Patent Document

CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is the 371 National Stage of International Application No. PCT/EP2005/012580, filed Nov. 24, 2005; which claims priority to European Patent Application No. 04030000.6, filed on Dec. 17, 2004, which are all incorporated herein by reference. 
     TECHNICAL FIELD 
     The invention concerns an intervertebral stabilization system for at least three vertebrae. 
     BACKGROUND 
     With deformations or degenerative changes of the vertebral column, it may be necessary to stabilize the individually affected unstable vertebral column segment by means of surgery. 
     In this respect, the stiffening of the affected vertebral column segment is known. With such a partial vertebral column stiffening, the intervertebral discs are at least partially removed; bony tissues are embedded between the vertebrae to be stiffened; and the vertebrae to be stiffened are connected rigidly with one another with screws and at least one rod. The stiffening of the vertebral column segment, however, makes the adjacent vertebrae more stressed with bending and stretching movements of the vertebral column than before the stiffening. 
     Alternatively, “with easier cases,” especially before an intervertebral disc incident also appears, an implant has been more recently used which supports the affected vertebral column segment posteriorly but does not stiffen, and thus to a large extent maintains the mobility of the affected vertebrae. An elastic band with pliable spacers is thereby used between screws fastened on the vertebrae. The elastic band limits the bending movement, whereas the spacers limit the stretching movement. 
     The problem of the invention is to create a device of the type mentioned initially, which is designed so as to stiffen an unstable vertebral column segment in such a way that the vertebral column is stressed as little as possible with bending and stretching movements, in particular, in order to prevent further operations or at least to delay them as much as possible. 
     SUMMARY 
     The solution of this problem takes place with the features described herein, particularly in that pedicle screws which can be fastened on the vertebrae, a rod to connect at least two pedicle screws to a rigid stiffening system, and a band that can be prestressed when pulled and that, when the stabilization system is implanted, is surrounded by at least one compressible pressure body that is located between two adjacent pedicle screws and is provided to connect the pedicle screws to an elastic support system wherein a common pedicle screw is correlated both with the stiffening system and also with the support system, and the band is, or can be connected with the rod by means of a band-fastening. 
     The invention is consequently characterized in that the rigid stiffening system combines the known prior art, which comprises the rod, with the elastic support system, also known from the prior art, which comprises the band and the pressure body. The elastic support system, previously used as an alternative to the known rigid stiffening system is used in accordance with the invention together with the rigid stiffening system for the stabilization of an unstable vertebral column segment. 
     The rod of the stiffening system is designed for the stiffening of an unstable vertebral column segment comprising at least two vertebrae. The band, which is connected with the rod when the stabilization system is implanted and is or can be connected with the rod when the system is not implanted, is used to support at least one vertebra adjacent to the stiffened vertebral column segment. The rod and the band are fastened to the vertebrae to be stabilized by means of the pedicle screws. 
     Preferably, at least two stiffening systems, in particular, two rods, are provided, which are situated to the left and to the right of pin extensions of the affected vertebrae when the stabilization system is implemented, wherein preferably the two stiffening systems are or can be connected with one another. Furthermore, several support systems can be provided. In particular, two support systems that are connected to one end of the stiffening system can be provided for the stiffening system for each system or for several systems. Basically, several stiffening and support systems can also be provided that are alternately connected with one another in the implanted state. 
     In the implanted state of the stabilization system the band of the support system is prestressed when pulled. The pressure body, on the other hand, is in a compressed state—that is, it is prestressed with pressure. The rod and the band are thereby connected with one another via a band-fastening—that is, the band is fastened to the rod or vice-versa. The common pedicle screw, on which or in whose vicinity the connection of the band with the rod is usually designed in the implanted state of the stabilization system, is equally used by the rigid stiffening system and the elastic support system. If the band-fastening is located approximately in the middle between two pedicle screws, an arbitrary one of the two pedicle screws can be regarded as the common pedicle screw. 
     By means of the elastic support system that follows it as an extension of the rigid stiffening system, or by means of the elastic support systems that follow it on both sides of the rigid stiffening system, the vertebra(e), following the vertebrae connected rigidly with one another by the stiffening system are supported, so that these adjacent vertebrae are not exposed to increased stresses with bending and stretching movements of the vertebral column. 
