Must LT

Surgical Technique
Joint Spine Sports Med

M.U.S.T.® LT System Surgical Technique
2
TABLE OF CONTENTS
1. INTRODUCTION 4
1.1 Indications 5
1.2 Contraindications 5
1.3 Pre-operative Planning 5
2. SCREW PREPAR ATION AND INSERTION 6

2.1 Pedicle Preparation 6
2.2 Dilation and Tapping 7
2.3 Implant Selection 8
2.4 Screw Insertion - Quick Screwdriver 9
2.5 Screw Insertion - Modular Screwdriver 11
2.6 Screw Adjustment 13
3. ROD INSERTION AND REDUCTION 14

3.1 Rod Sizing 14
3.2 Rod Preparation 15
3.3 Rod Insertion 16
3.4 Rod Reduction and Temporary Locking 16
3.5 Extra Reduction 17
4. COMPRESSION/DISTR ACTION AND TIGHTENING 18

4.1 Compression/Distraction 18
4.2 Final Tightening 19
4.3 Tab Removal 20
5. REVISION PROCEDURES 21
6. IMPL ANT NOMENCL ATURE 22
3
1. INTRODUCTION
The Medacta M.U.S.T. LT system is a sub-family of the

M.U.S.T. system designed to provide a minimally invasive
• The tab length is 110mm for the Short Tab design,
150mm for the Long Tab design;
solution for spinal thoracolumbar fixation. The system
offers several advantages for patients including smaller • 15mm or 25mm reduction thread for each design (Short
or Long);
• The
incisions, minimal muscle resection, reduction of blood
loss and post-operative pain, precision and efficiency in the screw can be cannulated and cannulated with
pedicle screw placement. fenestration;
The M.U.S.T. LT implant is composed of the pedicle screw • Red plastic cap sleeve for Short design, White for Long
design. The plastic cap sleeve design does not change
with welded tab, the set screw and the removable plastic between Short and Long design.
sleeve. Different options are available:
Removable plastic sleeves

ease surgical steps.
Screw diameter and Tab

reduction capacity (15 or 25mm)
are marked on the implant.
Long 150mm
Short: 110mm
15 mm 25 mm
reduction reduction
Laser markings indicate

depth levels
Ti-alloy Pedicle Screw and

Set Screw
Short Tab Long Tab Cannulated 1.75mm screws

compatible with 1.5mm K-wire
1.
Short and long tab implants are compatible with short or Colour code for implants and instruments
long instruments respectively, colour code and the marking
on the instruments allow for easy identification of the
correct matching. Short design
Long design
4
The M.U.S.T. LT system includes MIS Rods with bullet nose 1.2 CONTRAINDICATIONS
profile to ease the navigation through soft tissues while the
hexagonal interface allows for the secure connection with The use of the M.U.S.T. Pedicle Screw System is
the inserter. contraindicated in the following cases:
The MIS Rods are available in different designs: • Active infectious process or significant risk of infection
(immunocompromised hosts).
• Straight Rods • Signs of local inflammation.
• Bent Rods, with standard pre-lordosis curvature (R200) • Fever or leukocytosis.
• Bent Rods R100, with increased lordosis to treat the
• Morbid obesity.
• Mental illness.
short lumbar tracts
• Dual Bent Rods, with an enhanced proximal lordosis to

match the sacrum and a standard distal curvature to • Grossly distorted anatomy caused by congenital
treat the lumbar spine abnormalities.
• Any other medical or surgical condition which would

preclude the potential benefit of spinal implant surgery,
such as the presence of congenital abnormalities,
elevation of sedimentation rate unexplained by other
diseases, elevation of white blood count (WBC), or a
marked left shift in the WBC differential count.
• Suspected or documented metal allergy or intolerance.

• Any case not needing a bone graft and fusion.
• Any case where the implant components selected
for use would be too large or too small to achieve a
successful result.
• Any patient having inadequate tissue coverage over the

operative site or inadequate bone stock or quality.
• Any patient in which implant utilisation would interfere

with anatomical structures or expected physiological
performance. Any patient is unwilling to follow
postoperative instructions.
• Any case not described in the indications.

