DE102010000229A1 - Spinal column stabilization implant for insertion in intermediate space between dorsal processes of adjacent vertebras of human or animal spinal column, has contact body which has two dorsal process contact surfaces - Google Patents

Abstract

The spinal column stabilization implant has a contact body which has two dorsal process contact surfaces for contacting at the dorsal processes (18,20) of adjacent vertebras (22,24). A fastening unit is provided for fixing one contact body to the supraspinous fascia (38) joining the dorsal processes of the adjacent vertebras with each other. The dorsal process contact surfaces are curved in a concave manner away from the contact body. The fastening unit is partially formed of metal or a plastic.

Description

The present invention relates to a spinal stabilization implant for insertion into a space between spinous processes of adjacent vertebrae of a human or animal spine, comprising at least one abutment body having first and second opposing spinous process surfaces for abutment with the spinous processes of the adjacent vertebrae.

Furthermore, the present invention relates to a method for stabilizing a human or animal spine, wherein a spinal stabilization implant comprising at least one abutment body, the first and second, facing away from Dornforzatzaniageflächen for application to spinous processes of adjacent vertebrae, in a space between the spinous processes of used adjacent vertebrae of the spine and is applied to the spinous process surfaces of these spinous processes.

Wirebisäulenstabilisierungsimplantate and methods for stabilizing a spine are known in various embodiments, for example from US Pat. No. 6,626,944 B1 or the US Pat. No. 6,761,720 B1 , The known spinal stabilization implants and methods are characterized in that the spinal stabilization implant is fixed by means of suitable fastening means directly to the spinous processes on which rests the spine stabilization implant. However, this has the disadvantage that in a fixation of the spinal stabilization implant to the spinous processes, especially in a determination with the spinous processes encompassing bands or holding devices, a relatively large access to the operation site inside the patient's body must be selected. Furthermore, often specially designed instruments are required to allow the application of the fastening device to a spinous process, for example in the form of a flexible band. Furthermore, for example, screwing the spinal stabilization implant to a spinous process entails the risk that a screw used for it tears, which can also lead to a spinous process fracture, since the strength of the spinous processes is not very high. Furthermore, in the segment L5 / S1 of a human spine, a fixation on the spinous process of the segment S1 can often not be made, since this spinous process, depending on the anatomical variance, is only slightly pronounced.

It is therefore an object of the present invention to improve a spinal stabilization implant and a method of the type described in the opening paragraph in such a way that the implantation of the spine stabilization implant is simplified and a risk of injuring spinous processes is minimized.

This object is achieved according to the invention in a spinal stabilization implant of the type described above by a fastening device for fixing the at least one contact body on the supraspinous, the spinous processes of the adjacent vertebrae interconnecting band.

The fastening device makes it possible to fix the spinal stabilization implant to the supraspinous ligament, unlike the known systems. An attachment of the spinal stabilization implant directly to the spinous processes is therefore not required. Therefore, otherwise usually used for use fasteners for fixing the spinal stabilization implant to the spinous processes can be completely dispensed with. As a result, a size of the spinal stabilization implant can be minimized. It is therefore only with the spinous process surfaces on the spinous processes of the adjacent vertebra, but is held in position by fixing to another body structure, namely the supraspinous ligament. The smaller design of the spinal stabilization implant, which is possible in the solution proposed according to the invention, in turn allows a simpler implantation, in particular minimally invasive implantation techniques are possible. Furthermore, fixation on the supraspinous ligament is easier and more accessible than, for example, fixation of the spinal stabilization implant by means of a fastening band around the spinous processes.

In order to optimize and in particular also to define a relative position of the spinal stabilization implant relative to the spinous processes, it is expedient for the first and / or the second spinous process attachment surface to be concavely curved away from the at least one abutment body. Such a curved spinous process attachment surface can additionally serve as a stabilization of the spinous processes connected to one another via the spinal stabilization implant, since a transverse movement through the concave curvature of the spinous process attachment surface can be minimized or even eliminated altogether.

Preferably, the at least one abutment body has at least one spinous process recess for at least partially receiving a spinous process. By providing the at least one spinous process recess, movement of the spinous process relative to the abutment body may be restricted or, depending on the design, in one or more directions entirely be excluded. Advantageously, two spinous process plant depressions are formed on the contact body. Conveniently, they comprise or define the spinous process surfaces.

According to a preferred embodiment of the invention, it can be provided that the at least one contact body comprises two or more parts forming the contact body, that one of the parts is formed by a main body and at least one further part by an enveloping body, which enveloping body has a body receptacle for receiving the Basic body or an enveloping body. This proposed development makes it possible in particular to form the body of the plant in a kind of "Russian doll", with several parts that can be accommodated in one another. For example, a smallest part of the contact body can be formed by the main body, the outer dimensions of which can be successively increased by introducing into body shots further enveloping bodies. This embodiment makes it possible, in particular, to adapt the contact body to a spacing of the spinous processes, for example by appropriate combination of the base body with one or more enveloping bodies or without additional enveloping bodies. The enveloping bodies preferably have one or two spinous process attachment surfaces and / or one or two spinous process attachment depressions for at least partially accommodating a spinous process.

In order to increase the stability of the contact body, it is advantageous if the body receptacle is dimensioned such that the main body or an enveloping body can be introduced into the body receptacle in a force-locking and / or form-fitting manner and / or in it. In particular, when pressure is exerted on the abutment body on the spinous processes, for example in an extension movement of the spine, so the stability of the contact body can be increased overall.

The spinal stabilization implant preferably comprises a guide device for guiding a connection of at least two of the parts forming the abutment body. The guide device makes it possible to bring at least two parts forming the contact body, for example the main body and an enveloping body receiving the main body, into engagement with one another in a defined manner.

The structure of the spinal stabilization implant is simplified if the guide device comprises at least one guide groove and at least one guide projection corresponding to the guide groove. If the guide groove and at the other of the guide projection are arranged or formed on one of the two parts of the abutment body to be engaged with each other, the two parts of the abutment body can be simply and safely pushed into each other, wherein a movement is defined and predetermined by a shape and orientation of the guide.

It is advantageous if the guide device defines a mounting direction and if the parts forming the contact element can be inserted into or disconnected from one another parallel to the mounting direction. For example, the guide device can be provided on the contact body in such a way that the direction of installation is a direction which, in particular, is predetermined by a minimally invasive access to the intermediate space between the spinous processes. This makes it possible, for example, to bring the main body and one or more enveloping bodies into engagement with each other, for example by successively pushing the respective larger part through the minimally invasive access via the part or parts of the abutment body previously used.

In order to simplify the implantation of the contact body, it is advantageous if the guide device is assigned a stop device which limits a relative movement of the parts forming the contact element. If, for example, a first part of the abutment body is inserted into the patient's body between the spinous processes of the adjacent vertebral bodies, the next larger enveloping body can be pushed over the main body or a previously inserted enveloping body until a relative movement is prevented by the abutment device. Thus, an operator can also determine without direct view of the operation site, when the tracked part of the body has reached its desired position.

The construction of the stop device is particularly simple if it comprises at least one stop for defining an implantation position in which the parts forming the bearing body engage or are connected to one another. The at least one stop makes it possible to connect the body forming parts in a defined manner with each other, especially without a direct view of the operation site.

The manufacture of the spinal stabilization implant can be further simplified if the at least one stop is arranged or formed at one end of the at least one guide groove or the at least one guide projection. If the guide groove, for example, formed like a blind hole and does not extend completely over a side surface of a portion of the body forming the body, then the guide groove in cooperation with the Guide projection not only lead a relative movement of the parts to be brought together of the contact body, but also limit a relative movement of the same.

Conveniently, the at least one enveloping body is sleeve-shaped. This makes it possible to easily and securely enclose the main body or a smaller enveloping body.

It is advantageous if the at least one enveloping body comprises a sidewall which extends transversely to the mounting direction and is at least partially closed. Basically, the pages can be completely closed. The side wall may in particular form a stop and thus a part of the stop device. Furthermore, it is thus possible to protect the system body at least on one side against the penetration of foreign bodies or tissue.

Particularly simple is the structure of the contact body when the parts forming it have a cuboidal or substantially cuboidal outer contour. Thus, as a whole, a cuboid contact body can be formed by the base body and corresponding enveloping bodies.

As already stated above, it is favorable if the at least one enveloping body has at least one, preferably two spinous process attachment depressions for at least partially accommodating a spinous process. Preferably, the at least one enveloping body has an opening in the region of the at least one spinous process recess. In particular, connective tissue can grow into and penetrate the abutment body, which allows additional stabilization of a position of the abutment body between the spinous processes. Furthermore, it is also possible for a side wall forming the enveloping body to be made as thin as possible, without having to forego the deepest spinous process plant recess which is advantageous for the positioning of the contact body.

The configuration of the at least one enveloping body is particularly simple if the opening is formed in the form of a slot.

It is advantageous if the parts forming the bearing body are perforated parallel to the mounting direction for receiving a fastening element of the fastening device. The perforated parts, which preferably have a continuous opening, can thus be threaded bead-like in particular onto a fastening element, for example a band or a thread. At the same time, an implantation of the spinal stabilization implant can be simplified in this way since, for example, the fastening element is firstly carried out between the spinous processes and subsequently the abutment body or the parts forming it can be successively threaded onto the fastening element.

