Visual examination of the returned four level plate found one of the blocking slides had become completely detached from the implant.Witness marks along both the anterior and posterior sides of the plate are present and reveal the location of the instrument to plate during countering/bending.The plate contains a single witness mark on the posterior side directly behind the location of the detached blocking slide and two witness marks at the graft window on the anterior side.The combination of these witness marks confirms the plate bending instrument was improperly positioned while contouring/bending the plate.Alphatec surgical technique (lit-84315) provides instructions as to proper plate contouring.It also provides caution to reduce/eliminate the risk of this type of event.· caution: do not place the anvil portion of the plate bender over the blocking slide as damage can occur and affect its function.The provided instructions for use (ins-048) state; intraoperative management: 2.Trestle luxe anterior cervical plates are contoured to closely match the anatomical configuration of the spine.If the plate cannot be fitted and additional contouring is necessary, it is recommended that such contouring be minimal and be performed with the instrumentation provided.The plate must not be contoured in proximity of bone screw pockets or screw retention mechanism.3.When contouring the plate, great care should be taken not to scratch, notch or dent the surface as such deformities may compromise the strength of the implant.
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