Spinal implant

Abstract

Disclosed herein is a spinal implant (1) for interconnecting in a mounted position a first vertebra (21) and a second vertebra (22) with respect to each other by at least a first loop (5) and a second loop (6). The implant comprises a strap (3) extending in a longitudinal direction from a leading end (31) to a trailing end (32). The implant further comprises a thereto unidirectionally arranged auxiliary filament (4) configured to be interconnected to the leading or trailing end (32) of the strap (3), for pulling the leading (31) respectively trailing end (32) of the strap (3) by the auxiliary filament (4) around the first and second vertebra (22). Furthermore, the leading end (31) and the trailing end (32) of the strap (3) are configured to be interconnected to each other, thereby forming the second loop (6).

Description

[0001] P29012PC00 08.12.2025

[0002] 1 / 36

[0003] Spinal Implant

[0004] FIELD OF THE DISCLOSURE

[0005] This disclosure relates to a spinal implant for interconnecting a first vertebra and a second vertebra with respect to each other by at least two loops.

[0006] BACKGROUND OF THE DISCLOSURE

[0007] Spinal stabilization refers to a diverse range of procedures aimed to correct spinal instability or deformity while maintaining or restoring the physiological load-bearing function and mobility of the spine. The indications related to these procedures include low-back pain due to facet joint osteoarthritis, degenerative spondylolistheses, degenerative scoliosis and segmental instability.

[0008] Many different techniques, implants and instruments have been developed to date to achieve spinal stabilization. Traditional approaches such as spinal fusion (e.g. posterior spinal fusion) rely on rather rigid fixation of vertebrae while more recent techniques such as semi-rigid fixation techniques aim to combine sufficient fixation with retaining more spinal mobility than the rigid fixation techniques. Vertebropexy has recently emerged as a particularly promising technique to achieve spinal stabilization. It involves interconnecting two or more vertebrae to elastically restrict flexion, while exerting minimal to no influence over other directions of spinal motion, such as torsion or extension.

[0009] Many of the spinal stabilization procedures and indeed many other procedures involving the spine require looping of an implant around one or more vertebrae, particularly around the respective spinous processes of the vertebrae involved. In many instances, more than one loop is required. For example, in some vertebropexy applications, an implant such as a graft is passed around two adjacent vertebrae to form two or even more loops. P29012PC00 08.12.2025

[0010] 2 / 36

[0011] Guiding implants or other surgical structures around vertebrae to form one or more loops is challenging to perform, especially under minimally invasive conditions. Furthermore, the complex anatomical environment of the spine imposes specific challenges, including restricted spatial access to certain sections of the vertebrae. As an example, if an implant needs to be passed around two adjacent spinous processes under minimally invasive conditions, the path along which the implant needs to be guided is neither linear nor oval or circular, but instead includes two relatively long sections corresponding to the two lateral faces of the spinous processes and two relatively short sections corresponding to the cranial face of the cranial spinous process and the caudal face of the caudal spinous process. Passing the implant around the cranial edge of the cranial spinous process and then towards the caudal spinous process requires an abrupt change in direction by approximately 90° over a short distance travelled.

[0012] The known techniques, instruments and implants require forming each loop consecutively and separately. For example, forming two loops around two vertebrae using standard techniques would require using a looping instrument to guide an implant around the two vertebrae to form the first loop, following by guiding the implant around the two vertebrae with the looping instrument a second time to form the second loop. Thus, for each loop, the looping instrument is passed around the respective body structure.

[0013] The known approaches suffer from a range of disadvantages. A major disadvantage is that the known techniques involve numerous steps and are therefore time-consuming and prone to errors. The known techniques are also manually complex to perform because they require specific maneuvers to be performed in a complex anatomical environment and ideally under minimally invasive conditions. By increasing the number of steps in this challenging environment, the risk of inadvertent damage to adjacent body structures such as soft tissue, cartilage or bone structures is increased significantly.

[0014] A further challenge is that the known techniques often have limited or even no possibilities to correct or adjust the position of the implant after the loops have been passed P29012PC00 08.12.2025

[0015] 3 / 36 around the respective body structures. Finally, the known implants, instruments and techniques are often specifically adapted to the concrete anatomical environment of a given body structure of interest (e.g. the spinous processes of specific vertebrae) and cannot be adapted to other body structures with different anatomical environments.

[0016] Consequently, there is a need to advance the state of the art with respect to spinal implants for interconnecting two vertebrae by at least two loops. More broadly, although the challenges have primarily been outlined in the context of spinal fixation, they also apply to many other surgical procedures outside the domain of spinal surgery that require looping implants around body structures, e.g. numerous cerclage applications or sternum closure.

[0017] SUMMARY OF THE DISCLOSURE

[0018] It is a general object of the present disclosure to provide an implant, particularly a spinal implant, and a surgical method of forming at least two loops around body structures which address at least some of the disadvantages of the known implants. It is a particular object to provide an implant and a surgical method which facilitate forming two or more loops around a body structure, e.g. around two vertebrae. In at least some embodiments, it is an object to provide an implant which can be implanted easily, for example requiring only a limited number of steps and / or steps that are easy to perform. Preferably, the implant disclosed herein can be looped two or more times around a body structure while only requiring a looping instrument to be guided once around the body structure.

[0019] The general object is achieved by the subject-matter of the independent claims. Further favorable embodiments follow from the dependent claims and the overall disclosure.

[0020] According to the present disclosure, an implant, particularly a spinal implant, is provided.

[0021] The spinal implant can be configured for interconnecting in a mounted position a first P29012PC00 08.12.2025

[0022] 4 / 36 vertebra and a second vertebra with respect to each other by at least a first loop and a second loop.

[0023] The implant comprises a strap extending in a longitudinal direction from a leading end to a trailing end of the strap. The implant further comprises an auxiliary filament arranged unidirectionally to the strap. Preferably, the strap is configured to be passed during mounting in a first step with its leading end in a first mounting direction around the first and second vertebra, thereby at least partially forming the first loop. Preferably, the auxiliary filament is configured to be interconnected to the leading or trailing end of the strap, for pulling in a second step the leading respectively trailing end of the strap by the auxiliary filament around the first and second vertebra. The leading end and the trailing end of the strap are configured to be interconnected to each other in a third step, thereby forming the second loop.