     Advantageous embodiments of the invention are also indicated in the subclaims, the description, and the drawing. 
     Preferably, the band-fastening is designed as a clamping device for the clamping of the band. By means of the clamping forces of the band-fastening designed as a clamping device, it is possible to hold the band, which is under fraction in the implanted state of the stabilization system, in a particularly safe and reliable manner. 
     It is also preferred for the band-fastening to comprise an end of the rod, a separate component, and/or the common pedicle screw. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The invention is described below, as an example, with reference to the drawing, which comprises various embodiments, the individual features of which—to the extent that it makes sense—can be combined arbitrarily with one another. The figures show the following: 
         FIGS. 1 to 7 , band-fastenings of a stabilization system in accordance with the invention that embrace an end of the rod; 
         FIGS. 8 to 10 , band-fastenings of a stabilization system in accordance with the invention that embrace a separate component; and 
         FIGS. 11 to 15 , band-fastenings of a stabilization system in accordance with the invention that embrace a common pedicle screw. 
     
    
    
     DETAILED DESCRIPTION 
     The embodiments explained below show only the part of the stabilization system which is needed for the description of the connection between the rod of the stiffening system and the band of the support system. The same components of the different embodiments of the invention, or those components which correspond to one another, are designated with the same reference symbols. 
       FIG. 1  shows a stabilization system in accordance with a first embodiment of the invention with a rigid metal rod  11  of a rigid stiffening system, which is otherwise not depicted, wherein the rod  11  has an end  13 , which has a larger diameter than the middle part  15  of the rod  11 . The end of the rod  11 , which is designed as the head  13  and which can be used, simultaneously, as the stop for an undepicted pressure body, is at least part of a band-fastening and has an essentially cylindrical hollow space  17 , into which, via a band entry opening  19 , an end  21  of an elastic band  23 , made of plastic, for example, of an otherwise not undepicted elastic support system is introduced or can be introduced. 
     The band-fastening also comprises a sleeve-like clamping element  27 , which is ( FIG. 1   c ) or can be ( FIG. 1   a ) introduced into the cavity  17  along the introduction direction  25  of the end  21  of the band  23  and is closed in the circumferential direction; the clamping element is pushed to the end  21  of the band  23  and is designed to clamp the end  21  of the band  23  with the head  13  of the rod  11 , introduced into the cavity  17  of the rod  11 . The sleeve-like clamping element  27  can also be designated as a clamping sleeve or as a clamping ring. 
     The clamping sleeve  27  is designed so that it tapers conically on its outside when it has not been introduced into the cavity  17  of the rod  11 , wherein the wall thickness of the clamping sleeve  27  increases toward the end that has the larger outside diameter. In accordance with  FIG. 1   d , a protrusion  29 , which runs along the circumference, is directed inwards and constricts the inside diameter of the clamping sleeve  27 , can be designed on the inside of the clamping sleeve  27  on the end which has the larger outside diameter. In accordance with  FIG. 1   e , the clamping element  27  can be slit, in particular, on two opposite sides. Basically, the clamping sleeve can have a protrusion and can also be slit. 
       FIGS. 1   a  to  1   c  show the connection of the rod  11  with the band  23 . First, the clamping sleeve  27  is pushed onto the end  21  of the band  23  that is to be introduced in the cavity  17  or rod  11  in such a way that the end of the conical clamping sleeve  27  that has the larger outside diameter faces the middle of the band  23  ( FIG. 1   a ). Afterwards, the end  21  of the band  23 , which is provided with the clamping sleeve  27  is pressed into the cavity  17  of the head  13  of the rod  11  by means of a suitable tool, along the introduction direction  25  ( FIG. 1   b ). 
     The end of the clamping sleeve  27  that has the larger outside diameter is compressed onto the inside diameter of the cylindrical cavity  17  of the rod  11 , which at least essentially corresponds to the smaller outside diameter of the other end of the clamping sleeve  27 . When assembled ( FIG. 1   c ), the inside diameter of the clamping sleeve  27  decreases toward the end which originally has a larger outside diameter, because of the wall thickness of the clamping sleeve  27 , which increases in this direction—that is, the passage of the clamping sleeve  27  is constricted in the direction of the band entry opening  19  of the cavity  17  of the head  13  of the rod  11 , so that the band  23  is effectively clamped. 
