Written Exam Study Guide Flashcards
What are three different physician customer segments that IVS serves?
Hospitals, Surgery Centers, Pain Clinics
What is the difference between Stryker Spine and Stryker IVS?
Stryker Spine focuses on hospitals, and are generally invasive procedures to correct deformities, perform discectomies, and to perform spinal fusions. IVS utilizes percutaneous approaches for vertebral augmentation and pain management procedures
What city are IVS Marketing and R&D located in?
Kalamazoo, MI
What are the two types of tips for access needles?
Diamond and Bevel
Where on the implant does cement exit from a spinejack?
Cement exits from ports on the center hub of the implant.
What are the different volumes for the 4.2, 5.0, and 5.8 cement pushers/injector transfer tubes?
4.2mm = .9cc, 5.0&5.8mm = 1.8cc
What two spinejack sizes utilize the same cement injection tools?
5.0mm and 5.8mm
Why is it recommended to pause periodically as you expand SJ implants?
To allow anatomy to adjust
Can you retract/close a SJ after you have opened it?
No
How many radiopaque markers are there on a SJ cannula plug and where is it?
One marker on the distal tip
What tool(s) in a SJ prep it the same length as the corresponding size SJ implant?
Each implant matches the corresponding reamer and template size for each kit
What two items must be reassembled prior to accessing the second implant side in a SJ procedure?
- Access cannula and stylet
- Reamer into the second working cannula, ensuring that the reamer is cleared with the guidewire
What is the minimum depth the reamer should be advanced to ensure unobstructed opening of a SJ implant?
Ream until the entire fluting of reamer is inside the vertebral body
What is a risk of adjusting the SJ trajectory if the guidewire is still in the vertebral body?
Bending the guidewire making it difficult to remove
When is it appropriate to remove the guidewire in a SJ reamer?
Once the reamer has advanced into the V.B., the guidewire can be removed. This makes it easier to adjust trajectory of reamer without bending guidewire.
What is the risk to the physician with the guidewire/reamer when advancing the reamer during the SJ procedure?
The guidewire will begin to protrude out of the handle of the reamer as it is advanced. If unaware, the guidewire can puncture the physician’s glove, compromising the sterile field.
What is a potential risk with the guidewire when removing the access cannula during the SJ procedure?
- Anterior wall perforation by accidentally advancing the guidewire during removal
- Accidentally removing the guidewire with the cannula
How far should the guidewire be advanced into the V.B. in a SJ procedure?
Halfway into the V.B
What is the recommended depth to stop advancing the access cannula in a SJ procedure?
Posterior 1/3 of V.B
How does the trajectory of a SJ cannula placement differ from balloon access cannula?
Trajectory is parallel to the target endplate, with a more lateral approach.
What are the associated colors and sizes of the 3 different SJ implants?
- 2mm = Yellow
- 0mm = Blue
- 8mm = Green
What are the three functions of the cannula plug in a SJ procedure?
- Stabilizes working cannula
- Stops bleeding through cannula
- Radiopaque marker at distal tip shows depth of first site
What are 2 functions of template in SJ procedure
- Smooths out implant site
- Confirms final implant size and location
What items are needed for a SJ procedure that are not included in the prep kit and implant boxes?
- Access needles
- Cement
- Cement Pushers
How much cement per full turn of PCD?
.4cc’s
How do you stop the flow of cement on a PCD mixer?
Turn outer body back 1/2 turn
How much deliverable cement does PCD make?
10cc’s
Where does the PCD plunger need to be before you disconnect the handle?
Plunder needs to be at the top of the chamber on the mixing unit. Disconnect by pressing and rotating blade release tab.
What is the proper technique for the PCD mixer to mix the cement?
push and twist for one minute
What is the working time for Vertaplex?
20 minutes
What is the working time for Vertaplex HV?
18 minutes
If an MG2 channel is reading an impedance of 100ohms, what might that suggest
That you are in fatty tissue, and you are not on the intended location
When conducting motor testing, what should you not see with the patient?
twitching or movement
Describe how a bi-polar lesion is formed differently than a monopolar lesion
- Bipolar lesions do not need a grounding pad, since the second needle completes the circuit. Forms a larger lesion
- Monopolar lesions need a grounding pad to complete the circuit, and forms a smaller lesion.
What is the recommended voltage range for RF sensory testing?