[0024] By providing an auxiliary filament which is arranged unidirectionally to the strap and which is configured to be interconnected to the leading or trailing end of the strap, as described above, the implant can be easily looped around the first and second vertebra. In particular, it is possible to form two or more loops around the first and second vertebra even if an external looping instrument is passed around the first and second vertebra only once. For example, the external looping instrument may be used to guide the strap and the unidirectionally arranged filament around the first and second vertebra to form the first loop at least partially. Subsequently, it is no longer necessary to use the looping instrument to form the second loop. Rather, the auxiliary filament can be used to pull the leading or trailing end of the strap around the first and second vertebra to form the second loop. In another illustrative example, an external looping instrument is used to place an initial pilot suture around the first and second vertebra. Only a single looping operation by the external looping instrument is necessary to place the initial pilot suture. Afterwards, the initial pilot suture may be interconnected to the spinal implant to pull the spinal P29012PC00 08.12.2025

[0025] 5 / 36 implant around the first and second vertebra to at least partially form the first loop. Subsequently, the auxiliary filament may be used to pull the leading or trailing end of the strap around the first and second vertebra, thereby at least partially forming the second loop. Thus, the implant disclosed herein greatly facilitates forming two or more loops around body structures under minimally invasive conditions.

[0026] Depending on the application, the implant disclosed herein may be used for different applications. Preferably, the implant is used as a spinal implant, e.g. to interconnect the first and second vertebra. In some embodiments, the spinal implant is configured for interconnecting in the mounted position a first spinous process and a second spinous process with respect to each other by the first loop and the second loop. Preferably, the first spinous process and the second spinous process are directly adjacent to each other. More specifically, the spinal implant disclosed herein may advantageously be used for interconnecting two or more vertebrae to elastically restrict flexion, while exerting minimal to no influence over other directions of spinal motion, such as torsion or extension.

[0027] The implant disclosed herein may adopt different configurations e.g. to perform different steps for placement of the implant. For example, the implant may be in a first mounting configuration in which the first step during mounting may be performed. The implant may also be in a second mounting configuration in which the second step during mounting may be performed. Lastly, the implant may also be in a third mounting configuration in which the third step during mounting may be performed.

[0028] The implant comprises a strap having a leading end and a trailing end. The leading end is typically the end of the strap that is configured to be guided first around the first and second vertebra to form the first loop. Conversely, the trailing end is typically the end of the strap that is configured to be pulled along as a result of movement of the leading end.

[0029] Similarly, the auxiliary filament may in some embodiments be described to have a leading end and a trailing end. Typically, the auxiliary filament is arranged unidirectionally to P29012PC00 08.12.2025

[0030] 6 / 36 the strap in a first mounting configuration. Unidirectionally, in this context, means that the leading end of the auxiliary filament faces the leading end of the strap, and the trailing end of the auxiliary filament faces the trailing end of the strap.

[0031] The strap and the auxiliary filament are typically interconnected to each other, but the interconnection between them may depend on the mounting configuration, respectively on the step during mounting. For example, in some embodiments, in the first mounting configuration, the leading end of the strap may be interconnected to the leading end of the auxiliary filament, while in the second mounting configuration the interconnection between the leading end of the strap and the leading end of the auxiliary filament may be interrupted and a new interconnection between e.g. the leading end of the auxiliary filament and the trailing end of the strap (or, alternatively, between trailing end of the auxiliary filament and the leading end of the strap) may be established.

[0032] In the following, different embodiments are discussed for interconnecting the strap and the auxiliary filament, especially in the first and second mounting configuration.

[0033] Depending on the application, different interconnections may be envisioned for the first mounting configuration. In some embodiments, the auxiliary filament is in the first mounting configuration not interconnected to the strap. For example, the auxiliary filament may be separate from the strap in the first mounting configuration. During mounting, they may, for example, be pulled jointly around the first and second vertebra. However, it is preferred that the auxiliary filament is in the first mounting configuration interconnected, preferably directly interconnected, to the strap. For example, the auxiliary filament may be attached to the strap in the first mounting configuration. Depending on the application, the auxiliary filament may in the first mounting configuration be interconnected, e.g. attached, to the strap at different longitudinal positions. In some embodiments, at least the leading end of the auxiliary filament is interconnected to, preferably attached to, the leading end of the strap in the first mounting configuration. For example, the leading end of P29012PC00 08.12.2025

[0034] 7 / 36 the strap may contact the leading end of the auxiliary filament in the first mounting configuration. In some embodiments, the leading end of the auxiliary filament is in the first mounting configuration interconnected to the strap through an intermediate structure, e.g. through a first traction filament interconnecting the leading end of the auxiliary filament and the leading end of the strap. Alternatively or in combination, the auxiliary filament may also be interconnected to (e.g. attached to) the strap with a trailing end of the auxiliary filament in the first mounting configuration.

[0035] In some embodiments, the leading end of the strap is releasably attachable to a leading end of the auxiliary filament. For example, the leading end of the strap may in the first step be attached to a leading end of the auxiliary filament. In some embodiments, the leading end of the strap is configured to be releasably (and optionally indirectly) interconnected to the leading end of the auxiliary filament, e.g. interconnected by a traction filament.

[0036] Depending on the application, there are different options to interconnect the auxiliary filament and the strap in the first mounting configuration. For example, in some embodiments the leading end of the strap and the leading end of the auxiliary filament are (preferably releasably) interconnectable to each other. In some embodiments, the strap comprises a first strap interface configured to be interconnected to a first auxiliary interface of the auxiliary filament. In a typical embodiment, the first strap interface serves to provide a handle of the leading end of the strap, and the first auxiliary interface serves to provide a handle of the leading end of the auxiliary filament. Thus, in some embodiments, the first strap interface is arranged at or near the leading end of the strap. More generally, in some embodiments, the first strap interface is arranged closer in longitudinal direction of the strap to the leading end of the strap than to the trailing end of the strap. Alternatively or in combination, the first auxiliary interface of the auxiliary filament is in some embodiments arranged at or near the leading end of the auxiliary filament. More generally, in some embodiments, the first auxiliary interface is arranged closer in longitudinal P29012PC00 08.12.2025

[0037] 8 / 36 direction of the auxiliary filament to the leading end of the auxiliary filament than to the trailing end of the auxiliary filament.