     The clamping force of the band-fastening can be additionally reinforced by the protrusion  29  shown in  FIG. 1   d . A slit clamping sleeve  27  ( FIG. 1   e ) offers the advantage that, upon introduction of the clamping sleeve  27  into the cavity  17  of the head  13  of the rod  11 , additional space for material deformation is available, so that the pressing-in process can be carried out with an overall smaller expenditure of force. 
       FIG. 2  shows a stabilization system in accordance with a second embodiment of the invention. In contrast to the embodiment in  FIG. 1 , the band-fastening in accordance with  FIG. 2  comprises two clamping sleeves  27 ,  31  braced against one another. 
     Analogous to  FIG. 1 , the first clamping sleeve  27  is shoved onto the end  21  of the band  23  to be introduced into the cavity  17  of the rod  11  in the embodiment example according to  FIGS. 2   a  and  2   b  in such a way that the end of the conical first clamping sleeve  27 , which has the larger outside diameter, faces the middle of the band  23  ( FIG. 2   a ). The second clamping sleeve  31 , which is used as the conical pressing ring, is, in a minor image to the first clamping sleeve  27  and relative to a plane which is perpendicular to the introduction direction  25 , pressed into the cavity  17  of the head  13  of the rod  11  ( FIG. 2   a ). To connect the band  23  with the rod  11 , the first clamping sleeve  27  is pressed along the introduction direction  25  into the cavity  17  of the head  13  of the rod  11 , wherein the first clamping sleeve  27  is braced with the second clamping sleeve  31 . 
     The first clamping sleeve  27  is deformed in such a way that the band  23  is effectively clamped in ( FIG. 2   b ). Basically, several conical pressing rings can also be provided. 
     In the embodiment example in accordance with  FIGS. 2   c  and  2   d , the two clamping sleeves  27 ,  31  are exchanged with respect to their orientations in comparison to the embodiment example according to  FIGS. 2   a  and  2   b , wherein the first clamping sleeve  27  is pressed onto the end  21  of the band  23  in the unintroduced state ( FIG. 2   c ). When assembled, the end  21  of the band  23 , provided with the first clamping sleeve  27 , is introduced along the introduction direction  25  into the cavity  17  of the head  13  of the rod  11 . Subsequently the second clamping sleeve  31  is pressed into the cavity along the introduction direction ( FIG. 2   d ). 
       FIG. 3  shows the stabilization system in accordance with a third embodiment of the invention. 
     The band-fastening of the embodiment example in accordance with  FIGS. 3   a  to  3   c  comprises a clamping pin  33  that can be introduced under press fit into the cavity  17  transverse to the introduction direction  25  of the end  21  of the band  23 ; the pin is designed to clamp the end of the band, which can be introduced into the cavity  17  of the rod  11  with the head  13  of the rod  11 . The clamping pin  33  introduced through an opening  35  into the cavity  17  of the rod  11  can be designed round ( FIG. 3   a ) or wedge-shaped ( FIG. 3   b ) at its tip, which tip acts with radial pressure on the introduced end  21  of the band  23  relative to its longitudinal extension. A greater contact pressure on the clamped-in band  33  can be attained with a wedge-shaped clamping pin  33 . 
     Diametrically opposite the opening  35  through which the clamping pin  33  is introduced into the cavity  17 , a cavity  17  is formed on the inside of the head  13  of the rod  11 , which limits the cavity  17 ; the pressed-in clamping pin  33  is pressed into the hollow. The clamping force on the band  23  can be increased additionally by the deviation of the band  23  created in this way. In order to facilitate the introduction of the band  23 , an introduction aid designed as a sleeve  39  can be stuck on the end  21  of the band  23  to be introduced ( FIGS. 3   a  and  3   b ). As can be seen in  FIG. 3   c , one, two, three, or any number of clamping pins  33 ,  41 ,  43  can be provided. 