In a simple way, the abutment body can be fixed to the supraspinous band if the attachment device comprises a fastening element which defines an attachment plane in an implantation position which runs parallel or substantially parallel to and between the spinous process abutment surfaces. This embodiment ensures that the abutment body can be fastened with the fastening element on the supraspinous band, in a plane extending between the spinous processes. It is customary, as for example in the systems from the publications cited above, to provide a fastening device with a fastening element which, in the implantation position, defines a fastening plane which perpendicularly intersects the spinous process surfaces. Such a plane is just perpendicular to the attachment plane in a spinal stabilization implant according to the invention. The fastener can be introduced much easier and with less risk for a patient, since with him not one or two spinous processes must be wrapped, but in a plane between the spinous processes only the plant body must be fixed to the supraspinous tape.

Particularly simple, the fastening device can be formed when the fastener is formed in the form of a tether. Preferably, the widest possible band is used, which has a width which, for example, can be adapted to a width of the intraspinous band in order to enable a large-area load introduction into the supraspinous band.

It is advantageous if the tether is elastic or flexible or rigid. Also conceivable are straps that are partially elastic or flexible and sometimes rigid. Such straps can be used in particular depending on a physiology of the patient to allow optimal fixation of the abutment body between two spinous processes by attachment to the supraspinous band.

It may be favorable if the fastening device is made of a resorbable material. After the implantation of the contact body, the retention of a foreign body in the patient's body can be avoided by appropriate absorption of the fastening device. At the same time, the ingrowth and enforcement can also be promoted of the plant body with connective tissue.

In order to enable a permanent stabilized attachment of the abutment body to the supraspinous band, it is advantageous if the attachment means is made of a non-resorbable material.

Preferably, the fastening device is at least partially made of a metal and / or a plastic. In particular, it can be made entirely of a metal or even entirely of a plastic. Preferably, the metals or plastics used are biocompatible materials. By appropriate choice or combination of metals and plastics, stability of the spinal stabilization implant can be optimized as desired.

It is advantageous if the plastic is polyester, polyetheretherketone (PEEK) or polypropylene and if the metal is titanium or steel. Thus, on the one hand ensures a required body compatibility and on the other hand, a sufficient stability of the fastening device can be ensured.

In order to facilitate the implantation of the spinal stabilization implant, it is favorable if the tether is opened in an insertion position and has two free band ends and if it is closed or closable in the implantation position. Such a retaining band can be introduced, for example, through a minimally invasive access into the patient's body and through between the spinous processes and around or around the supraspinous band. Attachment and positioning of the tether on the supraspinous tape can then be ensured, for example, by closing the tape by joining the two free tape ends together. In particular, the free tape ends can also be connected directly to the supraspinous tape, for example by knotting, crimping, riveting, stapling or locking. It is also conceivable to design the free ends of the band so that they can be brought into engagement with each other in the manner of a cable tie. Alternatively, the design of the free band ends in the form of engageable elements of a hook and loop fastener is conceivable.

So that the tether can be transferred in a simple manner from the insertion position into the implantation position, it is advantageous if a closing device is provided for closing the tether in the implantation position. The locking device may in particular be designed so that it can be easily and safely connected with her free ends of the tether.

The handling of the closure device can be simplified, for example, by comprising at least one closure element for closing the tether by connecting the free tape ends.

Particularly free can be free tape ends of the tether connected together when the at least one closure element in the form of a thread, a crimp, a rivet, a clamp, a cable tie, a hook and loop fastener, a locking element, a hydrogel element or a locking element is formed. With a thread, the free ends can be sewn, crimped with a crimp clip. A rivet is suitable for riveting the free ends of the tape. With a clip, the free ends of the tape, similar to a thread, a crimping clip or a rivet, connected to each other and also be set at the same time on the supraspinous tape. A cable tie-type closure element allows the free tape ends to be engaged and unidirectionally moved relative to each other. No additional tools are required if the closure element is in the form of a hook-and-loop fastener. The free tape ends must then only engaged with each other, that is brought into contact. With one or more latching elements for forming a latching device, the free ends can also be connected, wherein the configuration cable-tie-like band ends in the form of engageable latching elements is conceivable. A hydrogel member also allows closure by hydrogenating and thus reducing, for example, a distance between two parts or regions of the hydrogel member so that the free tape ends can be jammed therebetween. In an analogous manner, with such a hydrogel element, the tether can also be fixed to the supraspinous tape.

According to a further preferred embodiment of the invention it can be provided that the fastening device comprises at least one support element which can be applied to the supraspinous band and to which the fastening element can be fastened or through which the fastening element can be carried out. In particular, the support element serves to ensure large-scale load transfer into the supraspinous band to prevent it from tearing or otherwise injuring as a result of securing the tether. The support member may be formed in particular in the form of a flat plate or disc, each of which can be applied over a large area to the supraspinous tape.

Preferably, the at least one support element is designed in the form of a plate or a plate, which have at least one opening for attaching or passing the holding strap. Thus, a force introduced via the tether can be introduced over a large area into the supraspinous tape.

The stability of the spinal stabilization implant can be easily increased by being integrally formed. So it can also be made particularly simple depending on the design. In particular, it is conceivable to produce the spinal stabilization implant in one piece from a hydrogel.

Preferably, the at least one contact body is at least partially in the form of a hydrogel body. By appropriate hydrogenation or dehydrogenation so desired damping properties of the introduced between the spinous process body can be adjusted specifically. In particular, the tether may also be in the form of a hydrogel body, so that the spinal stabilization implant as a whole may have the shape of a round or oval ring of a hydrogel which can be laid or passed around or through the supraspinous ligament.

It is advantageous if the at least one holding strap is tubular and if the at least one contact body is arranged and held in the tubular holding strap. This embodiment is particularly suitable for an investment body produced from a hydrogel. The retaining band or free ends thereof can be connected to one another in the manner described above, for example with one or more of the closure elements described. Fixation of the abutment stabilizing implant comprising a hydrogel on the supraspinous ligament can then take place, for example, by swelling of the hydrogel, for example as a result of hydrogenation, so that the retaining band can form fit around the supraspinous ligament and thus form a flexible interface to the supraspinous ligament.

The object stated in the introduction is also achieved according to the invention in a method of the type described in the introduction by fastening the spinal stabilization implant to the supraspinous band connecting the spinous processes of the adjacent vertebrae.

An attachment of the abutment body to the spinous processes itself is not required. The attachment of the abutment body to the supraspinous ligament is sufficient to obtain a position of the abutment body between the spinous processes after implantation in the desired manner. The fixation of the contact body in the manner described is much easier than a determination of the contact body on one or both spinous processes. In particular, such a possible risk can be ruled out that the spinous process can be damaged during fixation of the plant body or under load.

It is advantageous if the spinal stabilization implant comprises a fastening device and if the at least one abutment body is fastened to the supraspinous band with the fastening device. The attachment device facilitates a surgeon's implantation and fixation of the spinal stabilization implant between spinous processes of adjacent vertebral bodies.

Preferably, one of the above-described spinal stabilization implants is used to perform the method of the invention. The described spinal stabilization implants can be implanted in the manner discussed and easily and safely immobilized on the intraspinous ligament.

It is favorable if a distance of the first and second spinous process attachment surfaces from each other is increased. In this way, the spinal stabilization implant can be adapted individually to the distance between the two spinous processes between which it is to be inserted.

It is advantageous if the spinal stabilization implant comprises two implant components, each of which has at least two supporting arms which are connected to one another at one end and spread apart at their free ends, at least one of which forms one of the spinous process attachment surfaces. Thus, the structure of the spinal stabilization implant can be made particularly simple and compact.

It is favorable if both implant components are directed with the free ends of their support arms against the free ends of the support arms of the respective other implant component and if both implant components slide on sliding surfaces of the respective other implant component and are thereby pivoted so that thereby the distance of the upper and lower Spinous process surfaces is increased. This configuration makes it possible, in particular, to increase the distance of the first and second spinous process attachment surfaces from one another by applying the two implant components in a direction transversely, in particular perpendicular, to a connecting line of the two or substantially.

