DE202010000088U1 - Spinal stabilization implant - Google Patents

Abstract

Spinal stabilization implant (10; 10 '; 10' '; 10' ''; 10 '' '') for insertion into a space (16) between spinous processes (18, 20) of adjacent vertebrae (22, 24) of a human or animal spine ( 26), having at least one abutment body (12; 152; 206, 207), which first and second, facing away from each other spinous process bearing 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).

Description

The The present invention relates to a spinal stabilization implant for insertion into a space between spinous processes adjacent vertebrae of a human or animal spine, with at least one contact body, which first and second, Having spinous process bearing surfaces facing away from each other for application to the spinous processes of the adjacent vertebrae.

Further is a method for stabilizing a human or animal spine, in which a Spinal stabilization implant, which at least comprises an abutment body, the first and second, from each other pointing away spinous process surfaces has for docking on spinous processes of adjacent vertebrae, in a gap between the spinous processes of the adjacent vertebrae Spinal column used and with the spinous process surfaces is applied to these spinous processes.

Spinal stabilization implants and methods for stabilizing a spinal column 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, in particular 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 It is therefore an object of the present invention to provide a spinal stabilization implant of the initially described type so that the implantation of the spinal stabilization implant and simplified a risk of injury to spinous processes is minimized.

These Task is with a spinal stabilization implant solved the type described above according to the invention by a fastening device for fixing the at least an abutment body at the supraspinous, the spinous processes the adjacent vertebra interconnecting band.

The Fastening device allows the spinal stabilization implant, unlike the known systems, at the supraspinous band set. An attachment of the spinal stabilization implant directly on the spinous processes is therefore not required. On otherwise usually used for mounting fasteners for fixing the spinal stabilization implant At the spinous processes can therefore be dispensed with altogether. As a result, a size of the spinal stabilization implant be minimized. It is therefore only with the spinous process surfaces at the spinous processes of the adjacent vertebra, is however held in its position by specifying at another Body structure, namely the supraspinous Tape. The smaller design of the spine stabilization implant, the possible in the proposed solution according to the invention is, in turn, allows easier implantation, In particular, minimally invasive implantation techniques are possible. Furthermore, fixation on the supraspinous band is easier possible and accessible as, for example, a Fixation of the spine stabilization implant by means of a fastening band around the spinous processes around.

Around a relative position of the spinal stabilization implant to optimize relative to the spinous processes and in particular Also, it is convenient if the first and / or the second spinous process attachment surface of the at least one Plant body pointing away concavely curved. Such a curved spinous process attachment surface In addition, as a stabilization of each other over the spinal stabilization implant connected spinous processes Serve as a transverse movement through the concave curvature the spinous process surface minimized or even completely can be excluded.

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 contact body can be restricted or, depending on the design, completely excluded in one or more directions. Advantageously, two spinous process recesses are ausgebil on the plant body det. Conveniently, they comprise or define the spinous process surfaces.

According to one preferred embodiment of the invention can be provided be that of at least one plant body two or more The body forming parts includes that one the parts by a body and at least one other Part is formed by an enveloping body, which Covering body has a body receiving the Picking up the main body or an enveloping body. This proposed training makes it possible in particular to train the investment body in a kind of "Russian doll", with several parts that can be incorporated into each other. For example a smallest part of the contact body can be formed through the base body, the outer one Dimensions can be gradually increased by introducing into body shots further enveloping body. This embodiment makes it possible in particular, the plant body to adapt to a distance of the spinous processes, for example by appropriate combination of the basic body with a or more enveloping bodies or without additional Covering body. Preferably, the enveloping bodies have a or two spinous process surfaces and / or one or two spinous process recesses for at least partial recording of a spinous process.

Around to increase the stability of the body, it is advantageous if the body size such dimensions is that the main body or an enveloping body positive and / or positive fit in the body insertable and / or durable in it. Especially if Pressure on the plant body over the spinous processes is exercised, for example in an extension movement the spine, so can the stability of the abutment body be increased overall.

Preferably For example, the spinal stabilization implant includes a guide device to keep a connection of at least two each the part forming the body. The management device makes it possible, at least two the plant body forming parts, such as the main body and a the body receiving enveloping body, engage in a defined manner with each other.

Of the Construction of the spine stabilization implant simplified when the guide means at least one guide groove and at least one guide projection corresponding to the guide groove includes. Is at one of the two to be engaged with each other Parts of the abutment body the guide groove and on other the guide projection arranged or formed The two parts of the plant body can be simple and be safely pushed into each other, defining a movement and is dictated by a shape and orientation of the guide groove.