     In the embodiment example in accordance with  FIG. 3   d , the band-fastening comprises a pressure element, for example, a clamping screw  137  that can be introduced into the cavity of the head  13  of the rod  11  via an opening  133  transverse to the introduction direction  25 , and is designed for the clamping of the end  21  of the band  23  within the head  13  of the rod  11 . Furthermore, a band exit opening  135  lying deeper and opposite the band entry opening  19  is provided, and through it the end  21  of the band  23  can again be moved out or is moved out of the cavity of the rod  11 . The part of the band  23  that is not introduced into the head  13  is surrounded by a pressure body  75  that can also be designated as a cushion. The rod  11  is or can be placed into a recess  139  of a common pedicle screw  67  that is formed tuning fork-like on its upper end in the assembled state and by means of a clamping screw  141  is or can be fastened to it. The upper end of the common pedicle screw  67  can also be designed as a passage, however. 
       FIG. 4  shows a stabilization system according to a fourth embodiment of the invention in which the cavity  17  is constricted toward the band entry opening  19  of the head  13  of the rod  11 . The constriction is thereby formed with the end  21  of the band  23  introduced into the cavity  17  by reshaping the head  13  of the rod  11 . By the constriction, the band  23  is effectively clamped ( FIGS. 4   b ,  4   f , and  4   h ). Analogous to  FIG. 3 , it is also possible to use a sleeve  39  as an introduction aid for the end  21  of the band  23  in the embodiment according to  FIG. 4  also, as is shown in  FIGS. 4   a  and  4   b.    
     In the embodiment example according to  FIGS. 4   a  and  4   b , the head  13  of the rod  11  exhibits a projection  45  that juts out against the introduction direction  25  and runs along the circumference of the rod  11 . The reshaping of the projection  45  from the position shown in  FIG. 4   a  to the position shown in  FIG. 4   b , in which the orientation of the projection  45  is rotated, as it were, by 90°, can be attained, for example, by roll-pressing ( FIG. 4   c ) or by using two half-shells ( FIG. 4   d ). 
     In the embodiment example according to  FIGS. 4   e  and  4   f , the head  13  of the rod  11  does not have a projection before the reshaping. Rather, when pressing in the end  21  of the introduction end  21  of the band  23 , the area of the head  13  of the rod  11  forming the limit of the band entry opening  19  is deformed by means of a punch  131  in such a way, in particular, pressed inwards so that the cavity  17  to the band entry opening  19  of the head  13  of the rod  11  is constricted. 
     The embodiment example according to  FIGS. 4   g  and  4   h  is characterized in that, before the reshaping the outside diameter of head  13  of the rod  11  and the related wall thickness of the head  13  in the area of the cavity  17  increase in the direction opposite the introduction direction  25  of the band  23 . With the reshaping of the head  13  of the rod  11 , a press ring  47  having an inside diameter that essentially corresponds to the outside diameter of the middle part  15  of the rod  11  moves against the introduction direction  25 . The head  13  of the rod  11  is thereby compressed to the inside diameter of the press ring  47  so that the cavity  17  is constricted toward the band entry opening  19  of the head  13  because of the wall thickness of the head  13 , which increases in this direction. 
       FIG. 5  shows a stabilization system according to a fifth embodiment of the invention in which the connection of the band  23  with the rod  11  is brought about by the reshaping of the head  13  of the rod  11 . The head  13  of the rod  11  and the cavity  17  within the head  13  are shaped spherically, at least before the reshaping, wherein the diameter of the band entry opening  19  is smaller than the cavity  17  formed in the head  13 . The cavity  17  is thus already constricted before the reshaping for the band entry opening  19 . 
     To bring about the connection of the band  23  with the rod  11 , a ring  49 , in particular a tapered ring  49 ′, is first shoved onto the end  21  of the band  23  ( FIG. 5   a ). The end  21  of the band  23 , provided with the ring  49 ,  49 ′, is then introduced into the cavity  17  of the head  13  of the rod  11 , wherein the head  13  of the rod  11  and thus also the ring  49 ,  49 ′ is compressed so that the band  23  is effectively clamped ( FIG. 5   b ). It is possible to additionally increase the pressing force exerted on the band  23  by tapering the ring  49 ′. 