[0038] Depending on the application, the first strap interface and the first auxiliary interface may be interconnectable to each other directly or indirectly. For example, in some embodiments, the first strap interface and the first auxiliary interface are connectable or attachable to each other, such that they preferably directly contact each other when connected or attached to each other. The connectability or attachability is preferably releasable. For example, in some embodiments, the first strap interface and the first auxiliary interface are releasably attachable to each other by a crimp connection, a suture, a hitch, a knot and / or a clip, preferably by a crimp connection. A crimp has been found to be particularly suitable, especially in the domain of spinal implants, because they can be easily mounted to the implant and are compatible with a wide range of implants. Furthermore, crimps can be easily removed without damage to the strap, particularly if grafts of other ligaments or tendons are used as straps. Furthermore, crimps have been found to give sufficient tensile strength to place the implant.

[0039] In some embodiments, the first strap interface and the first auxiliary interface are configured to be indirectly interconnected to each other. For example, in some embodiments, the first strap interface and the first auxiliary interface are each configured to be interconnected to each other by an intermediate structure, preferably by a first traction filament. Thus, for example, the first traction filament may be configured to interconnect the strap and the auxiliary filament in the first mounting configuration. Preferably, the first auxiliary interface is releasably attachable to the first traction filament (e.g. to a first traction interface of the first traction filament, as described in more detail later). The releasable attachability is preferable because it allows attaching the auxiliary filament to the first traction filament in the first mounting configuration, but also to release the attachment in the second mounting configuration. Depending on the application, the releasable attachment can be realized in different ways. Preferably, the first auxiliary interface is P29012PC00 08.12.2025

[0040] 9 / 36 configured to be releasably attachable to the first traction filament by a crimp connection, a suture, a hitch, a knot and / or a clip, preferably by a clip. The clip connection is preferable for the reasons outlined above. Alternatively to or in combination with the embodiments outlined in this paragraph, the strap may optionally be attached to the first traction filament. For example, the strap may be releasably or fixedly attached to the first traction filament, e.g. through a crimp connection.

[0041] Depending on the application, there are different possible interconnections between the strap and the auxiliary filament in the second mounting configuration. In a typical embodiment, the interconnection(s) between the strap and the auxiliary filament change from the first to the second mounting configuration. For example, in some embodiments, in the first mounting configuration, the leading end of the strap and the leading end of the auxiliary filament are interconnected to each other, while in the second mounting configuration, the leading end of the strap and the trailing end of the auxiliary filament are interconnected to each other. In the embodiments described in the previous sentence, the interconnection present in the first mounting configuration between the leading end of the strap and the leading end of the auxiliary filament may optionally be interrupted in the second mounting configuration.

[0042] In some embodiments, the auxiliary filament is configured to be interconnected to the trailing end of the strap, for pulling in the second step the trailing end of the strap by the auxiliary filament around the first vertebra and the second vertebra in opposite direction with respect to the first mounting direction of the first loop. Preferably, the leading end of the auxiliary filament may be interconnectable (directly or indirectly) to the trailing end of the strap. In some embodiments, this interconnection may be realized in a releasable fashion. For example, in some embodiments, the leading end of the auxiliary filament is releasably attachable to the trailing end of the strap. Preferably, the leading end of the auxiliary filament is releasably attachable to the trailing end of the strap in the second P29012PC00 08.12.2025

[0043] 10 / 36 mounting configuration. Typically, this attachment was not yet present in the first mounting configuration but was newly established in the second mounting configuration.

[0044] Other variants may also be envisioned. For example, in some embodiments, the auxiliary filament is configured to be interconnected to the leading end of the strap, for pulling in the second step the leading end of the strap by the auxiliary filament around the first vertebra and the second vertebra in a parallel direction with respect to the first mounting direction of the first loop.

[0045] In some embodiments, the trailing end of the auxiliary filament is interconnectable to the leading end of the strap. In some embodiments, this interconnection may be realized in a releasable fashion. For example, in some embodiments, the trailing end of the auxiliary filament is releasably attachable to the leading end of the strap. Preferably, the trailing end of the auxiliary filament is releasably attached to the leading end of the strap in the second mounting configuration. Typically, this attachment was not yet present in the first mounting configuration but was newly established in the second mounting configuration.

[0046] Depending on the application, there are different ways to realize the interconnections of the second mounting configuration, e.g. using different interfaces. In some embodiments, the strap comprises a second strap interface configured to be interconnected to a second auxiliary interface of the auxiliary filament. The second strap interface typically faces the trailing end of the strap and the second auxiliary interface faces the trailing end of the auxiliary filament. For example, the second strap interface may be arranged at or near the trailing end of the strap and the second auxiliary interface may be arranged at or near the trailing end of the auxiliary filament.

[0047] Different variations may be envisioned to perform the second mounting step. In some embodiments, the first strap interface is releasably interconnectable (directly or indirectly) to the second auxiliary interface. For example, the second auxiliary interface may be releasably attachable to a second traction interface of a first traction filament, and a P29012PC00 08.12.2025

[0048] 11 / 36 first traction filament of the first traction filament may be attachable (or optionally permanently attached) to the first strap interface. In some embodiments, the first strap interface is releasably and directly attachable to the second auxiliary interface.

[0049] In some embodiments, the second strap interface is releasably interconnectable (directly or indirectly) to the first auxiliary interface. For example, the first auxiliary interface may be releasably attachable to a fourth traction interface of a second traction filament, and a third traction filament of the second traction filament may be attachable (or optionally permanently attached) to the second strap interface. In some embodiments, the second strap interface is releasably and directly attachable to the first auxiliary interface.

[0050] In some embodiments,

[0051] - the second strap interface is releasably attachable to the first auxiliary interface; or

[0052] - the second auxiliary interface is releasably attachable to the first strap interface.