2.
1.3 PRE-OPERATIVE PLANNING
Review the MRI and/or CT based imaging to check and
1.1 INDICATIONS
determine the type/size of the implants to be used.
The M.U.S.T. Pedicle Screw System is intended for posterior Matching the patient’s anatomy is a critical step in the
non-cervical pedicle fixation (T1-S2/ilium) or anterolateral preoperative planning before each surgery.
fixation (T8-L5). These devices are indicated as an adjunct
to fusion for all of the following indications: degenerative
disc disease (defined as back pain of discogenic origin with
degeneration of the disc confirmed by history and
radiographic studies); spondylolisthesis; trauma (i.e.,
fracture or dislocation); spinal stenosis; curvatures (i.e.,
scoliosis, kyphosis, and/or lordosis); tumour;
pseudoarthrosis and failed previous fusion in skeletally
mature patients. When used for posterior non-cervical
pedicle screw fixation in pediatric patients, the Medacta
Pedicle screw system implants are indicated as an adjunct
to fusion to treat adolescent idiopathic scoliosis. The
system is intended to be used with autograft and/or
allograft. Pediatric applications are limited to a posterior
approach.
5
2. SCREW PREPAR ATION AND INSERTION
The patient should be positioned prone lying face down on

a radiolucent table. Perform a posterior incision through
the skin and fascia approximately 2 - 4 cm from the midline
to allow for muscle splitting along the multifidus and
longissimus plane.
2.1 PEDICLE PREPARATION

Insert the inner pin into the pedicle awl.
5.
3.
Target the pedicle and perforate the outer cortex with the
Cannulated Awl.
6.
Remove the Cannulated Awl.

Carefully hold the K-wire in place to ensure that the pedicle
entry point for screw placement is maintained.
4.
WARNING
Control the K-Wire position under radiographic imaging and
WARNING make sure it does not slip off during the procedure.
Confirm the pedicle anatomical positioning with
radiographic imaging. Markings on the wire designate 5mm increments and can
be used to check the penetration depth.
Remove the inner pin from the Cannulated Awl and insert
the K-wire. NOTE
A Jamshidi Needle can be used as an alternative to access
the pedicle and K-Wire guiding.
6
2.2 DILATION AND TAPPING
Insert the Depth Gauge over the K-wire. Further, advance
the K-wire if needed.
7.
9.
NOTE
The Depth Gauge shows the depth of the K-wire tip starting NOTE
from the pedicle entry point. The M.U.S.T. LT screws are self-tapping, but the use of Taps
Continue dilation by placing the blue dilator Ø14.0mm until is highly recommended for sclerotic bones and screws with
it is in contact with the lamina. a diameter larger than 6mm.
The blue dilator Ø14.0mm is the reference for the tap depth. Continue dilation by inserting the Ø18.6mm dilator onto the
blue Ø14.0mm dilator. Two Ø18.6mm dilators are available:
the red dilator, 70mm long, and the white dilator 110mm long.
8.
Insert the cannulated tap over the K-wire and tap the
pedicle.
10.
7
NOTE 2.3 IMPLANT SELECTION

Due to the different length, the red Ø18.6mm dilator is
compatible with Short M.U.S.T. LT implants, while the white The M.U.S.T. LT implants, independently from the length of
Ø18.6mm dilator is compatible with long M.U.S.T. LT the Tab, may be reduced 15mm or 25mm, based on the
implants. length of the internal thread selected.
Remove the blue Ø14.0mm dilator.

Carefully hold the K-wire in place, in order to ensure that the
pedicle entry point for screw placement is maintained.
Keep the red or white Ø18.6mm dilator in position to allow
for the M.U.S.T. LT implant insertion.
15 mm thread 25 mm thread
13.
The reduction capacity is marked on the tab.

A double black line is also marked when the reduction
capacity is 25mm, while the implants with reduction
capacity of 15mm have no markings.
11.
15 mm thread 25 mm thread
14.
12.
Select the desired combination of implants according to
the amount of reduction to be performed.
8
2.4 SCREW INSERTION - QUICK SCREWDRIVER Push and rotate clockwise the proximal thumbwheel of the
screwdriver to slide the pin laterally until the mechanical
Open the M.U.S.T. LT implant and accommodate it into the stop is reached.
loading station before coupling it with the Quick Screwdriver.
The Quick Screwdriver is available in a Short and a Long
version. The colour code and the marking help distinguish
between the two versions. Use the Short or the Long Quick
Screwdriver according to the implant selected.
17.
Release the pressure. The spring releases inside the Quick

Screwdriver moving the pin into the groove in a stable
position.
Short Implants Long

Quick Screwdriver in the Loading Quick Screwdriver
Station
15.
Engage the Quick Screwdriver to the M.U.S.T. LT implants

as follow:
Orientate the Screwdriver to insert the proximal thumbwheel
pin into the cap sleeve groove 18.
The procedure is identical when using the short Quick