       FIG. 6  shows a stabilization system according to a sixth embodiment of the invention. The embodiment according to  FIG. 6  essentially corresponds to the embodiment according to  FIG. 1 , with the difference that the band-fastening also comprises an inlay  51 , made, in particular, of metal or plastic, which is worked into the end  21  of the band  23 , in particular, centrically, which can be ( FIG. 6   a ) or is ( FIG. 6   b ) introduced into the cavity of the rod  11  and which extends along the introduction direction  25  of the band  23 . 
     The inlay  51  is designed in the shape of a pin and comprises a head  53  and a shaft  55 , wherein the diameter of the head  53  is larger than that of the shaft  55 . The head  53  protrudes, in part, from the end  21  of the band  23 . By means of the inlay  51 , it is possible to increase the pressing pressure, exerted on the clamped-in band  23 , and thus the holding force of the connection between the band  23  and the rod  11 , brought about by the band-fastening. 
       FIG. 7  shows a stabilization system according to a seventh embodiment of the invention. In  FIG. 7 , the band  23  is widened to form a large number of strength carriers, in particular, fibers of the band  23 , and can be ( FIG. 7   b ) or is ( FIG. 7   c ) pressed into the cavity  17  of the head  13  of the rod  11  by means of an insert  57 . In order to attain the widening, the end  21  of the band  23  is brushed upward by means of a brushing tool  59  ( FIG. 7   a ). 
     To press in, the insert  57 , which is designed as a ring insert in  FIG. 7 , is threaded onto the band  23  and introduced into the cavity  17  of the head  13  so that the individual fibers, which project radially in all directions toward the introduction direction  25 , are clamped between the front side of the ring insert  57  and the limit of the cavity  17 . In order to increase the holding forces of such a connection between the band  23  and the rod  11 , a centrally positioned spike  61 , which protrudes into the cavity  17  against the introduction direction  25 , and a lug  63 , which runs around the spike  61  with the lug also protruding into the cavity  17  against the introduction direction  25 , can be provided ( FIG. 7   d ). 
     In accordance with an undepicted eighth embodiment of the invention, the end of the band that can be introduced into the cavity is cemented, particularly by means of glue or cement. In this way, the fibers of the band are joined with one another so that the sliding of the individual fibers against one another is prevented and thus it is possible to attain a greater holding force for the connection between the band and the rod. 
     In accordance with an undepicted ninth embodiment of the invention, the end of the band that can be introduced or is introduced into the cavity is a formed through melting, shaping, and subsequent hardening. In particular, the shape can be such that the end of the band is designed as a hook after curing. 
       FIG. 8  shows a stabilization system according to a tenth embodiment of the invention, in which the band-fastening comprises a separate component  65 , wherein the rod  11  is, or can be fastened to the band-fastening—that is, in particular, on the separate component  65  and also on a common pedicle screw  67 . In particular, the separate component  65  is not, or cannot be, fastened directly on the common pedicle screw  67 . 
       FIGS. 8   a  and  8   b  show a stabilization system when implanted. The rod  11  connects two pedicle screws  67 ,  69 , which comprise the common pedicle screw  67  and are each fastened on a vertebra of a vertebral column to form a rigid stiffening system. The band  23 , which is prestressed when pulled, connects three pedicle screws  67 ,  71 ,  73 , which comprise the common pedicle screw  67 , wherein the pedicle screws  71 ,  73  are also each fastened to a vertebra to form an elastic support system. Compressed pressure bodies  75 ,  77  are located between the pedicle screws  67  and  71  and between the pedicle screws  71  and  73 ; they completely surround the band  23  in the circumferential direction. The common pedicle screw  67  is correlated with the stiffening system and also the support system. 
