Table of ContentsImage intensifier controlIntroductionProduct InformationSurgical TechniqueOverview2AO ASIF Principles 4Indications and Contraindications5Implants/Set6Instruments 7Preoperative Planning 8Patient Positioning and Approach 9Surgical Technique102SynthesECD - Expandable Corpectomy Device Technique GuideECD Expandable Corpectomy Device. Continuously Expandable Vertebral Body Replacement for Tumour Cases. ECD is a vertebral body replacement for the cervical and upper thoracic spine. Its expansion mechanism allows smooth, continuous expansion in situ. Radiolucent PEEK implants with different heights and endplate angulations enable the surgeon to choose the specific configuration suited to the individual pathology and anatomical condition.ECD Expandable Corpectomy DeviceFast surgical procedure Only one instrument for holding and expanding the implantSynthes3Compatible with proven Synthes productsAnatomical shaped endplatesCervical Retractor System enables a clear layout of the operative fieldCervical Spine Locking Plates (CSLP) for rigid anterior fixationAxon for posterior fixationVectra/Vectra-T for dynamic anterior fixationElectric/Air Pen Drive facilitates bone removalContinuous expansion mechanism, expandable in situ Locking clip, secures the expanded implant to prevent micro movementsVectraVectra-TCSLP ClassicCSLP NarrowCSLP Variable Angle4SynthesECD - Expandable Corpectomy Device Technique GuideAO ASIF PrinciplesAO ASIF Principles of internal fixationIn 1958 the AO ASIF (Association for the Study of Internal Fixation) formulated four basic principles1, which have be- come the guidelines for internal fixation. They are Anatomical reduction Stable internal fixation Preservation of blood supply Early, active, pain-free mobilizationThe fundamental aims of fracture treatment in the limbs and fusion of the spine are the same. A specific objective in the spine is returning as much function as possible to the injured neural elements.2AO ASIF Principles as applied to the spine2Anatomical reduction Restoration of normal spinal alignment to improve the biomechanics of the spine.Stable internal fixation Stabilization of the spinal segment to promote bony fusion.Preservation of blood supply Creation of an optimal environment for fusion.Early, pain-free mobilization Minimization of damage to the spinal vasculature, dura, and neural elements, which may contribute to pain reduction and improved function for the patient.1. M.E. Mller, M. Allgwer, R. Schneider, and R. Willenegger: AO Manual of Internal Fixation, 3rd Edition. Berlin; Springer-Verlag. 1991. 2. M. Aebi, J.S. Thalgott, and J.K. Webb. AO ASIF Principles in Spine Surgery. Berlin; Springer-Verlag. 1998.Synthes5Indications and ContraindicationsECD is a vertebral body replacement for the stabilization of the cervical (C3 to C7) and upper thoracic (T1 to T2) spine.Depending on anatomical and pathological requirements, ECD can be used in the replacement of one, two or three adjacent vertebral bodies.Indications Primary or secondary tumours of the cervical or upper thoracic spine.Note: Always combine ECD with an additional, stable internal anterior, posterior or a combined (anterior/posterior) fixation system to bear tensile forces as well as torsion, flexion and extension moments.Contraindications Severe osteoporosis Reconstruction of more than three adjacent vertebral bodies6SynthesECD - Expandable Corpectomy Device Technique GuideImplants/SetECD Expandable Corpectomy Device, PEEK, sterile Various endplate angles and heights Overlapping sizes Radiolucent material (PEEK)Art. NoHeightAngle891.300S1722 mm4.5891.301S2027 mm4.5891.302S2433 mm6891.303S3039 mm6891.304S3647 mm7891.305S4359 mm7891.306S5470 mm7ImplantsSet687.005Vario Case for ECD, with lid, without contentsECD Locking Clip, PEEK, sterile Secures the expanded implant to prevent micro movementsArt. No.890.005SECD Locking ClipSynthes7Instruments397.127Holding and Distraction Instrument, for ECD397.129Holder for ECD Locking Clip324.060Calliper for Corpectomy, shortX000012X-Ray Template for ECD in PEEK8SynthesECD - Expandable Corpectomy Device Technique GuidePreoperative Planning 1Estimate implant heightRequired instrumentsX000012X-Ray Template for ECD in PEEKThe X-Ray Template may be used to estimate the implant height. Place the template on the AP or lateral X-ray of the vertebrae to be bridged. Use the adjacent endplates as measuring points. Select the appropriate implant.Synthes9Patient Positioning and