[0053] In the embodiments described in the previous sentence, preferably, as explained above, the first strap interface may be arranged at or near the leading end of the strap, the second strap interface may be arranged at or near the trailing end of the strap, the first auxiliary interface may be arranged at or near the leading end of the auxiliary interface, and the second auxiliary interface may be arranged at or near the trailing end of the auxiliary interface.

[0054] These embodiments are particularly advantageous because they minimize the number of interfaces required and because they enable efficient loop formation. As an example, in the embodiment described under the first bullet point above, the first strap interface and the first auxiliary interface may be interconnected (e.g. attached) to each other in the first mounting configuration, and in the second mounting configuration, this interconnection may be released and the second strap interface may be interconnected (e.g. P29012PC00 08.12.2025

[0055] 12 / 36 attached) to the first auxiliary interface. This allows the second loop to be formed e.g. by pulling in the second step the trailing end of the auxiliary filament (which is arranged opposite the first auxiliary interface in longitudinal direction). In the embodiment described under the second bullet point above, the first strap interface and the first auxiliary interface may be interconnected (e.g. attached) to each other in the first mounting configuration, and in the second mounting configuration, this interconnection may be released and the first strap interface may be interconnected (e.g. attached) to the second auxiliary interface. This allows the second loop to be formed e.g. by pulling in the second step the leading end of the auxiliary filament (which is arranged opposite the second auxiliary interface in longitudinal direction).

[0056] Depending on the application, the spinal implant may optionally comprise one or more traction filaments. In some embodiments, the traction filaments are traction sutures. The traction filaments can for example be attached to one or both ends of the strap to provide a handle for placing the strap during implantation. One advantage of using traction sutures is that damage to the strap can be minimized by using the traction filaments as handles. The traction filaments may optionally be removed after successful implantation, such that the strap forms the final implant remaining in a patient’s body. However, it is also possible that the traction filaments remain in the patient’s body. A further advantage of using traction sutures is that they can be used to adjust the position of the strap during implantation.

[0057] In some embodiments, the leading end of the strap is attached to a first traction filament extending in the longitudinal direction beyond the leading end of the strap. For example, the leading end of the strap may be fixedly attached to the first traction filament. The first traction filament may preferably act as an application aid in at least the first step to control the position of the leading end with respect to the first and the second vertebra. In some embodiments, the first traction filament is permanently attached to the strap. Alternatively or in combination, the first traction filament may be releasably attachable to the auxiliary P29012PC00 08.12.2025

[0058] 13 / 36 filament. For example, in some embodiments, the auxiliary filament is configured to be attached in the first step to the first traction filament. Independently of the specific step, it may be said that in some embodiments, the auxiliary filament is releasably attachable to the first traction filament.

[0059] In some embodiments, the first traction filament is releasably attachable to the auxiliary filament, wherein preferably the first traction filament interconnects the strap and the auxiliary filament at least in the first mounting configuration. In these embodiments, the first traction filament may optionally form a semi-loop in a first mounting configuration. This semi-loop may then e.g. be configured to be engaged by a looping instrument or by an initial pilot suture for passing the implant in the first step around the first and second vertebra. In the second step, the interconnection between the auxiliary filament and the traction suture is preferably released or otherwise interrupted.

[0060] Depending on the application, the implant may comprise further traction filaments. Preferably, the spinal implant comprises a first traction filament and a second filament. For example, in some embodiments, the trailing end of the strap is attached to a second traction filament extending in the longitudinal direction beyond the trailing end of the strap. For example, the trailing end of the strap may be fixedly attached to the second traction filament. Preferably, the second traction filament acts as an application aid in the first and / or second and / or third step to control the position of the trailing end with respect to the first and the second vertebra. For example, the second traction filament may act as an application aid at least in the first step and / or second step, preferably at least in the second step.

[0061] In some embodiments, the second traction filament is permanently attached to the strap. Alternatively or in combination, the second traction filament may be releasable attachable to the auxiliary filament. For example, in some embodiments, the auxiliary filament is configured to be attached in the second step to the second traction filament. Independently of the specific step, it may be said that in some embodiments, the auxiliary P29012PC00 08.12.2025

[0062] 14 / 36 filament is releasably attachable to the second traction filament. For example, the auxiliary filament may be attached to the second traction filament in the second step, which can e.g. be used to pull the second traction filament - and consequently also the trailing end of the strap - by the auxiliary filament around the first and second vertebra.

[0063] In some embodiments, the second traction filament is releasably attachable to the auxiliary filament, wherein preferably the second traction filament interconnects the strap and the auxiliary filament in the second mounting configuration. Preferably, in these embodiments, the second traction filament does not interconnect the strap and the auxiliary filament in the first mounting configuration.

[0064] Depending on the application, different interconnections may be chosen to interconnect the first traction filament with either the strap or the auxiliary filament. For example, in some embodiments, the leading end of the strap is attached to the first traction filament by interweaving, intersewing, a splice connection, a suture, a hitch, a knot, a weld connection and / or a crimp connection. The advantages of using a crimp connection outlined above also apply to these embodiments (e.g. easy mounting, compatibility with a wide range of implants, removal without damage to strap, sufficient tensile strength for implant placement). In some embodiments, however, it could also be advantageous to choose a permanent interconnection between the strap and the first traction filament, especially in cases where the first traction filament is to remain in the patient’s body. For example, in some embodiments, the first traction filament can be used in a tensioning step after placement of the implant around the first and second vertebra has been completed. Accordingly, in some embodiments, the first traction filament is fixedly attached to the strap, e.g. by interweaving, intersewing, a splice connection, a hitch, a knot or a suture.

[0065] The embodiments described in the previous paragraph in the context of the first traction filament may also apply, alternatively or in combination, to the second traction filament. Thus, in some embodiments, the trailing end of the strap is attached to the second traction filament by interweaving, intersewing, a splice connection, a suture, a hitch, a knot, P29012PC00 08.12.2025

[0066] 15 / 36 a weld connection and / or a crimp connection. In some embodiments, however, it could also be advantageous to choose a permanent interconnection between the strap and the second traction filament, especially in cases where the second traction filament is to remain in the patient’s body, as explained above. Accordingly, in some embodiments, the second traction filament is fixedly attached to the strap, e.g. by interweaving, intersewing, a splice connection, a hitch, a knot or a suture.