Screwdriver and the short M.U.S.T. LT implant.
Attach the Handle to the Quick Screwdriver (web-A
connection).
Slide the construct over the K-wire and insert the M.U.S.T.
LT implant into the prepared pedicle. After gaining good
bone purchase remove the K-Wire in order to avoid inserting
it too far.
16.
9
If M.U.S.T. LT fenestrated screw are used, the cement

injection can be performed through the Quick Screwdriver
by inserting the dedicated cannula. The Long Quick
screwdriver is compatible with the 250mm cannula, the
Short Quick screwdriver is compatible with the 210 cannula.
19. 21.
NOTE
WARNING The actual distance between the screw tip and the most
proximal fenestration is about 15mm.
make sure it does not slip or move forward during the
screw insertion.
CAUTION
When positioning the screw, make sure that the fenestrated
WARNING portion of the shank is completely covered by unbroken/
To maintain the polyaxiality of the M.U.S.T. LT implants, solid bone in order to avoid any undesired cement leakages.
verify that the tulip is not fully seated against the bone.
Once the pedicle screw is inserted in the pedicle canal,

remove the Quick Screwdriver by pushing and rotating the
proximal thumbwheel counterclockwise.
22.
Repeat the steps for all the levels to be treated.
20.
10
2.5 SCREW INSERTION - MODULAR SCREWDRIVER Select the M.U.S.T. LT implant to be inserted and remove
the plastic sleeve.
If a more rigid connection between the M.U.S.T. LT implant
and the polyaxial screwdriver is desired, it is suggested to Press the lateral prongs medially and pull out the sleeve.
use the Modular Screwdriver.
The Modular Screwdriver is composed by the Outer Shaft,
the Handle Sleeve and the Inner Shaft.
Handle Outer Shaft Inner Shaft
23.
Two different designs of the Inner Shaft are available:

27.
• Compatible with M.U.S.T. LT implants 25mm thread
(Double black line mark)
Insert the M.U.S.T. LT implant with the Modular rigid
screwdriver until the mechanical stop is reached.
24.
28.
• Compatible with M.U.S.T. LT implants 15mm thread (No
black line mark)
Push and rotate the proximal thumbwheel clockwise to
match the inner thread of the tab and securely lock the
screw to the Modular Screwdriver.
25.
Couple the Outer Shaft, the Handle Sleeve and the selected
Inner Shaft.
Slide the Handle sleeve onto the Outer Shaft until the
mechanical stop is reached. Push the button to insert the
Inner Shaft into the Outer Shaft.
Handle Outer Inner

Sleeve Shaft Shaft
Push
26. 29.
11
Attach the Handle to the Modular Screwdriver (web-A Re-attach the plastic cap sleeve on the M.U.S.T. LT implant.
connection), slide the construct onto the K-wire and insert
the M.U.S.T. LT implant into the prepared pedicle.
32.
30.
A metal version of the plastic sleeve is also available. If

WARNING needed substitute the plastic sleeve with the metal version.
make sure it does not slip or move forward during the To re-attach the cap sleeve, a dedicated Sleeve Inserter is
screw insertion. also available.
WARNING
To maintain the polyaxiality of the M.U.S.T. LT implants
verify that the tulip is not fully seated against the bone.
After gaining good bone purchase remove the screwdriver

and the K-Wire in order to avoid inserting it too far. Repeat
the steps for all the levels to be treated.
33.
Connect the Sleeve (metal or plastic) to the Sleeve Inserter

by pushing down and rotating clockwise, as indicated on
the instrument, to lock the pin into the cap sleeve groove.
Once the mechanical stop has been reached, the pin moves
automatically in stable position thanks to the internal
spring mechanism. The following picture shows the steps
for the Metal cap sleeve; the same procedure applied for
the plastic cap sleeves.
31.
12
2.6 SCREW ADJUSTMENT
The position of each screw must be set appropriately to
accommodate the curvature of the rod; further adjustments
can be achieved using the modular bone screwdriver. Two
versions of the modular bone screwdriver shafts are
available. The long one is compatible both with the long
and short tab, while the short one is only compatible with
the short tab.
34.
Slide the Sleeve attached to the Sleeve Inserter into the