Cheap it is when the guide means a mounting direction defined and if the body forming the parts parallel to the mounting direction inserted into each other or are separable from each other. For example, the guide device be provided on the body so that it is in the mounting direction is a direction, in particular also through a minimally invasive access to the space between the spinous processes is specified. this makes possible for example, the main body and one or more Engaging enveloping bodies with each other, for example, by successive Nachschieben the larger part through the minimally invasive access over or before used parts of the plant body.

Around to simplify the implantation of the body is it favorable if the guide device a An associated stop device, which is a relative movement the parts forming the system body limited. Becomes For example, a first part of the plant body in the Patient body between the spinous processes of used adjacent vertebral body, so the next larger Covering body over the main body or pushed a previously introduced envelope body are prevented until a relative movement by the stopper becomes. Thus, an operator can also without direct view of the operation site Determine when the tracked part of the plant body has reached his desired position.

Especially simply the construction of the anchor device, if it is at least a stopper for defining an implantation position, in which the body forming the parts with each other are engaged or interconnected. The at least a stop makes it possible for the system body to connect training parts in a defined way, especially without a direct view of the surgical 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, for example, the guide groove is formed as a blind hole and does not extend completely over a side surface of a part of the body forming parts, then the guide groove in cooperation with the guide projection not only a relative movement of the parts of the Anla to be engaged body, but also limit a relative movement of the same.

conveniently, the at least one envelope is sleeve-shaped educated. This allows the body or a smaller envelope body simply and safely to enclose.

Advantageous it is when the at least one envelope body a extending transversely to the mounting direction, at least partially closed side wall includes. Basically you can the pages also be completely closed. The side wall in particular, a stop and thus a part of the stop device form. Furthermore, it is possible, the plant body at least one side against the penetration of foreign bodies or protect tissue.

Especially simply the structure of the plant body, if the him forming parts a cuboid or substantially have cuboid outer contour. So overall a cuboid contact body through the body and corresponding enveloping body can be formed.

As already stated above, it is advantageous if the at least an enveloping body at least one, preferably two spinous process recesses for at least partial recording having a spinous process. Preferably, the at least an enveloping body in the area of at least a spinous process plant depression an opening on. So can In particular, connective tissue grow into the plant body and penetrate this, giving extra stabilization a position of the abutment body between the spinous processes allows. Furthermore, as well as a shell the body forming side wall formed as thin as possible be without as deep and as possible the positioning of the abutment body advantageous spinous process recess to be without.

The Embodiment of the at least one enveloping body becomes particularly easy if the opening in the form of a long hole is trained.

Advantageous it is when the body forming parts parallel are broken to the mounting direction for receiving a fastener the fastening device. The openwork parts, preferably have a through opening, so in particular on a fastener, such as a band or a Thread, beaded be threaded. At the same time as well as an implantation of the spine stabilization implant be simplified because, for example, the fastener first performed between the spinous processes and it then the investment body or the parts forming it successively on the fastener can be threaded.

On easy way can be the plant body on Set supraspinous tape when the fastener includes a fastener, which in an implantation position defines a mounting plane which is parallel or substantially parallel to the spinous process surfaces and between this runs. This embodiment ensures that the abutment body with the fastener on the supraspinous Band is fastened, in a plane that is between the Spinous processes extending. It is common, such as in the systems of the publications mentioned above, to provide a fastening device with a fastener, which defined in the implantation position a mounting plane, the the spinous process surfaces vertically intersect. A such plane is just perpendicular to the mounting plane a spinal stabilization implant according to the invention. The fastener can thereby significantly easier and with introduced lower risks for a patient be, because with him not one or two spinous processes entwined but in a plane between the spinous processes only the body of the supraspinous band must be fixed.

Especially simply the fastening device can be formed when the fastening element is designed in the form of a holding strap. Preferably, the widest possible band is used, which has a width, for example, to a width The intraspinous band may be adapted to a large area To allow load introduction into the supraspinous band.

Cheap it is when the tether is elastic or flexible or rigid. Also conceivable are straps that are partially elastic or flexible and partly rigid. Such straps in particular depending on a physiology the patient used to achieve optimal fixation of the abutment body between two spinous processes by attachment to the supraspinous To enable band.

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

Around a permanent stabilized attachment of the plant body to enable the supraspinous band, it is advantageous when the fastening device made of a non-resorbable material is.

Preferably the fastening device is at least partially made of a metal and / or a plastic. In particular, she can completely made of a metal or entirely of a plastic be. Preferably, the metals used or plastics to biocompatible materials. By appropriate choice or combination of metals and plastics can provide stability of the spinal stabilization implant be optimized in the desired manner.