[0067] In some embodiments, the auxiliary filament and the first traction filament are integrally formed. Optionally, the second traction filament may additionally be integrally formed with the auxiliary filament and the first traction filament. For example, a continuous suture or other filament interconnecting the leading and trailing end of the strap may have different sections corresponding to the first traction filament, the auxiliary filament and the second traction filament. In further embodiments, at least the second traction filament is integrally formed with the auxiliary filament. One advantage of these integrally formed embodiments is that they are easy to manufacture. Due to the integral formation, they typically also display good tensile properties and have a low risk of tear.

[0068] However, in other embodiments, the auxiliary filament, the first traction filament and the second traction filament are not integrally formed but are distinct pieces. They may optionally be attached or at least releasably attachable to each other, but they are preferably nevertheless distinct pieces. One advantage of these embodiments is that different materials can be chosen for the first traction filament, the second traction filament and the auxiliary filament. This may be particularly advantageous in embodiments in which the first traction filament and the second traction filament are used in a subsequent tensioning step, e.g. for spinal stabilization.

[0069] Depending on the application, the traction filament or traction filaments may be made of different materials. For example, in some embodiments, the first traction filament comprises or consists or a suture, a thread or a cord. In some embodiments, the first traction filament is strap-shaped. In some embodiments, the first traction filament is made of a P29012PC00 08.12.2025

[0070] 16 / 36 textile or fabric. Alternatively or in combination, in some embodiments, the second traction filament comprises or consists or a suture, a thread or a cord. In some embodiments, the second traction filament is strap-shaped. In some embodiments, the second traction filament is made of a textile or fabric.

[0071] Typically, the first traction filament extends from a first end to an opposite second end. The first traction filament typically includes a first traction interface and a second traction interface. The first traction interface and the second traction interface are typically arranged on opposite longitudinal ends of the first traction filament. Similarly (but in principle independently of the first traction filament), the second traction filament typically extends from a first end to an opposite second end of the second traction filament. The second traction filament typically includes a third traction interface and a fourth traction interface. The third traction interface and the fourth traction interface are typically arranged on opposite longitudinal ends of the second traction filament. It is understood that the expression “third” or “fourth” traction interface of the second traction filament does not imply that the second traction filament also comprises a “first” and “second” traction interface. Rather, the first traction interface and the second traction interface are part of the first traction filament, as explained above.

[0072] Depending on the application, different straps may be used in the spinal implant of the present disclosure. For example, in some embodiments, the strap comprises a tendon, a ligament, an allograft, an autograft or a xenograft. Preferably, the strap comprises an allograft. In some variations, the strap may additionally comprise one or more other materials or components, e.g. to form a hybrid material. For example, the hybrid material may comprise a natural component (such as a tendon, a ligament, an allograft, an autograft or a xenograft) and a synthetic component (such as a braid and / or weave and / or stitched material and / or felt). However, in some embodiments, the strap essentially consists of a tendon, a ligament, an allograft, an autograft or a xenograft. P29012PC00 08.12.2025

[0073] 17 / 36

[0074] In some embodiments, the strap comprises a synthetic material, such as a braid and / or weave and / or stitched material and / or felt. The synthetic material may e.g. be or comprise a tape. Depending on the application, the strap may be braided or woven from a polyblend of ultra-high molecular weight polyethylene and polyester materials, such as pure polyethylene terephthalate (PET). Additionally or alternatively, the strap may be a flat braided suture or a woven suture. In some variations, the strap is made of a woven structure or a tape or a synthetic ligament.

[0075] When using a strap that comprises a synthetic material, it may be advantageous to sew or splice the auxiliary filament to the strap (or to interweave them) because this facilitates manufacturing and reduces the risk of uncontrolled or premature interruption of the interconnection between strap and auxiliary filament during mounting. Thus, in some embodiments, the strap comprises a synthetic material (such as a textile or a fabric), and wherein the auxiliary filament is interwoven with, sewn to or spliced to the strap. For example, the auxiliary filament may be interwoven with, sewn to or spliced to the synthetic material (e.g. the textile or fabric) of the strap.

[0076] Depending on the application, it may be advantageous to use a strap made of a hybrid material in which a synthetic component forms a sheath circumferentially encompassing at least a longitudinal section of the natural component. For example, the synthetic component forming the sheath may be chosen to provide good gliding properties to facilitate placement of the implant and to protect the natural component. Depending on the application, the sheath may be removed after placement of the implant, or it may remain in the patient’s body after placement.

[0077] Depending on the application, the strap may have different regions or surfaces along the longitudinal direction. In some embodiments, the strap comprises in the longitudinal direction arranged behind each other: P29012PC00 08.12.2025

[0078] 18 / 36

[0079] - A first load-bearing surface configured for contacting in the mounted position the first vertebra, preferably a spinous process of the first vertebra;

[0080] - A second load-bearing surface configured for contacting in the mounted position the second vertebra, preferably a spinous process of the second vertebra;

[0081] - A third load-bearing surface configured for contacting in the mounted position the first vertebra, preferably the spinous process of the first vertebra; and

[0082] - A fourth load-bearing surface configured for contacting in the mounted position the second vertebra, preferably the spinous process of the second vertebra.

[0083] Preferably, the strap comprises all four load-bearing surfaces. The first, second, third and fourth load-bearing surfaces are preferably arranged on the same lateral side of the strap. This arrangement facilitates passing the implant around the first and second vertebra without the need for twisting or other complex maneuvers to properly position the implant.

[0084] Typically, the first, second, third and fourth load-bearing surfaces are regularly interspaced from each other in the longitudinal direction. In other words, a distance in longitudinal direction between the first and second load-bearing surfaces may be essentially the same as a distance in longitudinal direction between the second and third load-bearing surfaces, as well as essentially the same as a distance in longitudinal direction between the third and fourth load-bearing surfaces.