M.U.S.T. LT Tabs until the stop is reached. 36.
Assembly the instrument by connecting the long or the

short shaft to the handle and perform implant adjustment.
35.
37.
Disengage the cap sleeve inserter by pushing and rotating
the Sleeve Inserter counterclockwise.
13
3. ROD INSERTION AND REDUCTION
To align the tabs before the rod insertion, insert the Head
Adjuster in the M.U.S.T. LT implant and rotate it until the
M.U.S.T. LT tabs are aligned to accommodate the rod. The
Head Adjuster is marked with a red and a white ring and it
is compatible both with the short and long M.U.S.T. LT
implants.
40.
CAUTION
Advance the instrument until the colour ring is flush with
the tab. If long tabs are used, the reference rings to be
considered are the white ones, if the short tabs are used the
reference rings to be considered are the red ones.
Once the instrument is fully inserted read the values on the

scale without squeezing the instrument.
38.
3.1 ROD SIZING

Place the Rod Measuring Device into the top cranial and the
bottom caudal M.U.S.T. LT implants to measure the length
of the rod to be inserted.
41.
The measured length includes +5mm overhang of the rod on

both sides. The Rod Measuring Device measures between
20 and 120mm. Segments greater than 120mm can be
measured by adding multiple measurements together.
CAUTION
39. In the case of multiple measurements, subtract 25mm for
every segment added to the first one.
14
3.2 ROD PREPARATION
Select the proper rod and contour it, if necessary, with the
French rod bender.
Assembly the rod inserter coupling the Inner shaft, the
Outer Shaft and the Handle.
Inner Outer
shaft shaft Handle
42.
46.
Insert the Outer Shaft on the Handle by sliding the Outer
Shaft and rotate the thumbwheel counterclockwise.
CAUTION
Do not press the button during the procedure, in order to
avoid accidentally disengaging the rod.
Assemble the enhanced rod with the Rod Inserter; secure

the assembly by rotating the thumbwheel clockwise until
the mechanical stop is reached.
43.
Check the stability of the interface before inserting the rod.
Insert the Inner Shaft into the Outer Shaft and the Handle
until it reaches the mechanical stop.
47.
44. OPTION
Use the Tissue Cutter to prepare the path for the rod
insertion.
The Inner Shaft is correctly inserted when the black line
matches the lines on the Outer Shaft.
45.
On the handle, there is a button that allows for releasing the

48.
Inner Shaft during the disassembling phase.
15
3.3 ROD INSERTION 3.4 ROD REDUCTION AND TEMPORARY LOCKING

Insert the rod into the most caudal or the most cranial To perform rod reduction, engage a M.U.S.T. LT setscrew
M.U.S.T. LT implant. with the Temporary set screwdriver and screw it in into the
M.U.S.T. LT Tab until the set screw is fully seated.
Advance the rod straight down towards the screw as deep
as the tissue allows. Preliminarily stabilize the rod by tightening at least one set
screw at the end of the construct (cranial or caudal).
The Temporary set screwdriver is modular, and it is
obtained by coupling the shaft with the handle.
The shaft is compatible with both the long and short
M.U.S.T. LT implants.
49.
Advance until the rod passes inside all the inserted M.U.S.T.
LT tab. 51.
A positive stop avoids an excessive insertion of the rod.
WARNING
Before removing the Rod Holder, make sure that the rod is
correctly placed within the cranial and caudal set screw.
Release the Rod Holder by rotating the thumbwheel

counterclockwise and pull.
50.
52.
16
3.5 EXTRA REDUCTION Attach the Reduction Instrument into the lateral groove of
the Sleeve of the M.U.S.T. LT implant and the groove of the
In the cases where the reduction needed is bigger than the Reduction Set screwdriver.
reduction thread selected, the Reduction Instrument is
available.
The following steps are explained with the Long Tab design;
however, the instruments can also be used for the Short
Tab design.
The Reduction Instrument allows for adding up to 15mm
reduction.
Attach the Plastic Ring over the Cap Sleeve that works as
a stabilizer for the manoeuvre and prevent accidental
disengagement of the Sleeve.
55.
The Reduction Set screwdriver has two grooves marked

with 15mm or 25mm. Connect the reduction instrument to
the appropriate groove in order to match the length of the
M.U.S.T. LT implant used.
53.
Connect a Handle to the Reduction Set Screwdriver and

insert it into the M.U.S.T. LT implant equipped with the
Plastic Cap.
56.
Squeeze the Reduction instrument until the set screw is in

contact with the threaded part of the tab.
Rotate the Reduction Set screwdriver clockwise to catch
the threaded part of the tab and continue to complete the
reduction.
The Reduction instrument can be removed during this last step.
54.
17
4. COMPRESSION/DISTR ACTION AND TIGHTENING
Once all the set screws have been inserted, perform the Attach the modular compressor/distractor to the M.U.S.T.
compression or distraction manoeuvre before the final LT implant and position the Fulcrum. To perform
tightening. The Compressor/Distractor is compatible both compression, position the fulcrum above the modular
with Long and Short Tab design. compressor/distractor, to perform distraction position the
Fulcrum below it.
4.1 COMPRESSION/DISTRACTION
Assemble the Modular Compressor/Distractor by pulling
the triggers backwards and couple the distractor valves.
59.
57.
Repeat the steps for the second valve. Three versions of