     The band  23  and the rod  11  are connected with one another by the separate component  65 . The separate component  65  extends essentially perpendicular to the longitudinal extension of the band  23  or perpendicular to the longitudinal extension of the rod  11 , which essentially run staggered parallel and medial/lateral with respect to one another, whereas, at least with the embodiments in accordance with  FIGS. 1 to 7 , the longitudinal extension of the band and the longitudinal extension of the rod run, at least without a medial/lateral staggering, parallel to one another. In accordance with  FIG. 8 , the separate component  65  can be located, relative to the common pedicle screw  67 , both on the side of the support system ( FIG. 8   a ) and also on the side of the stiffening system ( FIG. 8   b ). 
     The embodiment example in accordance with  FIG. 8   c  shows a separate component  65  that has two tube-like passages  79 ,  81  for the fastening of the band  23  and for the fastening of the rod  11 . The passage  79  to the fastening of the rod  11  has an upper and a lower half-shell  83 ,  85 , which can be moved relative to one another by means of a holding screw  87  in order to clamp the rod  11 . Perpendicular to the passage  81  for the fastening of the band  23 , there is an opening  89  into which a pressure element  91 , for example, a clamping screw for the clamping of the band  23 , can be inserted or is inserted on the common pedicle screw  67 . 
     The separate component  65  can be constructed in several parts, wherein, in particular, different relative positions of the parts of the separate component  65  can be implemented relative to one another. Such a component  65  is shown in the embodiment examples according to  FIGS. 8   d ,  8   e , and  8   f . The separate component  65  has a tube-like access or passage  81  for the band  23 , which can be fastened by means of the clamping screw  91  introduced through the opening  89 . The rod  11 , which can be introduced in the sector-wise open passage  79  when implanted, can also be fastened to the separate component  65  analogous to band  23  by means of a clamping screw  93  introduced through an opening  95 . The separate component  65  in which the passage is formed is provided with a rotating axle  97  between the one part of the separate component  65  in which the access or passage  81  is formed, and the other part of the separate component  65  in which the passage  79  is formed, so that the parts of the separate component  65  can be rotated relative to one another. An adjusted relative position of the two parts relative to one another can be locked by means of a locking screw  99 . 
     Other embodiment examples of the separate component  65  are shown in  FIGS. 8   g  and  8   h , either in perspective ( FIG. 8   g ) or in a top or transverse view ( FIG. 8   h ). In particular, it is clear that, in an angularly constructed one-part separate component  65  or a multipart, separate component  65 , the distance of the parts of the separate component  65  relative to one another can be changed by linear displacement. 
     The embodiment example according to  8   i  shows a separate component  65 , into which, an undepicted rod can be introduced from one side and an undepicted band from the other, opposite side. The separate component  65 , which, to a certain extent is designed as a double sleeve, has two tube-like accesses  79 ,  81 . Furthermore, openings  89 ,  95  are provided in order to connect the rod and the band with the separate component  65  by means of undepicted clamping screws. 
       FIG. 9  shows a stabilization system in accordance with an eleventh embodiment of the invention in which the band-fastening comprises a separate component  65 , wherein an undepicted rod is, or can be fastened onto the band-fastening  65 , and the band-fastening  65  to an undepicted common pedicle screw. In particular, the rod is not, or cannot be, fastened directly to the common pedicle screw. 
     In the embodiment example according to  FIGS. 9   a  and  9   b , the separate component  65  has a central passage  101  provided for the fastening of the separate component  65  to the common pedicle screw. Furthermore, two passages or accesses  79 ,  81 , running perpendicular to the central passage  101  and parallel to one another in the separate component  65 , are designed for the fastening of the band and the rod. For the clamping of the band, an opening  89  is provided into which an undepicted clamping screw can be inserted. The passage  79  is slit and can be constricted by means of the common pedicle screw so that the rod can be effectively clamped. 
       FIG. 10  shows a stabilization system according to a twelfth embodiment of the invention, in which the band-fastening comprises a separate component  65 , wherein the band-fastening and the rod are, or can be fastened to the common pedicle screw  67 . In particular, the rod  11  is not, or cannot be, fastened directly to the separate component  65 . 
     The separate component  65  according to  FIG. 10   a  has a sleeve or an access for fastening band  23  and a fastening ring  103  for fastening to the common pedicle screw  67 , wherein the longitudinal axis of the sleeve  81  and the middle axis of the fastening ring  103  are essentially perpendicular to one another. The fastening ring  103  can also have a recess  105  for the rod  11  ( FIG. 10   b ). 