[0085] In some embodiments, the strap has a deformable cross-section. For example, the deformable cross-section may in the mounted position flattens in lateral direction when in contact with the first or second vertebra, such that the load is distributed in lateral direction. One advantage of these embodiments is that they facilitate even load distribution. Furthermore, by having a deformable cross-section, it is also easier to pass the spinal implant around the first and second vertebra, including around constricted or otherwise P29012PC00 08.12.2025

[0086] 19 / 36 spatially challenging anatomical structures. In some embodiments, the strap has a deformable cross-section at least in the region of the load-bearing surfaces. Preferably, however, the strap may have a deformable cross-section along its entire length in longitudinal direction.

[0087] Depending on the application, different auxiliary filaments may be used. In some embodiments, the auxiliary filament comprises or consists or a suture, a thread or a cord. The auxiliary filament typically has a smaller cross-section than the strap. For example, in some embodiments, the auxiliary filament has a cross-section that is at least 50%, preferably at least 75%, smaller by area than the cross-section of the strap.

[0088] In some embodiments, the first traction filament has a cross-section of at least 10%, preferably at least 25%, by area with respect to the cross-section of the strap. Alternatively or in combination, in some embodiments, the second traction filament has a crosssection of at least 10%, preferably at least 25%, by area with respect to the cross-section of the strap.

[0089] In some embodiments, the auxiliary filament has a smaller cross-section than the first traction filament. Alternatively or in combination, the auxiliary filament may have a smaller cross-section than the second traction filament.

[0090] Depending on the application, the strap and the auxiliary filament can have different lengths. In typical embodiments, the auxiliary filament has a length in longitudinal direction of at least 75%, preferably at least 100%, more preferably at least 125%, of a length in longitudinal direction of the strap.

[0091] In some embodiments, the auxiliary filament has a length in longitudinal direction of at least 300 mm, preferably at least 400 mm, or even at least 500 mm.

[0092] In use, the length of the strap and the length of the auxiliary filament may be chosen depending on a vertebral distance, which is defined as the distance between the first P29012PC00 08.12.2025

[0093] 20 / 36 vertebra and second vertebra, specifically between an implant-contacting section of the first vertebra and an implant-contacting section of the second vertebra. For example, the vertebral distance is preferably defined as the distance between a cranial edge of the spinous process of the first vertebra (being a cranial vertebra) and the caudal edge of the spinous process of the second vertebra (being a caudal vertebra). Thus, the auxiliary filament typically has a length in longitudinal direction of at least 375%, preferably at least 500%, more preferably at least 625%, with respect to the vertebral distance. It is understood that the length ultimately depends on various factors, including the number of loops and the relation between a final tensile force to be applied to the strap and the elasticity of the strap. In variants in which two loops formed, the strap preferably has a length from 350% to 450%, preferably from 350% to 400%, with respect to the vertebral distance.

[0094] Depending on the application, the strap and the auxiliary filament can have different arrangements with respect to each other. The arrangement may for example be used to control the final orientation and / or shape of the strap after implantation. As an example, in some embodiments, the auxiliary filament extends parallel and preferably next to the strap in longitudinal direction, at least in the first mounting configuration. For example, the auxiliary filament and the strap may optionally be laterally interspaced from each other in the mounting configuration, or they may contact each other with their respective outer surfaces in the first mounting configuration. These embodiments can e.g. be used to obtain a final implant in which the first loop formed by a portion of the strap is arranged next to (and potentially contacts) the second loop formed by another portion of the strap in a mounted position.

[0095] In some embodiments, the auxiliary filament extends in the first mounting configuration coaxially within at least a portion of the strap forming a sheath around the auxiliary filament. These embodiments can e.g. be used to obtain, in the mounted position, an implant in which a portion of the strap is arranged inside another portion of the strap. In other words, in some embodiments, a first portion of the strap may be configured to be P29012PC00 08.12.2025

[0096] 21 / 36 arranged in the mounted position coaxially with a second portion of the strap, wherein preferably the first portion forms a core circumferentially encompassed by a sheath formed by the second portion of the strap. One advantage of these embodiments is that they make it easy to place a coaxially formed implant under minimally invasive conditions.

[0097] As outlined in the present disclosure, including the claims, different variants of the spinal implant are conceivable. Selected preferred embodiments of the spinal implant are outlined in further detail in the following sections:

[0098] In a preferred embodiment, the first strap interface is releasably (directly or indirectly) interconnectable to the auxiliary filament, preferably to the first auxiliary interface of the auxiliary filament.

[0099] In a preferred embodiment, the first strap interface is (releasably or fixedly) attached to a first traction interface of the first traction filament.

[0100] In a preferred embodiment, the first traction filament is configured to releasably interconnect the strap and the auxiliary filament in a first mounting configuration. For example, a first strap interface may be (releasably or fixedly) attached to a first traction interface of the first traction filament, and a first auxiliary interface may be releasably attachable to a second traction interface of the first traction filament.

[0101] In a preferred embodiment, the second strap interface is (releasably or fixedly) attached to a third traction interface of the second traction filament.

[0102] Alternatively or in combination, in a preferred embodiment,

[0103] - either the first auxiliary interface is releasably (directly or indirectly) interconnectable to the second strap interface, preferably by a clip; P29012PC00 08.12.2025

[0104] 22 / 36

[0105] - or the second auxiliary interface is releasably (directly or indirectly) interconnectable to the first strap interface, preferably by a clip.

[0106] For example, in some embodiments,

[0107] - the first auxiliary interface is releasably attachable to a fourth traction interface of the second traction filament, preferably by a clip;

[0108] - or the first auxiliary interface is releasably attachable to the second strap interface, preferably by a clip;

[0109] - or the second auxiliary interface is releasably attachable to a second traction interface of the first traction filament, preferably by a clip;

[0110] - or the second auxiliary interface is releasably attachable to the first strap interface, preferably by a clip.

[0111] Preferably, in some embodiments,

[0112] - the first auxiliary interface is releasably attachable to a fourth traction interface of the second traction filament, preferably by a clip;

[0113] - or the second auxiliary interface is releasably attachable to a second traction interface of the first traction filament, preferably by a clip.