valves are available: straight, offset 25mm and offset
35mm.
60.
Using fluoroscopy, monitor and ensure that the appropriate

distraction/compression is achieved, and check the correct
seating of the rod. Once the set screw is in the desired
position, proceed with the tightening.
Straight Offset 25 mm Offset 35 mm
58.
18
4.2 FINAL TIGHTENING OPTION
If more stability is needed or if one or both Tabs of the
Connect the long or the short T-27 shaft to the 9Nm
M.U.S.T. LT accidentally break, the counter torque can be
T-handle. The long and the short shafts are marked with a
used.
colored ring.
The counter torque comes in a Short and a Long version
and must be used with the corresponding Short or Long
Bone Screwdriver.
61.
Slide on the M.U.S.T. LT implant the long or the short

counter-torque until the mechanical stop is reached, insert
the torque limiter and close to 9Nm until the audible click
is heard.
Long Bone Short Bone

Screwdriver Screwdriver
and 4-arm long and 4-arms short
counter-torque counter-torque
63.
62.
19
Long/Short Bone Screwdriver and

Long/Short Shaft and
corresponding Long Short 4 arms
corresponding counter-torques
counter-torques
4.3 TAB REMOVAL

To break off the M.U.S.T. LT Tab, remove the Sleeve from
the M.U.S.T. LT Tab. If the metal sleeve is used, remove it in
the same way.
Slide the Tab Remover onto one of the Tab of the M.U.S.T.
LT implant until the mechanical stop is reached.
64.
Gently move the tab removal tool medially and laterally to

break off the tab from the polyaxial head.
Repeat the step for the other side of the M.U.S.T. LT implant
and the remaining implants.
20
5. REVISION PROCEDURES
The existing M.U.S.T. LT instruments can be used in case CAUTION

of revision surgery or removal of the implants. Check carefully that no metal fragments from the removed
implants remain in situ.
The M.U.S.T. LT implants are compatible also with M.U.S.T.
Percutaneous system (99.perc46.12) and M.U.S.T. system
(99.46.12). The MUST LT screw, once the wings have been removed,
can be connected to the one step or the two step reducer
of the MUST system.
OPTION
If one tab or both tabs of a M.U.S.T. LT implant breaks
during the surgery, instead of substituting the damaged
M.U.S.T. LT implant with a new one, a M.U.S.T. Percutaneous
tower can be used. This will facilitate the rod insertion and
continue the surgery.
Insert the K-wire into the M.U.S.T. LT screw. Slide the MIS
Rescue Instrument on the K-wire until catching the screw tulip.
One Step Reducer
Two Step Reducer
67.
65.
Slide the percutaneous tower onto the MIS Rescue

Instrument and connect it to the M.U.S.T. LT screw tulip.
Use the engage handle to facilitate the engagement.
66.
Perform the step indicated in the M.U.S.T. Percutaneous