0.5V to 1.5V
Why might a physician skip sensory testing and go right to motor testing?
Experience/confidence and speed/efficiency
If a physician is using a venom needle and electrode, but wanted to do a standard lesion, what is the easiest solution?
Rotate the hub of the needle to the “Standard” marking, which prevents the electrode from exiting the side port.
How many sterilization cycles are Stryker electrodes rated for?
520 cycles
What are the four electrode lengths and their corresponding colors?
- 50mm = blue
- 100mm = red
- 150mm = yellow
- 200mm = Green
What are two distinguishing features of a 100mm venom probe/electode?
- Red hub
- Signature V
- White cable
What are two ways to know that a probe/electrode is a standard probe?
- black cable
- black hub
- straight electrode
- no signature V
How many total watts of power are most competitive RF generators?
50 watts
How many watts of power total and per channel does MG2 have?
100 watts total, 25watts/channel
How does a grounding pad work and what is it’s purpose?
- A grounding pad completes the electrical circuit, allowing the electricity to return to the generator
- helps control impedance and ensures frequency will be transmitted to correct treatment level
What is the function of the syringe in an iVAS Elite kit?
To prepare the balloon for introduction by removing the air from the balloon, creating a vacuum.
What is the max pressure of iVAS Elite balloons?
808 psi
What allows a balloon to be visible under fluoroscopy?
-Radiopaque markers at distal and proximal tips of balloon.
What are the fill volumes of each size of iVAS Elite balloon?
- 10mm = 4cc
- 15mm = 5cc
- 20mm = 6cc
What gauge sizes are offered for iVAS Elite?
- 8g
- 10g
- 11g
How far do you drill in the lateral view for a kypho?
Anterior 1/3
What is an optional part of a VCF procedure after placing the access cannula but before drilling?
Bone Biopsy
What are the exact differences between iVAS Elite uni and bipedicular kits?
- Bipedicular kit comes with a hand drill
- Unipedicular kit only comes with contents for one side, so 1 balloon, 1 inflator, and 1 access cannula while the bipedicular kit comes with 2 of each.
Can you “direct inject” with Cortoss?
No, verteport required
How many tips does a cortoss kit come with?
3
Why do you have to pull the trigger until material comes out of each side before attaching the tip with cortoss?
To ensure an even mix of the two components. It is common for one side to be expressed before the other.
What are the different handle colors and directional arrows on AVAflex products?
- All Green: curved introducer with PEEK sheath
- Green and white: curved needle for cement introduction
- Arrow indicates the direction of the curve of the instrument
What is the function of the “one-way valve” in the AVAflex kit?
Maintains the pressure of the balloon
What is the max pressure of an AVAflex balloon?
400 psi
What are the balloon fill volumes for 11g AVAflex balloons?
- 15mm = 3cc
- 20mm = 4cc
- 30mm = 6cc
What are the balloon fill volumes for 10g AVAflex balloons?
- 15mm = 4cc
- 20mm = 6cc
- 30mm = 8cc
What substance goes into the balloon inflators for AVAflex and iVAS elite?
Contrast Medium
How do you troubleshoot if an AVAflex sheath is left behind in a patient due to shearing/breakage?
Remove inner stylet/curved introducer, then the sheath. It is ok to leave a portion of PEEK sheath in the body.
What are the AVAflex components made out of?
- Curved introducer: nitinol
- Sheath = PEEK = Polyether Ether Ketone
Why must you not remove the curved needle and sheath at the same time in AVAflex
- Do not remove the needle and sheath at the same time, since the balloon uses the sheath as a path to desired location
- Removing both at the same time can result in the PEEK sheath shearing off and remaining in the body.
How many cc’s of deliverable cement per turn of an Autoplex handle?
5cc’s/360 degree rotation
How do you slop the flow of cement with autoplex?
half turn counterclockwise
How much deliverable cement total does an autoplex create?
10-12 cc’s
How long does an autoplex take to mix cement?
60 seconds
What denotes touch points on autoplex?
All touch points are blue
How do you know if the lid is secured correctly on autoplex?
There is an audible click once lid is secured correctly.
What are the working times and viscosity of Stryker cements?
- Spineplex: 11 minute working time/56 pascals
- Vertaplex: 20 minute working time/ 160 pascals
- Vertaplex HV: 18 minutes working time/ 830 pascals
What substance makes cement visible under X-ray?
Barium Sulfate, 30%