[0114] More preferably, in some embodiments, the first auxiliary interface is releasably attachable to a fourth traction interface of the second traction filament, preferably by a clip.

[0115] The present disclosure further provides a method for interconnecting a first vertebra and a second vertebra with respect to each other by at least a first loop and a second loop. The method comprises the steps of: a. Arranging an auxiliary filament unidirectionally with respect to a strap extending in a longitudinal direction from a leading end to a trailing end; P29012PC00 08.12.2025

[0116] 23 / 36 b. Passing the strap and the unidirectionally arranged auxiliary filament with the leading end of the strap in a first mounting direction around the first and second vertebra, thereby at least partially forming the first loop; c. Interconnecting the auxiliary filament to the leading or trailing end of the strap; d. Pulling the leading respectively trailing end of the strap by the auxiliary filament around the first and second vertebra; e. Interconnecting the leading and trailing end of the strap, thereby forming the second loop.

[0117] In step b), typically, the strap and the unidirectionally arranged auxiliary filament are jointly passed around the first and second vertebra.

[0118] Preferably, an implant according to any of the embodiments disclosed herein is used in the method.

[0119] Further provided herein is a kit for performing the method. The kit typically comprises the spinal implant according to any of the embodiments disclosed herein. Optionally, the kit may further comprise a manual containing instructions to perform the method described herein, i.e. the method for interconnecting a first vertebra and a second vertebra with respect to each other by at least a first loop and a second loop.

[0120] Interconnected, as used in the present disclosure, typically includes a direct interconnection as well as an indirect interconnection, unless specified otherwise or unless the context clearly dictates otherwise. For example, in a direct interconnection, the two elements that are described as being directly interconnected to each other typically contact each other. As an example of an indirect interconnection, e.g., two elements that are described as being indirectly interconnected to each other may be interconnected P29012PC00 08.12.2025

[0121] 24 / 36 through the intermediacy of one or more intermediate structures or elements. For example, an intermediate suture may interconnect two elements that are described as being indirectly interconnected to each other.

[0122] BRIEF DESCRIPTION OF THE DRAWINGS

[0123] The disclosure described herein will be more fully understood from the detailed description given herein below and the accompanying drawings, which should not be considered limiting to the disclosure described in the appended claims. The drawings show:

[0124] Fig. 1 An embodiment of a spinal implant 1 ;

[0125] Fig. 2 A mounting process of the spinal implant 1 illustrated in Fig. 1 ;

[0126] Fig. 3 Another embodiment of a spinal implant 1 ;

[0127] Fig. 4 Another embodiment of a spinal implant 1 .

[0128] DESCRIPTION OF THE VARIATIONS

[0129] Reference will now be made in detail to certain variations, examples of which are illustrated in the accompanying drawings, in which some, but not all features are shown. Indeed, variations disclosed herein may be embodied in many different forms and should not be construed as limited to the variations set forth herein; rather, these variations are provided so that this disclosure will satisfy applicable legal requirements. Whenever possible, like reference numbers will be used to refer to like components or parts.

[0130] Figures 1 and 2 show an embodiment of the spinal implant of the present disclosure. Specifically, figure 1 illustrates the spinal implant in a pre-mounted configuration and figure 2 illustrates the use of the implant in a spinal stabilization procedure, thus illustrating the implant in different mounted configurations. P29012PC00 08.12.2025

[0131] 25 / 36

[0132] As shown in Figure 1 , the illustrated spinal implant 1 includes a strap 3, an auxiliary filament 4, a first traction filament 7 and a second traction filament 8. Strap 3 is formed by a graft, preferably an allograft. The first and second traction filaments 7, 8 are both formed by a suture or cord, and the auxiliary filament 4 is formed by a suture.

[0133] In the illustrated embodiment, strap 3 extends from a leading end 31 to a trailing end 32. At the leading end 31 , strap 3 comprises a first strap interface 33 which is attached to a first traction interface 71 of the first traction filament 7. Conversely, a second traction interface 72 of the first traction filament 7 is interconnected to a first auxiliary interface 43 arranged at the leading end 41 of the auxiliary filament 4. Thereby, the first traction filament 7 interconnects the leading end 31 of the strap 3 and the leading end 41 of the auxiliary filament 4. Importantly, the second traction interface 72 is releasably attached to the first auxiliary interface 43 of the auxiliary filament 4. As will be seen in more detail in Figures 2c and 2d, this will allow, during mounting, the first auxiliary interface 43 to be released from the second traction interface 72 and to be attached to another interface (namely the fourth traction interface 82) in order to interconnect the auxiliary filament 4 during a second step with the trailing end 32 of the strap 3.

[0134] On the trailing end 32 of the strap 3, the strap comprises a second strap interface 34 which is attached to a third traction interface 81 of a second traction filament 8. In the illustrated embodiment, the second strap interface 34 and the third traction interface 81 are attached to each other by a crimp connection. Similarly, in the illustrated embodiment, the first strap interface 33 is attached to the first traction interface 71 by a crimp connection. Preferably, these crimp connections allow for a sufficiently strong connection between the respective interfaces. The crimp connections ultimately allow a tensile force to be effectively transmitted along the first and section traction filaments 7, 8 and the strap 3. Thus, during use, the first and second traction filaments 7, 8 can be used to adjust a longitudinal position of the strap 3 by providing a handle on both ends 31 , 32 of the strap 3. P29012PC00 08.12.2025

[0135] 26 / 36

[0136] In contrast to the rather strong attachment between the strap 3 and the first traction filament 7 (respectively between the strap 3 and the second traction filament 8), the second traction interface 72 and the first auxiliary interface 43 are more releasably attachable to each other. This releasable attachment may for example be realized by a clip. In the illustrated embodiment, the first auxiliary interface 43 is formed by a bulge that is received in a form-fit fashion by a corresponding receiving opening forming the second traction interface 72. In the illustrated embodiment, the fourth traction interface is also formed by a similar receiving opening configured for releasably receiving the first auxiliary interface 43.

[0137] Figures 2a-2f illustrate the process of mounting the spinal implant 1 illustrated in Figure 1.