surgical technique (99.perc46.12) in all levels where a
percutaneous tower is used.
21
6. IMPLANT NOMENCLATURE
M.U.S.T. LT 15MM SHORT M.U.S.T. LT 25MM SHORT
References Description References Description
M.U.S.T. LT 15mm SHORT - Pedicle Screw M.U.S.T. LT 25mm SHORT - Pedicle Screw
03.57.001 03.57.201
Ø4.5x25 Cann Ø4.5x25 Cann
03.57.002 03.57.202
03.57.003 03.57.203
03.57.004 03.57.204
03.57.005 03.57.205
03.57.006 03.57.206
03.57.007 03.57.207
03.57.011 03.57.211
Ø5x25 Cann Ø5x25 Cann
03.57.012 03.57.212
03.57.013 03.57.213
03.57.014 03.57.214
03.57.015 03.57.215
03.57.016 03.57.216
03.57.017 03.57.217
03.57.021 03.57.221
03.57.022 03.57.222
03.57.023 03.57.223
03.57.024 03.57.224
03.57.025 03.57.225
03.57.026 03.57.226
03.57.027 03.57.227
22
M.U.S.T. LT 15MM SHORT M.U.S.T. LT 25MM SHORT
03.57.031 03.57.231
03.57.032 03.57.232
03.57.033 03.57.233
03.57.034 03.57.234
03.57.035 03.57.235
03.57.036 03.57.236
03.57.037 03.57.237
03.57.053 03.57.253
03.57.054 03.57.254
03.57.038 03.57.238
03.57.039 03.57.239
03.57.040 03.57.240
03.57.051 03.57.251
03.57.041 03.57.241
03.57.042 03.57.242
03.57.043 03.57.243
03.57.044 03.57.244
03.57.045 03.57.245
03.57.046 03.57.246
03.57.047 03.57.247
03.57.055 03.57.255
03.57.056 03.57.256
03.57.048 03.57.248
03.57.049 03.57.249
03.57.050 03.57.250
03.57.052 03.57.252
23
M.U.S.T. LT 15MM LONG M.U.S.T. LT 25MM LONG
M.U.S.T. LT 15mm LONG - Pedicle Screw M.U.S.T. LT 25mm LONG - Pedicle Screw
03.59.001 03.59.201
03.59.002 03.59.202
03.59.003 03.59.203
03.59.004 03.59.204
03.59.005 03.59.205
03.59.006 03.59.206
03.59.007 03.59.207
03.59.011 03.59.211
03.59.012 03.59.212
03.59.013 03.59.213
03.59.014 03.59.214
03.59.015 03.59.215
03.59.016 03.59.216
03.59.017 03.59.217
03.59.021 03.59.221
03.59.022 03.59.222
03.59.023 03.59.223
03.59.024 03.59.224
03.59.025 03.59.225
03.59.026 03.59.226
03.59.027 03.59.227
24
M.U.S.T. LT 15MM LONG M.U.S.T. LT 25MM LONG
03.59.031 03.59.231
03.59.032 03.59.232
03.59.033 03.59.233
03.59.034 03.59.234
03.59.035 03.59.235
03.59.036 03.59.236
03.59.037 03.59.237
03.59.053 03.59.253
03.59.054 03.59.254
03.59.038 03.59.238
03.59.039 03.59.239
03.59.040 03.59.240
03.59.051 03.59.251
03.59.041 03.59.241
03.59.042 03.59.242
03.59.043 03.59.243
03.59.044 03.59.244
03.59.045 03.59.245
03.59.046 03.59.246
03.59.047 03.59.247
03.59.055 03.59.255
03.59.056 03.59.256
03.59.048 03.59.248
03.59.049 03.59.249
03.59.050 03.59.250
03.59.052 03.59.252
25
M.U.S.T. LT 15MM SHORT FENESTRATED M.U.S.T. LT 25MM SHORT FENESTRATED
03.77.001 03.77.201
Ø4.5x25 Fen Ø4.5x25 Fen
03.77.002 03.77.202
03.77.003 03.77.203
03.77.004 03.77.204
03.77.005 03.77.205
03.77.006 03.77.206
03.77.007 03.77.207
03.77.011 03.77.211
Ø5x25 Fen Ø5x25 Fen
03.77.012 03.77.212
03.77.013 03.77.213
03.77.014 03.77.214
03.77.015 03.77.215
03.77.016 03.77.216
03.77.017 03.77.217
03.77.021 03.77.221
03.77.022 03.77.222
03.77.023 03.77.223
03.77.024 03.77.224
03.77.025 03.77.225
03.77.026 03.77.226
03.77.027 03.77.227
26
M.U.S.T. LT 15MM SHORT FENESTRATED M.U.S.T. LT 25MM SHORT FENESTRATED
03.77.031 03.77.231
03.77.032 03.77.232
03.77.033 03.77.233
03.77.034 03.77.234
03.77.035 03.77.235
03.77.036 03.77.236
03.77.037 03.77.237
03.77.053 03.77.253
03.77.054 03.77.254
03.77.038 03.77.238
03.77.039 03.77.239
03.77.040 03.77.240
03.77.051 03.77.251
03.77.041 03.77.241
03.77.042 03.77.242
03.77.043 03.77.243
03.77.044 03.77.244
03.77.045 03.77.245
03.77.046 03.77.246
03.77.047 03.77.247
03.77.055 03.77.255
03.77.056 03.77.256
03.77.048 03.77.248
03.77.049 03.77.249
03.77.050 03.77.250
03.77.052 03.77.252
27
M.U.S.T. LT 15MM LONG FENESTRATED M.U.S.T. LT 25MM LONG FENESTRATED
03.79.001 03.79.201
03.79.002 03.79.202
03.79.003 03.79.203
03.79.004 03.79.204
03.79.005 03.79.205
03.79.006 03.79.206
03.79.007 03.79.207
03.79.011 03.79.211
03.79.012 03.79.212
03.79.013 03.79.213
03.79.014 03.79.214
03.79.015 03.79.215
03.79.016 03.79.216
03.79.017 03.79.217
03.79.021 03.79.221
03.79.022 03.79.222
03.79.023 03.79.223
03.79.024 03.79.224
03.79.025 03.79.225
03.79.026 03.79.226
03.79.027 03.79.227
28
M.U.S.T. LT 15MM LONG FENESTRATED M.U.S.T. LT 25MM LONG FENESTRATED
03.79.031 03.79.231
03.79.032 03.79.232
03.79.033 03.79.233
03.79.034 03.79.234
03.79.035 03.79.235
03.79.036 03.79.236
03.79.037 03.79.237
03.79.053 03.79.253
03.79.054 03.79.254
03.79.038 03.79.238
03.79.039 03.79.239
03.79.040 03.79.240
03.79.051 03.79.251
03.79.041 03.79.241
03.79.042 03.79.242
03.79.043 03.79.243
03.79.044 03.79.244
03.79.045 03.79.245
03.79.046 03.79.246
03.79.047 03.79.247
03.79.055 03.79.255
03.79.056 03.79.256
03.79.048 03.79.248
03.79.049 03.79.249
03.79.050 03.79.250
03.79.052 03.79.252
29
SETSCREW
References Description
03.57.903 Combined setscrew Ti h 3.9mm