• 1. Wirbelsäulenstabilisierungsimplantat (10; 10'; 10''; 10'''; 10'''') zum Einsetzen in einen Zwischenraum (16) zwischen Dornfortsätze (18, 20) benachbarter Wirbel (22, 24) einer menschlichen oder tierischen Wirbelsäule (26), mit mindestens einem Anlagekörper (12; 152; 206, 207), welcher erste und zweite, voneinander weg weisende Dornfortsatzanlageflächen (28, 28a, 28b, 28c, 30, 30a, 30b, 30c; 222, 223) aufweist zum Anlegen an die Dornfortsätze (18, 20) der benachbarten Wirbel (22, 24), gekennzeichnet durch eine Befestigungseinrichtung (14; 14'; 14''; 14'''; 14'''') zum Festlegen des mindestens einen Anlagekörpers (12; 152; 206, 207) am supraspinösen, die Dornfortsätze (18, 20) der benachbarten Wirbel (22, 24) miteinander verbindenden Band (38).
• 2. Wirbeisaulenstabilisierungsimplantat nach Ausführungsform 1, dadurch gekennzeichnet, dass die erste und/oder die zweite Dornfortsatzanlagefläche (28, 28a, 28b, 28c, 30, 30a, 30b, 30c; 222, 223) vom mindestens einen Anlagekörper (12; 152; 206, 207) weg weisend konkav gekrümmt sind.
• 3. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 1 oder 2, dadurch gekennzeichnet, dass der mindestens eine Anlagekörper (12; 152; 206, 207) mindestens eine Dornfortsatzanlagevertiefung (50, 50a, 50b, 50c, 52, 52a, 52b, 52c) aufweist zum mindestens teilweisen Aufnehmen eines Dornfortsatzes (18, 20).
• 4. Wirbelsäulenstabilisierungsimplantat nach einer der voranstehenden Ausführungsformen, dadurch gekennzeichnet, dass der mindestens eine Anlagekörper (12) zwei oder mehr den Anlagekörper (12) ausbildende Teile (40, 54a, 54b, 54c) umfasst, dass eines der Teile (40, 54a, 54b, 54c) durch einen Grundkörper (40) und mindestens ein weiteres Teil (40, 54a, 54b, 54c) durch einen Hüllkörper (54a, 54b, 54c) gebildet wird, welcher Hüllkörper (54a, 54b, 54c) eine Körperaufnahme (56a, 56b, 56c) aufweist zum Aufnehmen des Grundkörpers (40) oder eines Hüllkörpers (54a, 54b).
• 5. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 4, dadurch gekennzeichnet, dass die Körperaufnahme (56a, 56b, 56c) derart dimensioniert ist, dass der Grundkörper (40) oder ein Hüllkörper (54a, 54b) kraft- und/oder formschlüssig in die Körperaufnahme (56a, 56b, 56c) einführbar und/oder darin haltbar sind.
• 6. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 4 oder 5, gekennzeichnet durch eine Führungseinrichtung (64) zum Führen einer Verbindung von mindestens jeweils zwei der den Anlagekörper (12) ausbildenden Teile (40, 54a, 54b, 54c).
• 7. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 6, dadurch gekennzeichnet, dass die Führungseinrichtung (64) mindestens eine Führungsnut (66) und mindestens einen zur Führungsnut (66) korrespondierenden Führungsvorsprung (70) umfasst.
• 8. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 6 oder 7, dadurch gekennzeichnet, dass die Führungseinrichtung (64) eine Montagerichtung (48) definiert und dass die den Anlagekörper (12) ausbildenden Teile (40, 54a, 54b, 54c) parallel zur Montagerichtung ineinander einführbar oder voneinander trennbar sind.
• 9. Wirbelsäulenstabilisierungsimplantat nach einer der Ausführungsformen 6 bis 8, dadurch gekennzeichnet, dass der Führungseinrichtung (64) eine Anschlageinrichtung (76) zugeordnet ist, welche eine Relativbewegung der den Anlagekörper (12) ausbildenden Teile (40, 54a, 54b, 54c) begrenzt.
• 10. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 9, dadurch gekennzeichnet, dass die Anschlageinrichtung (76) mindestens einen Anschlag (72, 74) umfasst zum Definieren einer Implantationsstellung, in welcher die den Anlagekörper (12) ausbildenden Teile (40, 54a, 54b, 54c) miteinander in Eingriff stehen oder miteinander verbunden sind.
• 11. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 10, dadurch gekennzeichnet, dass der mindestens eine Anschlag (72, 74) an einem Ende der mindestens einen Führungsnut (66) oder des mindestens einen Führungsvorsprungs (70) angeordnet oder ausgebildet ist.
• 12. Wirbelsäulenstabilisierungsimplantat nach einer der Ausführungsformen 4 bis 11, dadurch gekennzeichnet, dass der mindestens eine Hüllkörper (54a, 54b, 54c) hülsenförmig ausgebildet ist.
• 13. Wirbelsäulenstabilisierungsimplantat nach einer der Ausführungsformen 4 bis 12, dadurch gekennzeichnet, dass mindestens einer der Hüllkörper (54c) eine sich quer zur Montagerichtung (48) erstreckende, mindestens teilweise geschlossene Seitenwand (78) umfasst.
• 14. Wirbelsäulenstabilisierungsimplantat nach einer der Ausführungsformen 4 bis 13, dadurch gekennzeichnet, dass die den Anlagekörper (12) ausbildenden Teile (40, 54a, 54b, 54c) eine quaderförmige oder im Wesentlichen quaderförmige Außenkontur aufweisen.
• 15. Wirbelsäulenstabilisierungsimplantat nach einer der Ausführungsformen 4 bis 14, dadurch gekennzeichnet, dass der mindestens eine Hüllkörper (54a, 54b, 54c) im Bereich der mindestens einen Dornfortsatzanlagevertiefung (50a, 50b, 50c, 52a, 52b, 52c) eine Durchbrechung (58a, 58b, 58c, 60a, 60b, 60c) aufweist.
• 16. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 15, dadurch gekennzeichnet, dass die Durchbrechung (58a, 58b, 58c, 60a, 60b, 60c) in Form eines Langlochs ausgebildet ist.
• 17. Wirbelsäulenstabilisierungsimplantat nach einer der Ausführungsformen 8 bis 16, dadurch gekennzeichnet, dass die den Anlagekörper (12) ausbildenden Teile (54a, 54b, 54c) parallel zur Montagerichtung (48) durchbrochen sind zum Aufnehmen eines Befestigungselements (86; 86'; 86'') der Befestigungsvorrichtung (14).
• 18. Wirbelsäulenstabilisierungsimplantat nach einer der voranstehenden Ausführungsformen, dadurch gekennzeichnet, dass die Befestigungseinrichtung (14; 14'; 14''; 14'''') ein Befestigungselement (86; 86'; 86''; 86'''') umfasst, welches in einer Implantationsstellung eine Befestigungsebene (84) definiert, welche parallel oder im Wesentlichen parallel zu den Dornfortsatzanlageflächen (28, 28a, 28b, 28c, 30, 30a, 30b, 30c; 222, 223) und zwischen diesen verläuft.
• 19. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 18, dadurch gekennzeichnet, dass das Befestigungselement (86; 86'; 86''; 86'''') in Form eines Haltebandes (32; 32'; 32''; 32'''') ausgebildet ist.
• 20. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 18 oder 19, dadurch gekennzeichnet, dass das Halteband (32; 32'; 32''; 32'''') elastisch oder flexibel oder starr ist.
• 21. Wirbelsäulenstabilisierungsimplantat nach einer der Ausführungsformen 18 bis 20, dadurch gekennzeichnet, dass die Befestigungseinrichtung (14; 14'; 14''; 14'''') aus einem resorbierbaren oder nichtresorbierbaren Material hergestellt ist.
• 22. Wirbelsäulenstabilisierungsimplantat nach einer der Ausführungsformen 18 bis 21, dadurch gekennzeichnet, dass die Befestigungseinrichtung (14; 14'; 14''; 14'''') mindestens teilweise aus einem Metall und/oder einem Kunststoff hergestellt ist.
• 23. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 22, dadurch gekennzeichnet, dass der Kunststoff Polyester, Polyetheretherketon oder Polypropylen und dass das Metall Titan oder Stahl ist.
• 24. Wirbelsäulenstabilisierungsimplantat nach einer der Ausführungsformen 19 bis 23, dadurch gekennzeichnet, dass das Halteband (32; 32'; 32''; 32'''') in einer Einführstellung geöffnet ist und zwei freie Bandenden (34, 36; 130, 140) aufweist und dass es in der Implantationsstellung geschlossen ist oder schließbar ist.
• 25. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 24, gekennzeichnet durch eine Schließeinrichtung (88; 254) zum Schließen des Haltebandes (32) in der Implantationsstellung.
• 26. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 25, dadurch gekennzeichnet, dass die Schließeinrichtung (88; 254) mindestens ein Verschlusselement (90; 256) umfasst zum Schließen des Haltebandes (32; 32'''') durch Verbinden der freien Bandenden (34, 36).
• 27. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 26, dadurch gekennzeichnet, dass das mindestens eine Verschlusselement (90; 256) in Form eines Fadens (92), einer Crimpklammer (94), eines Niet (96), einer Klammer (98; 256), eines Kabelbinders, eines Klettverschlusses, eines Rastelements, eines Hydrogelelements (152) oder eines Verriegelungselements (112, 142) ausgebildet ist.
• 28. Wirbelsäulenstabilisierungsimplantat nach einer der Ausführungsformen 18 bis 27, dadurch gekennzeichnet, dass die Befestigungseinrichtung (14'; 14'') mindestens eine Stützelement (100; 100'') umfasst, welches an das supraspinöse Band (38) anlegbar und an dem das Befestigungselement (14', 14'') befestigbar oder durch das das Befestigungselement (14', 14'') durchführbar ist.
• 29. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 28, dadurch gekennzeichnet, dass das mindestens eine Stützelement (100) in Form eines Tellers (102, 104) oder einer Platte (112) ausgebildet ist, welche mindestens eine Durchbrechung (106, 108; 146, 148) zum Befestigen oder Durchführen des Haltebandes (32'; 32'') aufweisen.
• 30. Wirbelsäulenstabilisierungsimplantat nach einer der voranstehenden Ausführungsformen, dadurch gekennzeichnet, dass es einstückig ausgebildet ist.
• 31. Wirbelsäulenstabilisierungsimplantat nach einer der voranstehenden Ausführungsformen, dadurch gekennzeichnet, dass der mindestens eine Anlagekörper (12) mindestens teilweise in Form eines Hydrogelkörpers (152) ausgebildet ist.
• 32. Wirbelsäulenstabilisierungsimplantat nach einer der Ausführungsformen 19 bis 31, dadurch gekennzeichnet, dass das mindestens eine Halteband (32''') schlauchförmig ausgebildet ist und dass der mindestens eine Anlagekörper (152) im schlauchförmigen Halteband (154) angeordnet und gehalten ist.
• 33. Wirbelsäulenstabilisierungsimplantat nach einer der voranstehenden Ausführungsformen, dadurch gekennzeichnet, dass ein Abstand der ersten und zweiten Dornfortsatzanlageflächen (222, 223) voneinander vergrößerbar ist.
• 34. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 33, dadurch gekennzeichnet, dass es zwei Implantatkomponenten (206, 207) umfasst, von denen jede mindestens zwei nebeneinander angeordnete, an einem Ende über eine Brücke miteinander verbundene und an ihren freien Enden auseinanderspreizbare Stützarme (215, 216) aufweist, von denen mindestens einer eine der Dornfortsatzanlageflächen (222, 223) ausbildet.
• 35. Wirbelsäulenstabilisierungsimplantat nach Ausführungsform 34, dadurch gekennzeichnet, dass beide Implantatkomponenten (206, 207) mit den freien Enden ihrer Stützarme (215, 216) gegen die freien Enden der Stützarme (215, 216) der jeweils anderen Implantatkomponente (206, 207) gerichtet sind und dass beide Implantatkomponenten (206, 207) an Aufgleitflächen der jeweils anderen Implantatkomponente (206, 207) aufgleiten und dadurch verschwenkt werden, so dass dadurch der Abstand der oberen und unteren Dornfortsatzanlageflächen (222, 223) vergrößert wird.
• 36. Verfahren zum Stabilisieren einer menschlichen oder tierischen Wirbelsäule, bei welchem ein Wirbelsäulenstabilisierungsimplantat, welches mindestens einen Anlagekörper umfasst, der erste und zweite, voneinander weg weisende Dornfortsatzanlageflächen aufweist zum Anlegen an Dornfortsätze benachbarter Wirbel, in einen Zwischenraum zwischen die Dornfortsätze der benachbarten Wirbel der Wirbelsäule eingesetzt und mit den Dornfortsatzanlageflächen an diese Dornfortsätze angelegt wird, dadurch gekennzeichnet, dass das Wirbelsäulenstabilisierungsimplantat am supraspinösen, die Dornfortsätze der benachbarten Wirbel miteinander verbindenden Band befestigt wird.
• 37. Verfahren nach Ausführungsform 36, dadurch gekennzeichnet, dass das Wirbelsäulenstabilisierungsimplantat eine Befestigungseinrichtung umfasst und dass der mindestens eine Anlagekörper am supraspinösen Band mit der Befestigungseinrichtung befestigt wird.
• 38. Verfahren nach Ausführungsform 36 oder 37, dadurch gekennzeichnet, dass zur Durchführung des Verfahrens ein Wirbelsäulenstabilisierungsimplantat nach einer der Ausführungsformen 1 bis 35 verwendet wird.