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

Around the implantation of the spine stabilization implant To facilitate, it is advantageous if the tether in one Insertion position is open and two free tape ends and if it is closed or closable in the implantation position is. Such a strap can be, for example through a minimally invasive access into the patient's body on and between the spinous processes through and around the lead supraspinous tape around or through this round lead. An attachment and positioning of the Tethers on supraspinous tape can then, for example be ensured by closing the tape by Connect the two free tape ends together. In particular, you can the free band ends also directly with the supraspinous Band, for example by knotting, crimping, Riveting, stapling or locking. It is also conceivable that free band ends in such a way that they in the manner of a cable tie can be engaged with each other. Alternatively it is also the design of the free tape ends in the form of each other engageable elements of a hook and loop fastener conceivable.

In order to the tether in a simple way from the insertion position be transferred to the implantation position can, it is advantageous if a locking device for closing the tether in the implantation position is provided. The locking device can in particular be formed so that with her free ends of the tether easy and safe to connect.

The Handling of the locking device can for example thereby be simplified, that it comprises at least one closure element for Close the tether by connecting the free ends of the tape.

Especially simply can free tape ends of the tether together connect, if the at least one closure element in the form of a Thread, a crimp clip, a rivet, a clip, a cable tie, a hook and loop fastener, a locking element, a hydrogel element or a locking element is formed. With a thread can the free ends are sewn with a crimp clip crimped. A rivet is suitable for riveting the free ends of the tape. With a bracket, the free tape ends, similar to with a thread, a crimp clip or a rivet, with each other connected and at the same time also on the supraspinous Band be set. A cable tie-type closure element allows the free tape ends to be engaged with each other and to move unidirectionally relative to each other. No additional Tools are required when the closure element in shape a Velcro closure is formed. The free band ends must then only engaged with each other, that is in contact to be brought. With one or more locking elements for training a latching device, the free ends can also be connected, the design of cable tie-like tape ends conceivable in the form of engageable locking elements is. A hydrogel element also allows closure, and although by hydrogenating and thus reducing, for example, a distance between two parts or regions of the hydrogel element, so that the free tape ends can be jammed in between. In an analogous manner, with such a hydrogel element, the tether also be fixed to the supraspinous ligament.

According to one Another preferred embodiment of the invention be provided that the fastening device at least one Supporting element which connects to the supraspinous Can be applied band and on which the fastener fastened or by which the fastener is feasible. The Support element is used in particular to a large area Load line into the supraspinous band to ensure to tear it out or otherwise injure to prevent as a result of fixing the tether. The support element can be formed in particular in the form of a flat plate or disc be, each large-scale to the supraspinous Band can be applied.

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

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

Preferably is the at least one investment body at least partially formed in the form of a hydrogel body. By appropriate Hydrogenation or dehydrogenation can be so desired Damping properties of between the spinous processes introduced investment body can be targeted. In particular, the tether can also be in the form of a hydrogel body be formed so that the spinal stabilization implant overall the shape of a round or oval ring of a hydrogel which may be around or through the supraspinous Band can be laid or passed.

Advantageous it is when the at least one tether is tubular is formed and if the at least one plant body is arranged and held in the tubular retaining strap. This embodiment is particularly suitable for one of a Hydrogel produced body. The tether or free ends thereof can be described in the above descriptions Way, for example with one or more the described closure elements. A fixation of a plant body spinal column stabilization implant comprising a hydrogel The supraspinous band can then be swollen, for example, by swelling of the hydrogel, for example as a result of hydrogenation, so that the tether is positively around the supraspinous Lay band and thus a flexible interface to the supraspinous Can train band.

Further it is advantageous in a method of the type described above, when the spinal stabilization implant at the supraspinous, connect the spinous processes of the adjacent vertebrae Band is attached.

A Attachment of the contact body to the spinous processes itself is not required. The attachment of the plant body At the supraspinous ligament is sufficient to position of the abutment body between the spinous processes after implantation in the desired manner. The fixation of the plant body in the manner described is much easier than fixing the body on one or both spinous processes. In particular, can so a potential danger can be ruled out that the Spinous process when fixing the plant body or under Stress can be damaged.

Cheap it is when the spinal stabilization implant a Includes fastening device and when the at least one contact body on supraspinous band fastened with the fastening device becomes. The fastening device makes it easier for a surgeon Implant and fix the spine stabilization implant between spinous processes of adjacent vertebral bodies.