Combined setscrew Ti h 3.9mm - (2x)
03.57.904
Sterile
03.57.905
Sterile
03.57.906
Sterile
30
ENHANCED BENT ROD, RADIO 200MM ENHANCED BENT ROD, RADIO 100MM
Ti Rod Size - ØxL [mm] CoCr Rod Ti Rod Size - ØxL [mm] CoCr Rod
03.52.421 5.5x25 03.52.521 03.52.451 5.5x25 03.52.551

03.52.422 5.5x30 03.52.522 03.52.452 5.5x30 03.52.552
03.52.423 5.5x35 03.52.523 03.52.453 5.5x35 03.52.553
03.52.424 5.5x40 03.52.524 03.52.454 5.5x40 03.52.554
03.52.425 5.5x45 03.52.525 03.52.455 5.5x45 03.52.555
03.52.426 5.5x50 03.52.526 03.52.456 5.5x50 03.52.556
03.52.427 5.5x55 03.52.527 03.52.457 5.5x55 03.52.557
03.52.428 5.5x60 03.52.528 03.52.458 5.5x60 03.52.558
03.52.429 5.5x65 03.52.529 03.52.459 5.5x65 03.52.559
03.52.430 5.5x70 03.52.530 03.52.460 5.5x70 03.52.560
03.52.431 5.5x75 03.52.531 03.52.461 5.5x75 03.52.561
03.52.432 5.5x80 03.52.532 03.52.462 5.5x80 03.52.562
03.52.433 5.5x85 03.52.533 03.52.463 5.5x85 03.52.563
03.52.434 5.5x90 03.52.534 03.52.464 5.5x90 03.52.564
03.52.435 5.5x95 03.52.535 03.52.465 5.5x95 03.52.565
03.52.436 5.5x100 03.52.536 03.52.466 5.5x100 03.52.566
03.52.438 5.5x110 03.52.538 03.52.468 5.5x110 03.52.568
03.52.440 5.5x120 03.52.540 03.52.470 5.5x120 03.52.570
03.52.442 5.5x130 03.52.542 03.52.472 5.5x130 03.52.572
03.52.444 5.5x140 03.52.544 03.52.474 5.5x140 03.52.574
03.52.446 5.5x150 03.52.546 03.52.476 5.5x150 03.52.576
ENHANCED DUAL BENT ROD ANODIZED RODS
Ti Rod Size - ØxL [mm] CoCr Rod Ref. (Sterile) Description
03.52.486 5.5x50mm 03.52.586 03.52.814 Enhanced Rod Ti Anodized 5.5x100mm

03.52.818 Enhanced Rod Ti Anodized 5.5x600mm
31
ENHANCED STRAIGHT ROD
Ti Rod Size - ØxL [mm] CoCr Rod
03.52.401 5.5x35 03.52.501

