Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential6/06 v.1 MANTIS TM Percutaneous Screw & Rod Delivery System · System Overview · Sextant · Medtronic · Sextant · Medtronic · Pathfinder · Abbott Spine · Pathfinder · Abbott Spine · Viper · DePuy · Viper · DePuy · MANTIS · Stryker · MANTIS · Stryker

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Philosophy – Approach · Features and Benefits Percutaneous delivery of bone graft True percutaneous screw and rod delivery Uses conventional screw & rod designs Supports multi-level procedures Manual, un-constrained rod insertion Simple procedure, uses current techniques Precise rod contouring before rod insertion Excellent visualization Radiolucent retractor · Features and Benefits Percutaneous delivery of bone graft True percutaneous screw and rod delivery Uses conventional screw & rod designs Supports multi-level procedures Manual, un-constrained rod insertion Simple procedure, uses current techniques Precise rod contouring before rod insertion Excellent visualization Radiolucent retractor Minimal Access Non- Traumatic Insertion System Minimal Access Non- Traumatic Insertion System

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Retractor Retractor Blades Blades dock to screw Tulip Angle one blade toward the other to dock / undock Retractor Blades Blades dock to screw Tulip Angle one blade toward the other to dock / undock

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Retractor Sliding Ring Sliding Ring automatically adjusts to the depth of pathology upon screw insertion Sliding Ring Sliding Ring automatically adjusts to the depth of pathology upon screw insertion

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Retractor Screw Insertion Retractor and screw inserted together Blades and slide ring assembled on back table Inserter retains screw and retractor, but allows retractor to stay stationary during insertion Screw Insertion Retractor and screw inserted together Blades and slide ring assembled on back table Inserter retains screw and retractor, but allows retractor to stay stationary during insertion

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Retractor Rod Insertion Rod inserter firmly grips rod for manual control of rod insertion Rod held at caudal end Rod overhangs caudal end of screw ~ 4mm Rod Insertion Rod inserter firmly grips rod for manual control of rod insertion Rod held at caudal end Rod overhangs caudal end of screw ~ 4mm

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 1: Insert K-wires Locate pedicle with jam-shidi needle under fluoroscopy Tap k-wires into pedicles under fluoroscopic guidance Step 1: Insert K-wires Locate pedicle with jam-shidi needle under fluoroscopy Tap k-wires into pedicles under fluoroscopic guidance

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 2: Dilate Tissue · Insert Blunt Dilator · Insert Hollow Dilator · Remove Blunt Dilator

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 2: Dilate Tissue Insert Blunt Dilator Step 2: Dilate Tissue Insert Blunt Dilator

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 3: Tap Pedicles Insert Tap Step 3: Tap Pedicles Insert Tap

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 3: Tap Pedicles Remove Tap and Dilators Dilator removal – optional Step 3: Tap Pedicles Remove Tap and Dilators Dilator removal – optional

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 4: Insert MANTIS Assembly Insert MANTIS retractor assembly over k-wire Screw inserted with or without cannula Step 4: Insert MANTIS Assembly Insert MANTIS retractor assembly over k-wire Screw inserted with or without cannula

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 4: Insert MANTIS Assembly Detach and remove pedicle screw inserter Step 4: Insert MANTIS Assembly Detach and remove pedicle screw inserter

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 4: Insert MANTIS Assembly Repeat procedure Step 4: Insert MANTIS Assembly Repeat procedure

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 5: Apply Distraction Insert Projection Shafts Step 5: Apply Distraction Insert Projection Shafts

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 5: Apply Distraction Insert Distractor Apply Distraction Step 5: Apply Distraction Insert Distractor Apply Distraction

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 6: Contour Rod · Retain Projection Shafts · Contour Rod · Insert Contouring Linkages

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 6: Contour Rod Insert Contouring Linkages Step 6: Contour Rod Insert Contouring Linkages

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 6: Contour Rod Contour Rod Step 6: Contour Rod Contour Rod

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 7: Cut Fascia Cut fascia between retractors using the fascia scissors or knife Step 7: Cut Fascia Cut fascia between retractors using the fascia scissors or knife

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 8: Insert Rod Assemble contoured rod to the rod inserter Insert rod percutaneously from the caudal side through the MANTIS Retractor Blades Step 8: Insert Rod Assemble contoured rod to the rod inserter Insert rod percutaneously from the caudal side through the MANTIS Retractor Blades

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 9: Seat Rod · Fully Seat Rod in Tulip · Install Blocker Screws

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 10: Apply Compression Insert Compression Shafts Insert Distractor / Compressor Apply Compression Step 10: Apply Compression Insert Compression Shafts Insert Distractor / Compressor Apply Compression

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 11: Final Tightening Insert Anti-Torque Shaft and Final Tightener down MANTIS Retractor Perform final tightening Step 11: Final Tightening Insert Anti-Torque Shaft and Final Tightener down MANTIS Retractor Perform final tightening

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential MANTIS Procedure Step 12: Remove MANTIS · Remove Slide Rings · Remove Retractor Blades

Spine For Internal Use Only Do Not Copy Do Not Distribute Confidential LITe Synergies · Ipsilateral MIS Decompression TLIF (BMP) · Contralateral Percutaneous Fixation This percutaneous system compliments our existing Luxor platform. · Ipsilateral MIS Decompression TLIF (BMP) · Contralateral Percutaneous Fixation This percutaneous system compliments our existing Luxor platform.