       FIG. 11  shows a stabilization system according to a thirteenth embodiment of the invention, in which the band-fastening comprises the common pedicle screw  67 , wherein the rod  11  can be fastened, or is fastened, to a separate component  107 , which is, or can be fastened to the common pedicle screw  67 . In particular, the rod  11  is not, or cannot be, fastened to the common pedicle screw  67 . 
     The separate component  107  according to  FIG. 11  has two laterally placed click arms  109  with which the separate component  107  is, or can be fastened according to a type of click closure to the common pedicle screw  67 . The click arms  109  lock into lateral depressions  111  of the common pedicle screw  67  for fastening. Moreover, the separate component  107  has an undepicted access into which the rod  11  is, or can be introduced and an opening  95  into which an undepicted clamping screw for the fastening of the rod  11  can be introduced. Moreover, an opening  113  is provided through which an undepicted fastening screw for the additional fastening of the separate component  107  to the common pedicle screw  67  can be introduced or is introduced. 
       FIG. 12  shows a stabilization system according to a fourteenth embodiment of the invention, in which the band-fastening comprises the common pedicle screw  67 , wherein the rod  11  is, or can be fastened to the common pedicle screw  67  by means of a crossbar  115  which, when implanted, is essentially perpendicular to the longitudinal extension of the band  23 . 
     The stabilization system depicted in  FIG. 12  shows a stiffening system, followed on its two ends by a support system—that is, two common pedicle screws  67  and two crossbars  115  are present. The crossbars  115 , shaped essentially in the form of an S, can have a passage  79 , which is open sector-wise on their end, correlated with the rod  11 , or a passage  79 , which is closed in the circumferential direction. To fasten a crossbar  115  on a common pedicle screw  67 , a longish hole  117  is formed on the end correlated with the common pedicle screw  67  so that various relative positions are possible between the common pedicle screw  67  and the rod  11 . The longitudinal extension of the rod  11  and the longitudinal extension of the band  23  run parallel and staggered medially/laterally relative to one another. 
       FIG. 13  shows a stabilization system according to a fifteenth embodiment of the invention, in which the band-fastening comprises the common pedicle screw  67 , wherein the rod  11  is, or can be fastened to the common pedicle screw  67  and the common pedicle screw  67  has a common passage  119  for the band  23  and the rod  11 . 
     In the embodiment example according to  FIG. 13 , the band  23  and the rod  11  are located next to one another or above one another within the common passage  119  of the common pedicle screw  67 . The band  23  and the rod  11  are jointly compressed by means of an undepicted clamping screw which is, or can be introduced through an opening  121  formed in the common pedicle screw  67  so that both the band and also the rod  11  are effectively clamped. 
       FIG. 14  shows a stabilization system according to a sixteenth embodiment of the invention. Analogous to the embodiment according to  FIG. 13 , the embodiment according to  FIG. 14  has a common passage  119  for the band  23  and the rod  11  and an opening  121  to introduce a clamping screw. 
     In the embodiment example according to  FIG. 14   a , the band  23  is, or can be pulled over the rod  11 , in contrast to the embodiment according to  FIG. 13 . Moreover, a sleeve  123  is, or can be shoved into the common passage  119  that in turn again surrounds the band  23 . Otherwise, the band  23  and the rod  11  can be clamped analogous to the embodiment in  FIG. 13 . An embodiment example is shown in  FIG. 14   b  in which the end  21  of the band  23  is, or can be introduced into rod  11 , similar to what is shown in  FIGS. 1 to 7 , wherein by means of a clamping screw  141 , which is, or can be introduced into the common pedicle screw  67  through an opening  143 , the band  23  and the rod  11  can be clamped in. 
     In the embodiment example in accordance with  FIG. 14   c , the common pedicle screw  67  is designed as a tuning fork on its upper end, so that a recess  139  is formed between two prongs  149  into which a rod is, or can be laid. The mounting of the rod on the common pedicle screw  67  takes place by means of a clamping screw  141  that is, or can be inserted into the bore sections  143  of the two prongs  149 , wherein the bore sections have an internal thread. The end  13  of the rod  11 , which is designed for connection with the end  21  of the band  23 , can have a diameter larger than that of a middle part  15  of the rod  11  ( FIG. 14   d ). The band  23  is, or can be connected with the rod  11  by means of a clamping screw  137  that is, or can be introduced through an opening  133  into the rod  11 . 
