Spine 301
Direct Look allows for visualization of:
Cutaneous Nerves
Psoas Muscle
Lumbar Plexus
All of the above
Direct Look should not be used at L4-5 due to the more anterior location of the neural elements within the retro peritoneal space, as well as the anterior location of the psoas muscle and lumbar plexus.
True
False
When closing the abdominis muscles, be sure to close all three layers (external oblique, internal oblique, and transverses abdominis) so to avoid ar abdominal hernia
True
False
Before dissecting through the psoas, you should first:
Use neuromonitoring to check for nerves
Insert Cannula A
Release the psoas fascia
Locate the genitofemoral nerve
All are advantages of direct visualization except for:
May help reduce iatrogenic nerve damage
Allows for more accurate navigation of the surgical corridor
Decreased reliance on neuromonitoring
Allows for better discectomy
More accurate navigation of the retroperitoneal surgical corridor may help to avoid areas that neuromonitoring cannot detect, such as the kidneys, bowels, and organs of the peritoneum, potentially preventing major complications.
True
False
The iliohypogastric and ilioinguinal nerves are located in the:
Peritoneum
Abdominis Muscles
Retroperitoneum
Psoas Muscle
Anatomic safe zones are always reliable, as the lumbar plexus remains static even with movement of the patient's lower extremities.
True
False
Neural complications of the LLIF procedure may be cause by:
Blindly dilating through the psoas muscle
Inaccuracy and overreliance on neuromonitoring
Prolonged retraction time on psoas muscle
All of the above
Incomplete release of the psoas fascia can increase intraneural strain within the femoral nerve and its branches from the tension generated on the psoas fascia by the pull of the retractor.
True
False
The MARS' 3VL blade lengths range from:
60-210mm
60-190mm
40-200mm
50-200mm
Which of these is a selling feature of MARS™ 3VL? Select all that apply.
22mm ID split tube
13mm starting ID
One docking point
Independent Blade Retraction
How far into the disc space does the Anchor Blade sit?
15mm
22mm
25mm
None of the above
Cannulas A, B, C, and D are used with the three bladed retractor.
True
False
How far into the disc space does the Disc Shim sit?
15mm
22mm
25mm
None of the above
Extra long docking pins can be used with blades lengths 40-200mm
True
False
The MARS' Midline Retractor blade lengths range from:
50-110mm
40-120mm
50-120mm
40-100mm
Which of these is a selling feature of the MARS™ Midline Retractor?
In-line blade connection
Pivoting arms to conform to patient anatomy
Blades attach at any initial angle
Low-profile light source
All of the above
To ensure proper attachment of the blades to the blade handles, you should pinch and hold the silver fork onto the blade prior to tightening don on the gold knob?
True
False
To verify that the blades are securely attached to the retractor you should check the following?
Check the spacing between the blade and retractor
Ensure the black tabs are depressed
Check that the silver blade release button is in the elevated position
None of the above
Both 1 and 3
To reengage the retractor arm ratcheting mechanism and prevent the arms from collapsing inward you should do the following?
Press the black tabs on the retractor
Press the silver buttons on the retractor
Rotate the gold hex nuts
None of the above
How much blade angulation does the MARS™ Midline Retractor offer?
30°
Infinite in both directions
15'
None of the above
CALIBER-L spacers are available in a Coronal Tapered footprint.
True
False
The CALIBER-L spacers have an automatic locking feature, this no extra locking step.
True
False
Globus Biomechanical testing for CALIBER- demonstrated times the pullout resistance when compared to a traditional static spacer.
7.7
5.8
9.5
10.2
What are the 3 sagittal profiles with Caliber-L?
4, 8, 12 degrees
6,10, 12 degrees
0, 6, 10 degrees
0, 4, 10 degrees
The 3 height ranges for Parallel Caliber-L spacers are
8-11 mm. 9-13 mm. 11-16 mm
7-10 mm, 9-13 mm, 11-16 mm
7-11 mm, 9-13 mm, 11-16 mm
7-10 mm, 9-12 mm, 11-17 mm
CALIBER- is FDA cleared for what levels of the spine?
