Single-Handedly Tighten Screws in Various Applications with Net-Zero Torque by the Surgeon

To date, surgeons have always needed to apply tightening torque (CW) and counter-torque (CCW) simultaneously during the final tightening of the set screws of top loading pedicle screw systems. This requires two instruments and two hands. The surgeon must also perfectly balance the two torques in opposite hands to avoid distortions or stresses in the implant construct and the patient’s spinal column.
Current Technique
IDT has developed a new type of fastening system based on its proprietary Counter-Torque Technology (CTT). The Counter-Torque Screwdriver (CTSD) allows surgeons to use only one hand to achieve final tightening of the set screws while experiencing net-zero torque.

The CTSD applies the tightening torque and counter-torque perfectly balanced at the same time within each pair of tulip and set screw. As a result, the possibility of unwanted stresses in the implant construct is significantly reduced, which greatly decreases the potential of damaging stresses in the patient’s spinal column.

Single-Handed Technique/Manual (CTSD-M)
Single-Handed Technique/Battery Operated (CTSD-P)

Available Options

CTSD-M - Manual Option

The manual counter-torque screwdriver (CTSD-M) is operated by squeezing a ‘pair of pliers’ at the handle. The CTSD-M includes:

  • Restorative spring-force for the handle
  • Ratcheting mechanism
  • Clutch for clockwise/counterclockwise rotation
  • Clutch for different torque/speed ratio (1:1 or 4:1)
  • Torque limiter

CTSD-M Advantages

  • Low weight to torque ratio
  • Net-zero torque to surgeon
Play Video

CTSD-P - Powered Option

The powered counter-torque screwdriver (CTSD-P) has an electric motor and battery pack. The CTSD-P includes:

  • Swivel button for clockwise/counterclockwise rotation
  • Torque limiter

CTSD-P Advantages

  • Fast advancement of set screw
  • Net-zero torque exposure to surgeon
Play Video

Clinical Benefits of CTSD

  • Improved patient outcomes due to:
    • Reduced surgery time resulting in:
      • Reduced OR time
      • Reduced anesthesia
      • Reduced blood loss
      • Less surgeon fatigue
  • Only one hand needed for surgeon to apply final tightening torque
    • Improved surgeon control
    • Ability to use free hand for other tasks (i.e., holding back soft tissue)
CTSD-M-CAD-Tech-1-Straight-scaled
CTSD-M plus spine - CAD - Tech-2 - New
CTSD-M plus spine - CAD - Tech-3 close up - New
CTSD-P - CAD - Tech 1 - Straight
CTSD-P plus spine - CAD - Tech-2 - New
CTSD-P plus spine - CAD - Tech-3 close up - New
  • No reaction torques are transmitted to the surgeon
    • Surgeon does not need to balance tightening torque and counter-torque in two hands
    • With the CTSD-M surgeons apply squeezing force, not a torque
    • With the CTSD-P surgeons do not apply any torque, but only a small force to operate the swivel button
  • No reaction forces or torques are transferred to the spinal construct or patient’s spinal column
  • Reduction/elimination of stresses created in the spinal construct or patient’s spinal column

Technical Benefits of CTSD

  • CTSD is non-system specific and can be used for any spinal fixation system
  • CTSD can be designed for use with open or minimally invasive surgery
  • CTSD can be designed for use with regular and reduction screws
  • CTSD can be customized for each implant system for further improved control
  • Torque limit can be customized to implant system
  • Choice of manual or powered options
  • Disposable or reusable
  • Less stress on surgeon’s wrist and elbow

Other Spinal Applications

IDT’s Counter-Torque Technology also has many other applications for spinal implant systems including:

  • Screw insertion into stand-alone cages
  • Screw insertion into cervical or lumbar plates
  • Tightening of set screws in cross-connectors
  • Tightening of set screws in rod-to-rod connector
  • Tightening of nuts for side-loading systems

Other orthopedic applications include, for example, screw tightening in trauma plates or nut tightening in external fixation frames.

Let’s Get Started

For more information, please contact IDT today.

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