Preferably is to carry out the described method of spinal stabilization implants described above used. The described spine stabilization implants can be implanted in the manner described and easy and securely fix it on the intraspinous band.

Cheap it is when a distance of the first and second spinous process surfaces can be enlarged from each other. In this way The spinal stabilization implant can be customized be adapted to the distance between the two spinous processes, between which it should be used.

Advantageous it is when the spinal stabilization implant two Includes implant components, each of which is at least two adjacent arranged, at one end over a bridge with each other connected and at their free ends auseinanderspreizbare support arms of which at least one of the spinous process surfaces formed. This is the structure of the spine stabilization implant very simple and compact.

Cheap It is when both implant components with the free ends of their Support arms against the free ends of the support arms the other implant component are directed and if both implant components on sliding surfaces of each other Slip implant component and thereby be pivoted, so that thereby the distance of the upper and lower spinous process surfaces is enlarged. This configuration allows in particular, the spacing of the first and second spinous process surfaces enlarge each other by applying the two implant components in a direction transverse, 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. Wirbelsäulenstabilisierungsimplantat 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.

The above description thus includes in particular those listed below Embodiments of a spinal stabilization implant 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. spinal stabilization implant 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. 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.

The following description of preferred embodiments The invention is in connection with the drawing of the closer 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 could already form an investment body alone and between the two Spinous 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 to formschlüssi gene 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 such as 3 to 5 is 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 attachment level 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 92 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, in stenoses, this is a mechanism that relieves the spinal cord or cauda equina or the nerve roots.

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 on the supraspinous ligament 38 can increase connective tissue growth around the tether 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 spine stabilization Implant shown. 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, the inner diameter substantially the inner diameter of the opening 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 before seen, which is 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 in diameter larger he 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 maintained.

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 vertebral column stabilization implant 10 '''' has the ability to do it at low height in the space between two spinous processes 18 . 20 can be used and then increase its height after insertion 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 '''' comprises two in this case identically constructed, 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 walk 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 essenli Chen is the same design as a second investment 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 by the support arms of an implant component cross each other and by pushing together two implant components, the crossover is reinforced, so the support arms to their free ends are spread open. Accordingly, the support surfaces arranged respectively on the inner sides of the support arms and opposite the support arms inclined so that the Support surfaces at the top and at the bottom of the implant substantially parallel to each other and parallel are arranged 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 an unillustrated 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 investment 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 spinal 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 The documents listed by the applicant have been automated generated and is solely for better information recorded by the reader. The list is not part of the German Patent or utility model application. The DPMA takes over no liability for any errors or omissions.

Cited patent literature

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

Claims (35)

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 claim 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. Spinal stabilization implant according to claim 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. Spinal stabilization implant according to one of claims 4 to 11, characterized in that the at least one enveloping body ( 54a . 54b . 54c ) is sleeve-shaped. Spinal stabilization implant according to one of Claims 4 to 12, 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 13, 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 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 ) one Breakthrough ( 58a . 58b . 58c . 60a . 60b . 60c ) having. Spinal stabilization implant according to claim 15, characterized in that the aperture ( 58a . 58b . 58c . 60a . 60b . 60c ) is formed in the form of a slot. Spinal stabilization implant according to one of claims 8 to 16, 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 '''' ) in the form of a tether ( 32 ; 32 '; 32 ''; 32 '''' ) is trained. Spinal stabilization implant according to claim 18 or 19, characterized in that the tether ( 32 ; 32 '; 32 ''; 32 '''' ) is elastic or flexible or rigid. Spinal stabilization implant according to one of claims 18 to 20, 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 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. Spinal stabilization implant according to claim 22, characterized in that the plastic polyester, polyetheretherketone or polypropylene and that the metal is titanium or steel. Spinal stabilization implant according to one of Claims 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. Spinal stabilization implant according to claim 24, characterized by a locking device ( 88 ; 254 ) for closing the tether ( 32 ) in the implantation position. Spinal stabilization implant according to claim 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 ). Spinal stabilization implant according to claim 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. Spinal stabilization implant according to one of Claims 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. Spinal stabilization implant according to claim 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. Spinal stabilization implant according to one of the preceding claims, characterized 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 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. 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. Spinal stabilization implant according to claim 33, characterized in that it comprises two implant components ( 206 . 207 ), each of which has at least two side by side, at one end connected via a bridge and at its free ends au seinrespreadable support arms ( 215 . 216 ), of which at least one of the spinous process surfaces ( 222 . 223 ) trains. Spinal stabilization implant according to claim 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.