The above description therefore includes in particular the embodiments of a spinal column stabilization implant explicitly listed below and a method for stabilizing a human or animal spine:

• 1. Spine Stabilization Implant ( 10 ; 10 '; 10 ''; 10 '''; 10 '''' ) for insertion into a gap ( 16 ) between spinous processes ( 18 . 20 ) of adjacent vortices ( 22 . 24 ) of a human or animal spine ( 26 ), with at least one abutment body ( 12 ; 152 ; 206 . 207 ), which first and second, facing away from each other spinous process surfaces ( 28 . 28a . 28b . 28c . 30 . 30a . 30b . 30c ; 222 . 223 ) for application to the spinous processes ( 18 . 20 ) of the adjacent vertebrae ( 22 . 24 ), characterized by a fastening device ( 14 ; 14 '; 14 ''; 14 '''; 14 '''' ) for fixing the at least one contact body ( 12 ; 152 ; 206 . 207 ) on the supraspinous, the spinous processes ( 18 . 20 ) of the adjacent vertebrae ( 22 . 24 ) interconnecting band ( 38 ).
• 2. Wirbeisaulstabilisierungsimplantat according to embodiment 1, characterized in that the first and / or the second spinous process attachment surface ( 28 . 28a . 28b . 28c . 30 . 30a . 30b . 30c ; 222 . 223 ) of at least one investment body ( 12 ; 152 ; 206 . 207 ) pointing away are concavely curved.
• 3. spinal stabilization implant according to embodiment 1 or 2, characterized in that the at least one plant body ( 12 ; 152 ; 206 . 207 ) at least one spinous process recess ( 50 . 50a . 50b . 50c . 52 . 52a . 52b . 52c ) for at least partially receiving a spinous process ( 18 . 20 ).
• 4. spinal stabilization implant according to one of the preceding embodiments, characterized in that the at least one plant body ( 12 ) two or more the plant body ( 12 ) forming parts ( 40 . 54a . 54b . 54c ) that one of the parts ( 40 . 54a . 54b . 54c ) by a basic body ( 40 ) and at least one other part ( 40 . 54a . 54b . 54c ) by an enveloping body ( 54a . 54b . 54c ), which enveloping body ( 54a . 54b . 54c ) a body image ( 56a . 56b . 56c ) for receiving the basic body ( 40 ) or an enveloping body ( 54a . 54b ).
• 5. spinal stabilization implant according to embodiment 4, characterized in that the body intake ( 56a . 56b . 56c ) is dimensioned such that the basic body ( 40 ) or an enveloping body ( 54a . 54b ) positively and / or positively in the body recording ( 56a . 56b . 56c ) are insertable and / or durable in it.
• 6. spinal stabilization implant according to embodiment 4 or 5, characterized by a guide device ( 64 ) for guiding a connection of at least two of each of the plant body ( 12 ) forming parts ( 40 . 54a . 54b . 54c ).
• 7. spinal stabilization implant according to embodiment 6, characterized in that the guide device ( 64 ) at least one guide groove ( 66 ) and at least one to the guide groove ( 66 ) corresponding leadership lead ( 70 ).
• 8. spinal stabilization implant according to embodiment 6 or 7, characterized in that the guide device ( 64 ) a mounting direction ( 48 ) and that the body ( 12 ) forming parts ( 40 . 54a . 54b . 54c ) are inserted into each other or separable from each other parallel to the mounting direction.
• 9. spinal stabilization implant according to one of the embodiments 6 to 8, characterized in that the guide device ( 64 ) an anchor device ( 76 ) is assigned, which a relative movement of the plant body ( 12 ) forming parts ( 40 . 54a . 54b . 54c ) limited.
• 10. spinal stabilization implant according to embodiment 9, characterized in that the stop device ( 76 ) at least one stop ( 72 . 74 ) for defining an implantation position, in which the abutment body ( 12 ) forming parts ( 40 . 54a . 54b . 54c ) are engaged with each other or connected to each other.
• 11 spinal stabilization implant according to embodiment 10, characterized in that the at least one stop ( 72 . 74 ) at one end of the at least one guide groove ( 66 ) or the at least one guide projection ( 70 ) is arranged or formed.
• 12. spinal stabilization implant according to one of the embodiments 4 to 11, characterized in that the at least one enveloping body ( 54a . 54b . 54c ) is sleeve-shaped.
• 13. spinal stabilization implant according to one of the embodiments 4 to 12, characterized in that at least one of the enveloping body ( 54c ) one transverse to the mounting direction ( 48 ) extending, at least partially closed side wall ( 78 ).
• 14. Spinal stabilization implant according to one of the embodiments 4 to 13, characterized in that the plant body ( 12 ) forming parts ( 40 . 54a . 54b . 54c ) have a cuboidal or substantially cuboidal outer contour.
• 15. Spinal stabilization implant according to one of embodiments 4 to 14, characterized in that the at least one enveloping body ( 54a . 54b . 54c ) in the region of the at least one spinous process recess ( 50a . 50b . 50c . 52a . 52b . 52c ) an opening ( 58a . 58b . 58c . 60a . 60b . 60c ) having.
• 16 spinal stabilization implant according to embodiment 15, characterized in that the opening ( 58a . 58b . 58c . 60a . 60b . 60c ) is formed in the form of a slot.
• 17 spinal stabilization implant according to one of the embodiments 8 to 16, characterized in that the plant body ( 12 ) forming parts ( 54a . 54b . 54c ) parallel to the mounting direction ( 48 ) are pierced for receiving a fastener ( 86 ; 86 '; 86 '' ) of the fastening device ( 14 ).
• 18. Spinal stabilization implant according to one of the preceding embodiments, characterized in that the fastening device ( 14 ; 14 '; 14 ''; 14 '''' ) a fastener ( 86 ; 86 '; 86 ''; 86 '''' ), which in an implantation position a fastening plane ( 84 ) which are parallel or substantially parallel to the spinous process surfaces ( 28 . 28a . 28b . 28c . 30 . 30a . 30b . 30c ; 222 . 223 ) and runs between them.
• 19. Spinal stabilization implant according to embodiment 18, characterized in that the fastening element ( 86 ; 86 '; 86 ''; 86 '''' ) in the form of a tether ( 32 ; 32 '; 32 ''; 32 '''' ) is trained.
• 20. The spinal stabilization implant according to embodiment 18 or 19, characterized in that the tether ( 32 ; 32 '; 32 ''; 32 '''' ) is elastic or flexible or rigid.
• 21. The spinal stabilization implant according to one of the embodiments 18 to 20, characterized in that the fastening device ( 14 ; 14 '; 14 ''; 14 '''' ) is made of a resorbable or non-resorbable material.
• 22 spinal stabilization implant according to one of the embodiments 18 to 21, characterized in that the fastening device ( 14 ; 14 '; 14 ''; 14 '''' ) is at least partially made of a metal and / or a plastic.
• 23. The spinal stabilization implant according to embodiment 22, characterized in that the plastic is polyester, polyetheretherketone or polypropylene and that the metal is titanium or steel.
• 24 spine stabilization implant according to one of the embodiments 19 to 23, characterized in that the tether ( 32 ; 32 '; 32 ''; 32 '''' ) is opened in an insertion position and two free tape ends ( 34 . 36 ; 130 . 140 ) and that it is closed or closable in the implantation position.
• 25. spinal stabilization implant according to embodiment 24, characterized by a locking device ( 88 ; 254 ) for closing the tether ( 32 ) in the implantation position.
• 26. The spinal stabilization implant according to embodiment 25, characterized in that the locking device ( 88 ; 254 ) at least one closure element ( 90 ; 256 ) includes for closing the tether ( 32 ; 32 '''' ) by connecting the free tape ends ( 34 . 36 ).
• 27. The spinal stabilization implant according to embodiment 26, characterized in that the at least one closure element ( 90 ; 256 ) in the form of a thread ( 92 ), a crimping clip ( 94 ), a rivet ( 96 ), a bracket ( 98 ; 256 ), a cable tie, a hook-and-loop fastener, a latching element, a hydrogel element ( 152 ) or a locking element ( 112 . 142 ) is trained.
• 28 spinal stabilization implant according to one of the embodiments 18 to 27, characterized in that the fastening device ( 14 '; 14 '' ) at least one support element ( 100 ; 100 '' ) which is attached to the supraspinous band ( 38 ) can be applied and on which the fastener ( 14 ' . 14 '' ) fastened or by which the fastener ( 14 ' . 14 '' ) is feasible.
• 29. The spinal stabilization implant according to embodiment 28, characterized in that the at least one support element ( 100 ) in the form of a plate ( 102 . 104 ) or a plate ( 112 ) is formed, which at least one opening ( 106 . 108 ; 146 . 148 ) for attaching or carrying the tether ( 32 '; 32 '' ) exhibit.
• 30. The spinal stabilization implant according to one of the preceding embodiments, characterized in that it is integrally formed.
• 31. The spinal stabilization implant according to one of the preceding embodiments, characterized in that the at least one abutment body ( 12 ) at least partially in the form of a hydrogel body ( 152 ) is trained.
• 32. Spinal stabilization implant according to one of the embodiments 19 to 31, characterized in that the at least one retaining band ( 32 ''' ) is tubular and that the at least one plant body ( 152 ) in the tubular retaining band ( 154 ) is arranged and held.
• 33. The spinal stabilization implant according to one of the preceding embodiments, characterized in that a distance of the first and second spinous process surfaces ( 222 . 223 ) Is enlarged from each other.
• 34. The spinal stabilization implant according to embodiment 33, characterized in that it comprises two implant components ( 206 . 207 ), each of which has at least two support arms (14) arranged side by side and connected at one end by means of a bridge and at their free ends ( 215 . 216 ), of which at least one of the spinous process surfaces ( 222 . 223 ) trains.
• 35. The spinal stabilization implant according to embodiment 34, characterized in that both implant components ( 206 . 207 ) with the free ends of their support arms ( 215 . 216 ) against the free ends of the support arms ( 215 . 216 ) of the other implant component ( 206 . 207 ) and that both implant components ( 206 . 207 ) on sliding surfaces of the respective other implant component ( 206 . 207 ) and thereby be pivoted so that thereby the distance of the upper and lower spinous process surfaces ( 222 . 223 ) is increased.
• A method for stabilizing a human or animal spine, wherein a spinal stabilization implant comprising at least one abutment body has first and second opposing spinous process surfaces for abutment with spinous processes of adjacent vertebrae, into a space between the spinous processes of the adjacent vertebrae of the spine is used and applied to the spinous process surfaces of these spinous processes, characterized in that the spinal stabilization implant is attached to the supraspinous, the spinous processes of the adjacent vertebra interconnecting band.
• 37. The method according to embodiment 36, characterized in that the spinal stabilization implant comprises a fastening device and that the at least one abutment body is fastened to the supraspinous band with the fastening device.
• 38. The method according to embodiment 36 or 37, characterized in that a spinal column stabilization implant according to one of embodiments 1 to 35 is used for carrying out the method.