T12-S1
T12-L5
L2-S1
L1-51
Globus's market position for the 3 key features with the CALIBER-L expandable spacers are,_________ impaction, ________ distraction, ________ expansion.
Minimized, incredible, continuous
Minimized, continuous, controlled
Maximized, controlled, ultimate
Minimized, controlled, continuous
What are the smallest heights of Caliber- 16 mm wide spacers?
7mm
5mm
6mm
8mm
The Caliber- spacers have the following widths:
16, 18, 22, 26 mm
18. 22 mm only
18,20, 22, 26 mm
16,18, 22 mm
The 3 height ranges for Lordotic Caliber-L spacers are:
7-11 mm w/6° lordosis, 10-13mm w/10° lordosis, 12-18mm w/10° lordosis
7-11 mm w/ 6° lordosis, 10-13 mm w/ 10° lordosis, 12-17 mm w/ 10° lordosis
8-11 mm w/ 10° lordosis, 10-13 mm w/ 10° lordosis, 12-17 mm w/ 10° lordosis
8-11mm w/ 6° lordosis, 10-13mm w/10° lordosis, 12-17mm w/10° lordosis
InterContinental comes in the following widths:
20 & 22mm
20mm
18mm
18 & 22mm
Intercontinental plates have torsional stabilizers.
True
False
The InterContinental locking set screw provides the surgeon with confident blocking by:
Having a tactile confirmation only
Having a tactile and visual confirmation only
Having a tactile, audible, and visual confirmation
Having an audible and visual confirmation only
InterContinental screws are Hydroxyapatite (HA) coated Lag Screws?
True
False
How should the awl be positioned for the INTERCONTINENTAL™ procedure?
With the flat on the upper end of the awl facing away from the endplate to be prepared
With the flat on the upper end of the awl facing the endplate to be prepared
Away from the endplates
Any direction
What is the recommended length of screws to use for INTERCONTINENTAL™?
(a) Surgeon preference, but typically 10mm less than length of INTERCONTINENTAL™ plate-spacer construct
(b) 10mm more than the length of the INTERCONTINENTAL' plate-spacer construct
(c) Whatever length it takes to go bi-cortical
A
B
C
A and B
A and C
On InterContinental, the color purple on trials, spacers and plate denotes what?
10 degrees lordotic
6 degrees lordotic
Parallel
Coronal Tapered
On INTERCONTINENTAL™, what do you look for while assembling the plate and spacer? (a) "A" on plate eyebrow on same side of "ANTERIOR" on spacer
(b) Lordotic plate matches Lordotic spacer
(c) Height of spacer matches height of plate
A
B
C
A and C
A, B, and C
Which of the following is true for INTERCONTINENTAL™?
(a) FDA cleared as a stand-alone device
(b) FDA cleared using supplemental fixation
(c) FDA cleared for one or two contiguous levels
A
B
B and C
A and B
The TransContinental spacer system offers implants ranging in height from:
6-18mm
8-16mm
7-17mm
7-21mm
The TransContinental spacer is intended to be used with supplemental fixation.
True
False
The TransContinental spacers have the following widths:
18, 20, 22mm only
16, 18, 20, 22, 26mm
16, 18, 22, 26, 30mm
18, 22mm only
TransContinental is FDA cleared for what levels of the spine?
L1-51
T12-51
T12-15
T1-S1
The TransContinental Coronal Tapered Spacers have a 4 degree profile.
True
False
What should be the final position of the TRANSCONTINENTAL® spacer?
(a) Bulleted shaped tip should overhang contralateral apophyseal ring
(b) Middle radiographic markers should align with spinous process
(c) Bulleted tip should only extend to the apophyseal ring
A
B
C
A and B
A and C
How many mm's is the anterior radiographic marker from the anterior edge of TransContinental implant?
2.25mm
3.25
3mm
5mm
Based on the image, what size TransContinental implant would you suggest to your surgeon?
55mm
40mm
35mm
45mm
50mm
What are the four sagittal profiles with TransContinental?
0, 4, 10, 12 degrees
4, 8, 12, 15 degrees
0, 6, 9, 12 degrees
0, 6, 10, 15 degrees
What are the three major benefits of RISE-L?