     To guide the rod  11  in the assembly with the common pedicle screw  67  or for the correct positioning of the rod  11  with regard to the common pedicle screw  67 , guiding means, for example, one or more round or angular pegs  145  are formed on the head  13  of the rod  11  ( FIGS. 14   d ,  14   e ,  14   g ) that mesh into guiding means of the common pedicle screw  67  ( FIGS. 14   c ,  14   f ), for example, one or more recesses, slots, or grooves  147 , which, in particular, correspond to the bore sections  143  of the two prongs  149  ( FIG. 14   c ). 
     Moreover, at least one, particularly plate-shaped, flange  151  oriented perpendicular to the longitudinal axis of the rod  11  can be provided ( FIGS. 14   e,    14   g ,  14   h ) that is connected with the rod  11  and permits correct positioning of the rod  11  with regard to the common pedicle screw  67  or offers a guide when the stabilization system is assembled. If the flange  151  is designed as a closure of the end  13  of the rod  11 , the flange can also be used simultaneously as a stop  151  for a pressure body  75  of a support system of the stabilization system. 
       FIG. 15  shows a stabilization system in accordance with a seventeenth embodiment of the invention, in which the band-fastening comprises the common pedicle screw  67 , wherein an undepicted rod is, or can be fastened to the common pedicle screw  67  and the band  23  is, or can be clamped between the pressure mechanism, in particular, a nut  125 , and the common pedicle screw  67 , wherein the common pedicle screw  67  has a passage  127  for the rod. 
     The rod introduced into the passage  127  is effectively clamped by means of a threaded pin  129  that has a continuous external thread and which is, or can be introduced through an opening  121  into the common pedicle screw  67 . The nut  125  is placed on the end of the threaded pin  129  that projects from the common pedicle screw  67  in order to clamp the band  23  between the common pedicle screw  67  and the nut  125 . For this purpose, the end  21  of the band  23  to be clamped is made as a loop into which the threaded pin  129  meshes. 
     REFERENCE SYMBOL LIST 
     
         
           11  Rod 
           13  Head 
           15  Middle part 
           17  Cavity 
           19  Band entry opening 
           21  End 
           23  Band 
           25  Introduction direction 
           27  Clamping sleeve 
           29  Protrusion 
           31  Clamping sleeve 
           33  Clamping rod 
           35  Opening 
           37  Hollow 
           39  Introduction aid 
           41  Clamping rod 
           43  Clamping rod 
           45  Projection 
           47  Press ring 
           49 ,  49 ′ Ring, tapered ring 
           51  Inlay 
           53  Head 
           55  Shaft 
           57  Insert 
           59  Brush tool 
           61  Spike 
           63  Lug 
           65  Separate component 
           67  Common pedicle screw 
           69  Pedicle screw 
           71  Pedicle screw 
           73  Pedicle screw 
           75  Pressure body 
           77  Pressure body 
           79  Passage, access 
           81  Passage, access, sleeve 
           83  Upper half-shell 
           85  Lower half-shell 
           87  Holding screw 
           89  Opening 
           91  Clamping screw 
           93  Clamping screw 
           95  Opening 
           97  Rotating axle 
           99  Locking screw 
           101  Central passage 
           103  Fastening ring 
           105  Recess 
           107  Separate component 
           109  Click arm 
           111  Depression 
           113  Opening 
           115  Crossbar 
           117  Longish hole 
           119  Common passage 
           121  Opening 
           123  Sleeve 
           125  Nut 
           127  Passage 
           129  Threaded rod 
           131  Punch 
           133  Opening 
           135  Band exit opening 
           137  Clamping screw 
           139  Recess 
           141  Clamping screw 
           143  Opening, bore sections 
           145  Peg 
           147  Recess 
           149  Prong 
           151  Flange, stop

Technology Category: 1