The following description of preferred embodiments of the invention is used in conjunction with the drawings for further explanation. Show it:

1 a spinal stabilization implant having an abutment body inserted between spinous processes of adjacent vertebrae immediately after insertion and prior to attachment to the supraspinous ligament;

2 : a view similar 1 the disassembled, formed of several parts investment body;

3 : an enlarged view of the plant body 1 ;

4 a sectional view taken along line 4-4 in 3 ;

5 : an enlarged view of the arrangement 1 with a supraspinous ligament tether of the spinal stabilization implant;

6 : a view analog 5 a further embodiment of a spinal stabilization implant;

7 : a partial exploded view of the in 6 spinal stabilization implant shown;

8th : a view analog 6 a further embodiment of a spinal stabilization implant;

9 : an exploded view of the in 8th spinal stabilization implant shown; and

10 : a view analog 5 a further embodiment of a spinal stabilization implant;

11 : a view similar 1 a further embodiment of a spinal stabilization implant; and

12 : an enlarged and partially broken view of the spinal stabilization implant 11 ,

In the 1 to 4 is a first embodiment of a total reference numeral 10 illustrated spinal stabilization implant, which hereinafter for the sake of simplicity only as an implant 10 referred to as. The implant comprises an abutment body 12 and a fastening device 14 , The investment body 12 is designed for insertion in a gap 16 between spinous processes 18 and 20 adjacent vortex 22 and 24 a spine 26 , The investment body 12 has two spinous process surfaces facing away from each other 28 and 30 on, attached to the spinous processes 18 and 20 can be applied to a movement of spinous processes 18 and 20 to limit and / or dampen one another.

The fastening device 14 includes a tether 32 , which in an insertion position, as in the 1 and 2 shown, is open and two free tape ends 34 and 36 having. The band ends 34 and 36 are connectable to each other as in 5 is shown schematically. Furthermore, the tether 32 designed for fixing the contact body 12 at the spinous processes 18 and 20 interconnecting supraspinous band 38 . all spinous processes of the spine 26 connects with each other.

The investment body 12 is a total of several parts. The in the 1 to 5 exemplified investment body 12 is formed in four parts. It includes a cuboid, solid body 40 which is rectangular in cross-section, parallel to both an upper side 42 as well as to a base 44 extending aperture 46 provided, which has a longitudinal axis 48 Are defined. A cross section of the opening 46 is adapted to a cross section of the retaining band 32 so that the tether through the opening 46 can be pushed through and this, as shown in the figures, almost completely fills.

Both on the top 42 as well as on the bottom 44 of the basic body 40 each is a spinous process recess 50 respectively 52 formed, each one from the main body 40 pointing away concave curved spinous process surface 28 respectively 30 define.

The main body 40 alone could form an abutment body and between the two spinous processes 18 and 20 be used, the distance from each other approximately the distance between the spinous process attachment surface 28a and 30a correspond. Are the spinous processes 18 and 20 however, further apart, the abutment body can 12 be formed by the body 40 together with one or more enveloping bodies 54a . 54b and 54c , All enveloping bodies have a substantially cuboidal outer contour. They are sleeve-shaped with a substantially rectangular inner cross section and each define a cuboid body 56a . 56b respectively 56c into which the basic body 40 or the next smaller envelope 54a respectively 54b non-positively and / or positively insertable and is durable in it. Specifically, this means that body absorption 56a is formed for positively receiving the body 40 , the body intake 56b for receiving the enveloping body 54a and the body intake 56c of the envelope 54c for positive reception of the enveloping body 54b , Of course, further, in the embodiment shown in the figures, however, not shown, enveloping body may be provided in a corresponding manner.

The enveloping body 54a . 54b and 54c define from their respective top 42a . 42b and 42c or their bottom 44a . 44b and 44c pointing away concave curved spinous process surfaces 28a . 28b and 28c respectively 30a . 30b and 30c , which correspond to the spinous process attachment surfaces 28 and 30 of the basic body 40 are shaped. Because a depth of the spinous process plant depressions 50a . 50b and 50c on the tops 42a . 42b and 42c are formed, and the spinous process recesses 52a . 52b and 52c on the bottoms 44a . 44b and 44c are formed, is slightly larger than a thickness of the top and bottom, so are openings 58a . 58b and 58c in the area of the spinous process plant depressions 50a . 50b and 50c formed, in an analogous way openings 60a . 60b and 60c in the area of the spinous process plant depressions 52a . 52b and 52c , The breakthroughs 58a . 58b and 58c such as 60a . 60b and 60c are each formed in the form of slots. They are all identically shaped and the same size and lie when the main body 40 and the enveloping bodies 54a . 54b and 54c as in the 3 and 4 shown, are pushed into each other, directly above each other. The elongated holes define a longitudinal axis 62 perpendicular to the longitudinal axis 48 is oriented.

To the the plant body 12 To be able to connect forming parts in a defined manner, is a guide device 64 intended. It comprises on the upper and lower sides of the body 40 or the enveloping body 54a . 54b and 54c connecting side walls 68a . 68b and 68c inside and / or outside formed or arranged guide grooves 66 as well as corresponding guide projections 70 , which are parallel to the longitudinal axis 48 extend. As the guide grooves 66 or the guide projections 70 not over the entire width of the side walls 68a . 68b and 68c extend, form end faces of the guide grooves 66 or the guide projections 70 attacks 72 respectively 74 off, which abut each other, when the plant body 12 forming parts are joined together. The attacks 72 and 74 form parts of a total with the reference numeral 76 designated stop means for limiting a relative movement of the plant body 12 training parts. The stop device 76 is thus also the management device 64 assigned.

Due to the orientation of the guide grooves 66 and the corresponding guide projections 70 a mounting direction is defined, which is parallel to the longitudinal axis 48 is oriented, which is the plant body 12 forming parts parallel to the mounting direction inserted into one another and optionally separated from each other.