Minimized insertion height, 7mm expansion, bone graft delivery port
Titanium body, large graft chamber, threaded inserter connection
Minimized impactin, maximized indirect decompression, optimized fusion potential
What widths is RISE-L offered in?
16mm and 18mm
20mm
18mm and 22mm
In the study assessing the trialing and impaction of a static lateral cage compared to insertion of an expandable lateral cage, the expandable group exhibited a _ increase in endplate strength compared to the static group.
25%
30%
5%
69%
The adjustable trial can be left in the disc space while prepping the implant to help prepare the ligaments and mobilize the disc space.
True
False
What steps help ensure the implant expansion feature will perform at its best?
Complete a thorough discectomy
Always expand until the driver torques out
Use the adjustable trial
All of the above
1 and 3
ELSA is intended for use as a standalone device and does not require supplemental fixation.
True
False
ELSA is approved for use with both autograft and allogenic bone graft.
True
False
ELSA is available in all of the following sagittal profiles except for:
0°
15°-30°
5°_15°
6°
ELSA is available in both 18mm and 20mm widths.
True
False
Which of the following is NOT true regarding the ELSA" system:
INDEPENDENCE bone screws can be used with ELSA™
ELSA' provides up to 15° of adjustable lordosis™
HA coated screws are additionally available
ELSA" does not have the ability to be backfilled
Which side of the patient does the surgeon stand on when doing an ATP approach?
Anterior side of the patient
Posterior side of the patient
All of the following are benefits of the ATP approach EXCEPT:
Less risk of complications surrounding the lumbar plexus
Reduced reliance on neuromonitoring
Avoid dissection of external oblique, internal gblique as well as transverse abdominus muscles
Less psoas retraction
The ELSA ATP system offers inserters for RISE-L, ELSA ATP, and TransContinental that are angled for the ATP approach.
True
False
The vessels are further away when doing an ATP approach when compared to a Direct Lateral Approach
True
False
ATP at L4-L5 is the same procedure and involves the same technique and anatomy as the oblique L5-S1 approach.
True
False
PLYMOUTH is intended for use at what levels in the spine?
T1-L1
T12-L5
T12-51
T1-L5
How many degrees are the fixed angle screws at the cephalad/caudal pre-set trajectory?
8
10
5
9
The variable angle screws allow for +/- how many degrees of angulation?
8
10
12
14
Which Anchor would be used for PLYMOUTH when used with CALIBER-L
Black (left)
Gold (right)
What is the PLYMOUTH plate profile?
4.5mm
3.5mm
3.0mm
4.0mm
What is the shortest length bone screw available with PLYMOUTH?
22mm
19mm
21mm
20mm
How many degrees are the fixed angle screws at the cephalad/caudal pre-set trajectory?
8
5
6
7
Which screw is the variable angle option?
0%
0
0%
0
Which plate is the L4/L5 plate?
0%
0
0%
0
0%
0
Plate sizes are measured from end to end.
True
False
The offset Keying Tool is compatible with CALIBER-L
True
False
CORBEL is available in which lordotic options?
0, 6, 5-20, and, 15-30
8, 15, 20, and 30
0, 6, 12, and 15
8, 20, 25, and 30
CORBEL is available in what footprints? (Select all that applv)
24x30
Regardless to which MARS Lateral ALIF retractor configuration a surgeon is using, the retractor blade will always be in the following locations?
Lateral
Medial
Cranial
All of the above
Which of the following are potential benefits with a Lateral ALIF approach
Efficient mult-level surgery
May reduce surgical time by eliminating the need to reposition the patient
Streamlined workflow
Increased Operating Room efficiency
CORBEL and the MARS Lateral ALIF are Globus' solution for surgeons performing lateral position surgery at L5-S1, and are a major components of our Excelsius Lateral 360 single position procedural solution.
True
False
The CORBEL Lateral ALIF system features instruments offset at what angle from the patients' midline?
5
10
15
25
The CORBEL spacer is compatible with both ALIF screws and anchors.
True
False
CORBEL is a smooth titanium implant because this is preferable to PEEK.
True
False
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