03.52.402 5.5x40 03.52.502
03.52.403 5.5x45 03.52.503
03.52.404 5.5x50 03.52.504
03.52.405 5.5x55 03.52.505
03.52.406 5.5x60 03.52.506
03.52.407 5.5x65 03.52.507
03.52.408 5.5x70 03.52.508
03.52.409 5.5x75 03.52.509
03.52.410 5.5x80 03.52.510
03.52.411 5.5x85 03.52.511
03.52.412 5.5x90 03.52.512
03.52.414 5.5x100 03.52.514
03.52.415 5.5x200 03.52.515
03.52.416 5.5x300 03.52.516
03.52.417 5.5x480 03.52.517
03.52.418 5.5x600 03.52.518
32
NOTES
33
NOTES
34
Part numbers subject to change.
NOTE FOR STERILISATION

The instrumentation is not sterile upon delivery. Instruments must be cleaned before use and sterilized in an autoclave, respecting
the regulations of the country, EU directives where applicable and following the manufacturer’s instructions for use of the autoclave.
For detailed instructions, please refer to the document “Recommendations for cleaning, decontamination and sterilsation of
Medacta International orthopaedic devices” available at www.medacta.com.
35
Medacta International SA
Strada Regina - 6874 Castel San Pietro - Switzerland
Phone +41 91 696 60 60 - Fax +41 91 696 60 66 M.U.S.T.® LT System
info@medacta.ch Surgical Technique
Find your local dealer at: medacta.com/locations ref: 99.46LT.12

rev. 01
All trademarks are property of their respective owners and are registered at least in Switzerland.
This document is not intended for the US market. Last update: July 2021
Please verify approval of the devices described in this document with your local Medacta representative. 0476

Must LT

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Must LT

Uploaded by

Copyright:

Available Formats

Surgical Technique

Joint Spine Sports Med

2. SCREW PREPAR ATION AND INSERTION 6

3. ROD INSERTION AND REDUCTION 14

4. COMPRESSION/DISTR ACTION AND TIGHTENING 18

6. IMPL ANT NOMENCL ATURE 22

The Medacta M.U.S.T. LT system is a sub-family of the

Removable plastic sleeves

Screw diameter and Tab

Laser markings indicate

Ti-alloy Pedicle Screw and

Short Tab Long Tab Cannulated 1.75mm screws

• Dual Bent Rods, with an enhanced proximal lordosis to

• Any other medical or surgical condition which would

• Suspected or documented metal allergy or intolerance.

• Any patient having inadequate tissue coverage over the

• Any patient in which implant utilisation would interfere

• Any case not described in the indications.

2. SCREW PREPAR ATION AND INSERTION

The patient should be positioned prone lying face down on

2.1 PEDICLE PREPARATION

Remove the Cannulated Awl.

NOTE 2.3 IMPLANT SELECTION

Remove the blue Ø14.0mm dilator.

The reduction capacity is marked on the tab.

Release the pressure. The spring releases inside the Quick

Short Implants Long

Engage the Quick Screwdriver to the M.U.S.T. LT implants

The procedure is identical when using the short Quick

If M.U.S.T. LT fenestrated screw are used, the cement

Once the pedicle screw is inserted in the pedicle canal,

Repeat the steps for all the levels to be treated.

Handle Outer Shaft Inner Shaft

Two different designs of the Inner Shaft are available:

Handle Outer Inner

A metal version of the plastic sleeve is also available. If

After gaining good bone purchase remove the screwdriver

Connect the Sleeve (metal or plastic) to the Sleeve Inserter

Slide the Sleeve attached to the Sleeve Inserter into the

Assembly the instrument by connecting the long or the

3. ROD INSERTION AND REDUCTION

Once the instrument is fully inserted read the values on the

3.1 ROD SIZING

The measured length includes +5mm overhang of the rod on

Assemble the enhanced rod with the Rod Inserter; secure

On the handle, there is a button that allows for releasing the

3.3 ROD INSERTION 3.4 ROD REDUCTION AND TEMPORARY LOCKING

Release the Rod Holder by rotating the thumbwheel

The Reduction Set screwdriver has two grooves marked

Connect a Handle to the Reduction Set Screwdriver and

Squeeze the Reduction instrument until the set screw is in

4. COMPRESSION/DISTR ACTION AND TIGHTENING

Repeat the steps for the second valve. Three versions of

Using fluoroscopy, monitor and ensure that the appropriate

Straight Offset 25 mm Offset 35 mm

Slide on the M.U.S.T. LT implant the long or the short

Long Bone Short Bone

Long/Short Bone Screwdriver and

4.3 TAB REMOVAL

Gently move the tab removal tool medially and laterally to

The existing M.U.S.T. LT instruments can be used in case CAUTION

Two Step Reducer

Slide the percutaneous tower onto the MIS Rescue

Perform the step indicated in the M.U.S.T. Percutaneous