The stop device 76 with the stops 72 and 74 defines an implantation position in which the plant body 12 forming parts are engaged with each other or interconnected, as in the 1 and FIGS. 3 to 5 are shown.

Optionally, at least one of the enveloping bodies 54a . 54b and 54c in which in 4 illustrated embodiment of the enveloping body 54c , a transverse side wall extending transversely to the mounting direction 78 exhibit. The side wall 78 has an opening 80 on that at the plant body 12 forming and nested parts with the opening 46 of the basic body 40 is aligned so that the tether 32 through the entire plant body 12 is feasible. The side wall 78 forms a stop for the body 40 and the enveloping bodies 54a and 54b All of them in the body 56c of the envelope 54c are insertable.

Cross sections of the tether 32 or the opening 46 define in their a longitudinal axis 82 , which are both perpendicular to the longitudinal axis 48 as well as perpendicular to the longitudinal axis 62 is oriented. Due to the special shape of the rectangular in cross-section, a fastener 64 forming tether 32 This can only be done in one attachment level 84 be deformed, which parallel to the top and bottom 42 . 44 of the basic body 40 is oriented and thus the gap 16 between the spinous processes 18 and 20 Splits. The longitudinal axis 82 runs perpendicular to the mounting plane 84 , the longitudinal axes 48 and 62 parallel to this. The closed in the implantation position fastener 86 thus defines the mounting plane 84 , It does not wrap around the spinous processes, as is the case with spine stabilization implants known in the art 18 and 20 but is not in contact with them at all.

To connect or close the free ends of the tape 34 and 36 can be a locking device 88 be provided for closing the retaining band 32 in the implantation position. The locking device 88 can one or more fastener elements 90 include closing the tether 32 by connecting the free tape ends 34 and 36 together. The closure element 90 However, also a part of the fastening device 14 form for fixing the tether 32 on the supraspinous ligament 38 ,

In 5 are closure elements 90 exemplified, in the form of a thread. 9 2 for sewing on the retaining band 32 with the tape 38 , a crimp clip 94 for crimping the free ends 34 and 36 and optionally for crimping the tether 32 with the tape 38 , Alternatively, a rivet can also be used 96 be provided for closing the retaining band 32 and / or for connecting it to the tape 38 , Another alternative of a closure element 90 is in the form of a conventional bracket 98 in 5 shown schematically, with which both the band ends 34 and 36 as well as the retaining element 32 with the tape 38 can be connected to each other.

Not shown in the figures is an embodiment in which the band ends 34 and 36 are formed in the form of free ends of a cable tie, which can be engaged with each other latching. It is also conceivable, the two inter-engageable elements of a hook and loop fastener at each end of a tape 34 respectively 36 to arrange to connect them together in the implantation position. Otherwise, any locking elements or locking elements are conceivable to the band ends 34 and 36 to connect with each other.

The investment body 12 can be made entirely from a plastic. This means that all the parts forming it, namely the basic body 40 and the enveloping bodies 54a . 54b and 54c , are made of a plastic. It would also be conceivable to produce the said parts from a biocompatible metal and optionally to provide it with an outer plastic coating. It is also conceivable, individual parts of the plant body 12 made of a plastic, others made of a metal.

The fastening device 14 may be wholly or partly made of a plastic or wholly or partly of a metal. Optionally, the material forming the fastening device may be made of a resorbable material, for example a resorbable plastic. The tether 32 can be rigid or flexible. It may in particular be made of all known non-absorbable materials, for example of polyester, polyetheretherketone (PEEK) or polypropylene. Also conceivable are cerclage parts made of titanium or steel. Overall, the investment body 12 preferably a rigid body. As already stated, depending on a spacing of the spinous processes 18 and 20 the size of the investment body 12 can be varied by adding a corresponding number of enveloping bodies 54a . 54b and 54c to the main body 40 because each of the enveloping bodies 54a . 54b and 54c Spinous process plant wells 50a . 50b . 50c such as 52a . 52b and 52c having.

The spinal stabilization implant 10 limits by the investment body 12 a movement of the adjacent vertebrae relative to each other, especially in extension. It is used for load sharing and supports the regeneration of one between the adjacent vertebrae 22 and 24 damaged disc. By the kyphotic position of the plant body 12 An area of the foramen and the spinal canal is enlarged. For example, this is a mechanism used in stenosis Relief of the spinal cord or the cauda equina or the nerve roots leads.

Additional stability may be after implantation of the spinal stabilization implant 10 take place by a connective tissue ingrowth, in particular by ingrowth of the plant body 12 , By fixing the plant body 12 by means of the fastening device 14 At supraspinous ligament 38, connective tissue growth around the tether may occur 32 and optionally also the plant body 12 even more strongly indicated. For particularly strong connective tissue growth is an absorbable attachment device 14 advantageous, since then the plant body 12 through the ingrown connective tissue in its position between the spinous processes 18 and 20 can be held. With the variants described, the tether 32 by looping and / or piercing the supraspinous band 38 be set at this. As also stated, the fixation of the spinal stabilization implant takes place 10 not around the spinous processes 10 in a cranial-caudal direction, but in the anterior-posterior direction.

In the 6 and 7 is a further embodiment of an overall reference numeral 10 ' provided spinal stabilization implant. It includes a plant body 12 that is identical to the one related to the 1 to 5 described plant body 12 is trained. The investment body 12 can with a fastening device 14 ' be set on the supraspinous band. The fastening device 14 ' includes a fastener 86 ' in the form of a circular cross-section tether 32 ' , This fills the opening 46 not completely out. Since it is much narrower than the tether 32 , Includes the fastening device 40 Furthermore, a total with the reference numeral 100 provided support member which is formed in two parts and two button-shaped discs 102 and 104 includes, which are identical and each have two holes 106 and two holes 108 have, wherein the holes 106 and 108 all are arranged in one line. The holes 108 are slightly larger in diameter than the holes 106 , which on both sides of the adjacent holes 108 are formed. An inner diameter of the holes 106 corresponds approximately to the diameter of the retaining band 32 ' ,

The disks 102 and 104 allow a large force application into the supraspinous band 38 , The tether 32 ' is first through the hole 106 the disc 102 , then through an opening 110 in the supraspinous band 38 and then through the one hole 106 the disc 102 guided. The tether 32 ' will then be 180 ° back through the adjacent hole 108 the disc 102 , through another opening 110 supraspinous band 32 ' and through the opening 106 adjacent opening 108 the disc 104 passed. Subsequently, the tether 32 ' again deflected by 180 ° and through the second opening 108 the disc 104 , through another opening 110 supraspinous band 38 and through the second puncture 108 the disc 102 guided. Finally, in the insertion position, the free end of the tape, not shown, of the retaining band 32 ' through the remaining hole 106 the disc 102 , through a fourth opening 110 in the supraspinous band 38 and through the remaining hole 106 the disc 104 guided. The free end of the tape is then in the area between the supraspinous tape 38 and the opening 46 of the basic body 40 with the other free end of the strap 32 ' connected in the manner described above, for example by knotting, crimping, riveting, stapling, locking, by means of a hook and loop fastener or by merging the trained in the form of free ends of a cable tie band ends of the retaining band 32 ' ,

In the 8th and 9 is another embodiment of a spinal stabilization implant, generally with the reference numeral 10 '' designated. It includes one associated with the 1 to 5 illustrated and described investment body identical body 12 and a fastening device 14 '' for fixing the abutment body to the supraspinous band 38 , The fastening device 14 '' includes a support element 100 '' , which is in the form of an elongated plate 112 is trained. The plate 112 has a central, bulged area, in which a circular cross-section opening 114 is trained. Adjacent to the opening 114 are along one of the plate 112 defined longitudinal axis 116 to the respective ends 118 and 120 in each case two in cross-section semicircular openings 122 formed by a crossbar 124 are separated from each other.

The plate 112 becomes on one of the spinous processes 18 and 20 laid away side of the supraspinous tape and by means of a retaining band 32 '' fixed. The tether 32 '' has an opening 46 of the basic body 40 positive fit filling body section 126 on, at one end two band parts 128 are formed protruding, preferably in one piece and each have a free end 130 having. The free ends 130 are each through slot-like openings 132 led the supraspinous tape, which are spaced apart and leave between them so much space that another opening 136 can be formed, whose inner diameter is substantially the inner diameter of the perforation 114 the plate 112 equivalent. The free ends of the band 130 are then each through an opening 122 to the associated crosspiece 124 around and back through the adjacent opening 122 guided. After subsequent passage through the opening 132 may the end 130 of the band 32 '' adjacent the plant body holding section 126 with the tether 32 '' in turn, as needed, with the bonding techniques described above, that is, knotting, crimping, riveting, stapling, and the like.

At the other end of the plant body section 126 are two more band sections 138 formed, whose free ends spherical thickenings 140 wear. These are through the opening 136 supraspinous tape 38 as well as through the opening 114 the plate 112 passed. To form a cross-locking is an elongated plate 142 provided, which has a longitudinal axis 144 Are defined. The holding plate 142 gets through the breakthroughs 136 and 114 passed through and with the thickenings 140 connected. For this purpose, the holding plate 142 , analogous to the discs 102 and 104 , along the longitudinal axis 144 arranged holes 146 and 148 where the holes 148 larger in diameter than the holes 146 are, but slightly smaller than a diameter of the thickenings 140 , The thickenings 140 can then through the holes 148 be pushed through and are in the field of drilling 148 something constricted so that the band ends of the band sections 138 clamped to the with its longitudinal axis 144 transverse to the longitudinal axis 116 oriented holding plate 142 are held, which turn to the plate 112 in the area of the opening 114 supported.

Another, generally with the reference numeral 10 ''' provided embodiment of a spine stabilization implant is in 10 shown schematically. It has the shape of a round or oval ring, which is essentially formed by a hydrogel body 152 that is between the spinous processes 18 and 20 can be introduced. The hydrogel body 152 is preferably in a tubular band 154 arranged. The ribbon 154 becomes the supraspinous band 38 guided and for example by sewing, stapling or by a clip at the end of the tape 154 attached. Similarly, free ends of the hydrogel body can also 152 by connecting free ends of the surrounding tubular band 154 be connected to each other. The hydrogel body 152 can then, as in 10 exemplified, an opening 156 define, through which the supraspinous band 38 extends. By hydrogenation or swelling of the hydrogel as a result of the absorption of the body's own water, for example, the opening 156 be reduced and the supraspinous band 38 so additionally through the spinal stabilization implant 10 ''' be fixed directly by clamping. Due to the annular fixing, it is also virtually impossible for the implant to be 10 ''' from the gap 16 slip out and solve in an undefined way.

Alternatively, it is also conceivable that the swelling process of the tape 154 held hydrogel for connection to the supraspinous tape 38 is used. In the area of the band 154 is in such a variant in the tubular closure portion also hydrogel, preferably in two adjacent, but separate sections, so that after hydrogenation held in the closure area hydrogel form fit to the supraspinous band 38 lay and thus a flexible interface to the band 38 can represent. Also the spinal stabilization implant 10 ''' defines a plane of attachment perpendicular to one through the supraspinous band 38 defined longitudinal direction 158 is oriented.

The tubular band 154 is preferably made of a plastic, conveniently it is formed from a permeable or semi-permeable membrane which prevents water from entering the interior to hydrogenate the hydrogel body 152 allows.

In the 11 and 12 is a further embodiment of an overall reference numeral 10 '''' spinal stabilization implant shown schematically. The spinal stabilization implant 10 '''' is also between spinous processes 18 . 20 adjacent vertebrae 22 . 24 used. It rests on both adjacent spinous processes 18 . 20 There, acting as a spacer element between them, so that by changing the height of the spinal stabilization implant 10 '''' the distance between the two spinous processes 18 . 20 and then through the spinal stabilization implant 10 '''' can be.

The construction of this spinal stabilization implant 10 '''' can be chosen differently, below is the hand of the 11 and 12 an embodiment of such a spinal stabilization implant 10 '''' described by way of example. Other embodiments are for example from the DE 20 2008 009 344 U1 is known, which is hereby incorporated by reference in its entirety in the following description. The spinal stabilization implant 10 '''' has the ability to do it at low height in the space between two spinous processes 18 . 20 be used and then after the Inserting his height can increase so that the desired distance of the spinous processes 18 . 20 can be adjusted and maintained.

That in the 11 and 12 illustrated spinal stabilization implant 10 '''' two in this case the same design, plant body defining implant components 206 . 207 of which only one will be described in more detail below. This implant component is made up of two separate components 208 . 209 assembled using a C-shaped bracket 210 held together. Both components 208 . 209 have at the mutually facing ends of the components 208 . 209 a band-shaped, bent portion 211 respectively 212 on, at the end of the components 208 . 209 in a strongly bent flange in the opposite direction 213 . 214 ends. This flange may additionally be bead-shaped thickened. The two flanges 213 . 214 be from the C-shaped bracket 210 encompassed and inferred, so that in this area a connection of the two components 208 . 209 which also causes a pivoting of the components 208 . 209 enabled against each other, so it is a hinge-like connection.

Both curved sections 211 . 212 go at her the flanges 213 respectively 214 opposite end in support arms 215 . 216 over, taking on a section 211 the support arm 215 over the entire width of the section 211 extends and through one of the free end of the component 208 until the beginning of the section 211 extending longitudinal slot 217 in two adjacent Stützarmabschnitte 218 . 219 is divided. For the other component 209 is the support arm 216 narrower than the section 212 and arranged in the middle, the width of the support arm 216 is equal to or less than the width of the longitudinal slot 217 on the other component, so that the support arm 216 in the longitudinal slot 217 between the two Stützarmabschnitte 218 . 219 can dive.

Both the support arm 216 as well as the two Stützarmabschnitte 218 . 219 wear on their facing inner sides in the region of their free ends a projection 220a . 220b respectively 221 , one side of which as a concavely curved, spinous process surfaces defining support surface 222a . 222b respectively 223 is trained.

If the two components 208 . 209 through the bracket 210 are held together, cross the support arms 215 and 216 , In doing so, the support arm dives 216 in the longitudinal slot 217 between the two support arm sections 218 . 219 of the other component. The support surfaces 222a . 222b and 223 thereby show each on the opposite side of the component to the outside. The two implant components of equal construction 206 . 207 be with the free ends of their support arms 215 . 216 facing each other so pushed against each other, that in each case abut the outer surfaces of the support arms of the one implant component on the outer surfaces of the support arms of the other implant component and the approach of the two implant components 206 . 207 slide on each other. In the spine stabilization implant 10 '''' these outer surfaces are substantially flat and therefore extend due to the crossing of the support arms 215 . 216 obliquely, the outer surfaces of the support arms 215 . 216 an implant component are arranged approximately V-shaped towards the free end. At the free ends are the outer surfaces 224a . 224b and 225 slightly bent to the first approach of the implant components 206 . 207 to facilitate slipping.

When pushing together the two implant components 206 . 207 and when the support arms slide up 215 . 216 on each other are the support arms 215 . 216 crossed stronger so that the free ends of the support arms 215 . 216 and thus the outwardly facing support surfaces 222a and 222b on the one hand, and 223 on the other hand remove from each other, that is, the distance of the outwardly facing, facing opposite sides of the implant component support surfaces is increased. Here are the support surfaces 222a and 222b an implant component and the support surface 223 the other implant component then immediately next to each other, the support surface 223 the other implant component is located between the support surfaces 222a and 222b an implant component, so that the three support surfaces together form a trough-shaped bearing surface for a spinous process, which is supported on these adjacent support surfaces.

The further the two implant components 206 . 207 be pushed against each other, the greater the distance between the support surfaces can be set on opposite sides of the implant component and thus the greater the height of the implant and the distance of the resting on the implant spinous processes.

To the implant components 206 . 207 in the manner described to push against each other, tie rods on both sides next to the implant components 226 . 227 arranged in the form of thin rods, the perforations 228 . 229 prevail, located at the ends of the two brackets 210 are located. Thus, on the one hand, these clamps hold together the two components of an implant component; on the other hand, they act as end pieces, as they approach, the two implant components 206 . 207 be pushed against each other.

Both tie rods 226 . 227 have a thickened head at one end 230 respectively 231 , which limits the immersion depth in the openings of a clip, on the opposite end, the opposite bracket of the implant is freely displaceable and can be moved there by means of an instrument not shown in the drawing in the direction of the other bracket, thereby characterized the two implant components be pushed against each other. When the desired insertion depth is reached, the displaceable clip can be fixed by suitable means in their position, these means are not shown in the drawing. It may be, for example, a deadlock, a deformation or the like or the distance is fixed by placing a stop on the tie rods.

In the spine stabilization implant 10 '''' In addition, band-shaped contact elements are inserted into the implant, namely a band-shaped, in the middle section 234 rectilinear and in the two-sided adjoining end sections 235 . 236 bent to opposite sides abutment element 237 which is formed substantially the same as a second contact element 238 , which is wider than the contact element 237 and a longitudinal slot extending from one end to almost the other end 239 so that this wider contact element 238 in two adjacent bridges 240 . 241 is divided. The width of the longitudinal slot 239 is equal to or greater than the width of the narrower contact element 237 so that this in the longitudinal slot 239 can dive.

The narrower investment element 237 is between the outer surfaces of the middle support arms 216 inserted the two implant components, the two webs 240 and 241 between the outer surfaces of the Stützarmabschnitte 218 . 219 of the two implant components, so that the end sections bent in opposite directions 235 . 236 the two investment elements 237 . 238 immediately next to the support surfaces 222a . 222b and 223 essentially protrude transversely to the displacement plane of the two implant components and thereby laterally to the spinous processes 18 . 20 with the implant inserted on the support surfaces 222a . 222b and 223 resting of. As a result, the implant is reliably secured against a transverse shift relative to the spinous processes, the two contact elements 237 . 238 are held between the two implant components in a press fit and thereby fixed against any further displacement.

In the implantation of the implant, the abutment elements are not yet used, so that the implant can be easily inserted through a relatively small access opening due to its low height. The investment elements 237 . 238 are inserted only between the outer surfaces of the support arms when the implant is inserted, however, this insertion takes place before pushing the implant components and thus before increasing the distance between the support surfaces, so that the contact element between the outer surfaces of the support arms can still be moved freely.

The described spine stabilization implant 10 '''' can be made of metal or a sterilizable, biocompatible plastic material, it results in a very simple structure, since both implant components are the same structure. The spinal stabilization implant 10 '''' can be used in preassembled condition, so with by the two tie rods 226 . 227 held together implant components, but not yet pushed together so far that the support surfaces are substantially removed from each other.

The described embodiment is characterized in that the support arms of an implant component cross over and the crossover is further enhanced by pushing together two implant components, that is, the support arms are spread open at their free ends. Accordingly, the support surfaces are each arranged on the inner sides of the support arms and relative to the support arms so inclined that the support surfaces are arranged on the top and bottom of the implant substantially parallel to each other and parallel to the displacement plane of the implant body.

In the described spinal stabilization implant 10 '''' The support arms abut with their outer surfaces on the outer surfaces of the support arms of the other implant body and are thus crossed even more when pushed together.

The support arms are bent concavely in all cases, so that on the outer surfaces of the support arms through these concave curved support surfaces 222 . 223 give their distance by pushing together the implant components 206 . 207 can be increased.

The band-shaped, narrow contact element 37 has a longitudinal slot extending over most of its length 301 on, in the insertion of the investment element 37 between the two implant components 206 . 207 not one illustrated guide projection engages on the outside of the implant component 206 is arranged and which is formed so broad that it is at the two side edges of the longitudinal slot 301 invests. This results when inserting the contact element 237 between the two implant components 206 . 207 a guide of the contact element 237 so that the user when inserting the contact element 237 is supported and receives a default for the feed direction.

At the investment element 38 is a relatively wide longitudinal slot 39 present, and on the side edges, other parts of the implant components can create leading, for example, two of the two implant components 206 . 207 penetrating tie rods 226 . 227 or other parts of the implant components.

The two implant components 206 . 207 are each made up of the two components 208 . 209 assembled in the same way by parentheses 210 held together. These braces 210 take over the task of end pieces

The investment element 38 carries on one of his footbridges 40 an extension 300 which facilitates insertion. Such an extension can also on the contact element 237 be provided.

To the brackets 210 each formed fasteners 86 '''' in the form of ribbons that form part of a tether 32 '''' a fastening device 14 '''' for fixing the spine stabilization implant 10 '''' on the tape 38 form and at their free ends coupling elements 250 and 252 a closing or coupling device 254 wear. In particular, the coupling elements 250 and 252 be formed in the form of connecting elements which correspond to those of a cable tie, so that only a unidirectional movement of the coupling elements 250 and 252 is possible if they are engaged with each other. The mutually engaging bands can, for example, with a clip defining a closure element 256 or alternatively with a thread on the belt 38 be determined.

Alternatively, instead of the described fasteners 86 '''' also variants are provided, as they are related to in the 1 to 10 described embodiments have been explained in more detail. Of course, the above-described alternatives for fixing the spinal stabilization implants on the belt 38 be exchanged with each other.

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• US 6626944 B1 [0003]
• US 6761720 B1 [0003]
• DE 202008009344 U1 [0087]

Claims (25)

Spine Stabilization Implant ( 10 ; 10 '; 10 ''; 10 '''; 10 '''' ) for insertion into a gap ( 16 ) between spinous processes ( 18 . 20 ) of adjacent vortices ( 22 . 24 ) of a human or animal spine ( 26 ), with at least one abutment body ( 12 ; 152 ; 206 . 207 ), which first and second, facing away from each other spinous process surfaces ( 28 . 28a . 28b . 28c . 30 . 30a . 30b . 30c ; 222 . 223 ) for application to the spinous processes ( 18 . 20 ) of the adjacent vertebrae ( 22 . 24 ), characterized by a fastening device ( 14 ; 14 '; 14 ''; 14 '''; 14 '''' ) for fixing the at least one contact body ( 12 ; 152 ; 206 . 207 ) on the supraspinous, the spinous processes ( 18 . 20 ) of the adjacent vertebrae ( 22 . 24 ) interconnecting band ( 38 ). Spinal stabilization implant according to claim 1, characterized in that the first and / or the second spinous process attachment surface ( 28 . 28a . 28b . 28c . 30 . 30a . 30b . 30c ; 222 . 223 ) of at least one investment body ( 12 ; 152 ; 206 . 207 ) pointing away are concavely curved. Spinal stabilization implant according to claim 1 or 2, characterized in that the at least one abutment body ( 12 ; 152 ; 206 . 207 ) at least one spinous process recess ( 50 . 50a . 50b . 50c . 52 . 52a . 52b . 52c ) for at least partially receiving a spinous process ( 18 . 20 ). Spine stabilization implant according to one of the preceding claims, characterized in that the at least one abutment body ( 12 ) two or more the plant body ( 12 ) forming parts ( 40 . 54a . 54b . 54c ) that one of the parts ( 40 . 54a . 54b . 54c ) by a basic body ( 40 ) and at least one other part ( 40 . 54a . 54b . 54c ) by an enveloping body ( 54a . 54b . 54c ), which enveloping body ( 54a . 54b . 54c ) a body image ( 56a . 56b . 56c ) for receiving the basic body ( 40 ) or an enveloping body ( 54a . 54b ). Spinal stabilization implant according to claim 4, characterized in that the body intake ( 56a . 56b . 56c ) is dimensioned such that the basic body ( 40 ) or an enveloping body ( 54a . 54b ) positively and / or positively in the body recording ( 56a . 56b . 56c ) are insertable and / or durable in it. Spinal stabilization implant according to claim 4 or 5, characterized by a guiding device ( 64 ) for guiding a connection of at least two of each of the plant body ( 12 ) forming parts ( 40 . 54a . 54b . 54c ). Spinal stabilization implant according to claim 6, characterized in that the guiding device ( 64 ) at least one guide groove ( 66 ) and at least one to the guide groove ( 66 ) corresponding leadership lead ( 70 ). Spinal stabilization implant according to claim 6 or 7, characterized in that the guiding device ( 64 ) a mounting direction ( 48 ) and that the body ( 12 ) forming parts ( 40 . 54a . 54b . 54c ) are inserted into each other or separable from each other parallel to the mounting direction. Spinal stabilization implant according to one of claims 6 to 8, characterized in that the guiding device ( 64 ) an anchor device ( 76 ) is assigned, which a relative movement of the plant body ( 12 ) forming parts ( 40 . 54a . 54b . 54c ) limited. Spinal stabilization implant according to one of claims 4 to 9, characterized in that at least one of the enveloping bodies ( 54c ) one transverse to the mounting direction ( 48 ) extending, at least partially closed side wall ( 78 ). Spinal stabilization implant according to one of claims 4 to 10, characterized in that the abutment body ( 12 ) forming parts ( 40 . 54a . 54b . 54c ) have a cuboidal or substantially cuboidal outer contour. Spinal stabilization implant according to one of claims 4 to 11, characterized in that the at least one enveloping body ( 54a . 54b . 54c ) in the region of the at least one spinous process recess ( 50a . 50b . 50c . 52a . 52b . 52c ) an opening ( 58a . 58b . 58c . 60a . 60b . 60c ) having. Spinal stabilization implant according to one of claims 8 to 12, characterized in that the abutment body ( 12 ) forming parts ( 54a . 54b . 54c ) parallel to the mounting direction ( 48 ) are pierced for receiving a fastener ( 86 ; 86 '; 86 '' ) of the fastening device ( 14 ). Spinal stabilization implant according to one of the preceding claims, characterized in that the fastening device ( 14 ; 14 '; 14 ''; 14 '''' ) a fastener ( 86 ; 86 '; 86 ''; 86 '''' ), which in an implantation position a fastening plane ( 84 ) which are parallel or substantially parallel to the spinous process surfaces ( 28 . 28a . 28b . 28c . 30 . 30a . 30b . 30c ; 222 . 223 ) and runs between them. Spinal stabilization implant according to claim 18, characterized in that the fastening element ( 86 ; 86 '; 86 ''; 86 '''' ) is elastic or flexible or rigid. Spinal stabilization implant according to one of claims 14 or 15, characterized in that the fastening device ( 14 ; 14 '; 14 ''; 14 '''' ) is made of a resorbable or non-resorbable material. Spinal stabilization implant according to one of claims 14 to 16, characterized in that the fastening device ( 14 ; 14 '; 14 ''; 14 '''' ) is at least partially made of a metal and / or a plastic. Spinal stabilization implant according to one of claims 15 to 17, characterized in that the tether ( 32 ; 32 '; 32 ''; 32 '''' ) is opened in an insertion position and two free tape ends ( 34 . 36 ; 130 . 140 ) and that it is closed or closable in the implantation position. Spinal stabilization implant according to claim 18, characterized by a locking device ( 88 ; 254 ) for closing the tether ( 32 ) in the implantation position, wherein the locking device ( 88 ; 254 ) at least one closure element ( 90 ; 256 ) includes for closing the tether ( 32 ; 32 '''' ) by connecting the free tape ends ( 34 . 36 ). Spinal stabilization implant according to one of claims 14 to 19, characterized in that the fastening device ( 14 '; 14 '' ) at least one support element ( 100 ; 100 '' ) which is attached to the supraspinous band ( 38 ) can be applied and on which the fastener ( 14 ' . 14 '' ) fastened or by which the fastener ( 14 ' . 14 '' ) is feasible. Spinal stabilization implant according to claim 20, characterized in that the at least one support element ( 100 ) in the form of a plate ( 102 . 104 ) or a plate ( 112 ) is formed, which at least one opening ( 106 . 108 ; 146 . 148 ) for attaching or carrying the tether ( 32 '; 32 '' ) exhibit. Spinal stabilization implant according to one of the preceding claims, characterized in that it is integrally formed. Spine stabilization implant according to one of the preceding claims, characterized in that the at least one abutment body ( 12 ) at least partially in the form of a hydrogel body ( 152 ) is trained. Spinal stabilization implant according to one of claims 15 to 23, characterized in that the at least one tether ( 32 '' ) is tubular and that the at least one plant body ( 152 ) in the tubular retaining band ( 154 ) is arranged and held. Spinal stabilization implant according to one of the preceding claims, characterized in that a distance of the first and second spinous process surfaces ( 222 . 223 ) Is enlarged from each other.

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