[0138] Figure 2a illustrates a first vertebra 21 and a second vertebra 22 which are to be interconnected by the spinal implant 1. More specifically, strap 3 is intended to be looped around the respective spinous processes of the vertebrae twice to form two loops. Figure 2a also illustrates an initial pilot suture 1 1 which has been passed around the first and second vertebra 21 , 22 and which essentially provides a handle for placing the spinal implant 1. The initial pilot suture 11 may e.g. be passed around the first and second vertebra 21 , 22 through a looping instrument (not shown). As an alternative to first placing an initial pilot suture 1 1 which is then used to pass the spinal implant 1 around the first and second vertebra 21 , 22, it is also possible to use the looping instrument directly to guide the spinal implant 1 around the first and second vertebra 21 , 22 (not shown). However, Figure 2 illustrates an embodiment in which an initial pilot suture 1 1 is first placed around the first and second vertebra 21 , 22. More specifically, the initial pilot suture 1 1 has been passed around the respective spinous processes of the first and second vertebra 21 , 22.

[0139] In Figure 2b, the initial pilot suture 11 has been attached to the first traction filament 7 by passing a part of the spinal implant 1 through a semi-loop formed by the initial pilot P29012PC00 08.12.2025

[0140] 27 / 36 suture 11 . Thereby, the initial pilot suture 1 1 is interconnected to both the leading end 31 of the strap 3, and to the leading end 41 of the auxiliary filament 4. This will ensure that when the opposite free ends of the initial pilot suture 1 1 are pulled, both the leading end 31 of the strap 3 and the leading end 41 of the auxiliary filament 4 are pulled along, thereby passing the strap 3 and the auxiliary filament 4 around the first and second vertebra 21 , 22. The free ends of the initial pilot suture 1 1 are pulled until the semi-loop of the initial pilot suture 11 interconnected to the first traction filament 7 has been passed around the second vertebra 22, thereby arriving at the position illustrated in Figure 2c.

[0141] Importantly, if the initial pilot suture 11 has been pulled too far, the second traction filament 8 which is attached to the trailing end 32 of the strap 3 provided a handle to pull at least the strap 3 in a reverse direction. In the illustrated embodiment, the auxiliary filament is only interconnected to the strap 3 through the first auxiliary filament 43. Thus, a reverse pulling of the second traction filament 8 will only retract the strap 3, but not the auxiliary filament 4 (not accounting for frictional effects that may lead to pulling the auxiliary filament along. Thus, in the illustrated embodiment, care should be taken not to pull the initial pilot suture 11 too far. However, in other embodiments (not shown), the strap 3 is additionally interconnected to the auxiliary filament 4 at the respective trailing ends 32, 42, which allows a reverse pulling of the second traction filament 8 to be transmitted to both the trailing end 32 of the strap 3 and to the trailing end 42 of the auxiliary filament 4.

[0142] In Figure 2c, the strap 3 and the auxiliary filament 4 both extend unidirectionally and have both been passed around the first and second vertebra 21 , 22. The leading end 31 of the strap 3 is still interconnected to the auxiliary filament 4 through the first traction filament 7 interconnecting the leading end 31 of the strap 3 and the leading end 41 of the auxiliary filament 4.

[0143] As illustrated in Figure 2d, in a next step, the interconnection between the leading end 31 of the strap 3 and the leading end 41 of the auxiliary filament 4 is interrupted, and a P29012PC00 08.12.2025

[0144] 28 / 36 new interconnection between the leading end 41 of the auxiliary filament 4 and the trailing end 32 of the strap 3 is established. In an alternative embodiment (not illustrated), it would also be conceivable to establish a new interconnection between the leading end 31 of the strap 3 and the trailing end 42 of the auxiliary filament 4. However, in the illustrated embodiment, the newly established interconnection is between the leading end 41 of the auxiliary filament 4 and the trailing end 32 of the strap 3. More specifically, this newly established interconnection is established by releasing the first auxiliary interface 43 of the auxiliary filament 4 from the second traction interface 72 of the first traction filament 7, and by attaching this first auxiliary interface 43 of the auxiliary filament 4 to the fourth traction interface 82 of the second traction filament 8. Thereby, the second traction filament 8 now interconnects the leading end 41 of the auxiliary filament 4 and the trailing end 32 of the strap 3. This switchover allows, in a next step, the free trailing end 42 of the auxiliary filament 4 to be pulled, thereby pulling the trailing end 32 of the strap 3 along, thereby passing the trailing end 32 of the strap 3 around the spinous process of the second vertebra 22 and then around the spinous process of the first vertebra 21 . Thus, the trailing end 32 of the strap 3 is essentially passed in reverse direction with respect to the original direction along which the leading end 31 of the strap 3 has been passed previously. The result of this movement is illustrated in Figure 2e.

[0145] As shown in Figure 2e, a first loop 5 has been formed by the strap 3. Furthermore, a second loop has almost been formed as well. To complete the second loop (cf. Fig. 2f), it is necessary to interconnect the leading end 31 and the trailing end 32 of the strap 3. At present, as illustrated in Figure 2e, the leading 31 of the strap 3 is still attached to the first traction filament 7, and the trailing end 32 of the strap 3 is still attached to the second traction filament. Additionally, the fourth traction interface 82 of the second traction filament 8 is still attached to the first auxiliary interface 43 of the auxiliary filament 4. At this stage, the auxiliary filament 4 has served its main purpose and may be released and discarded. P29012PC00 08.12.2025

[0146] 29 / 36

[0147] Depending on the application, the first traction filament 7 and the second traction filament 8 could be attached to each other or otherwise be interconnected to each other to form the second loop 6 (not illustrated). However, in the illustrated embodiment, the first and second traction filament 7, 8 are not intended to remain inside the body of the patient, but rather, separate tensile sutures are used for this purpose. Thus, in the illustrated embodiment, the first traction filament 7 and the second traction filament 8 are removed from the strap 3 by opening up the respective crimp connections between the first strap interface 33 and the first traction interface 71 , and between the second strap interface 34 and the third traction interface 81. Subsequently, tensile sutures 10 are interconnected to the leading end 31 of the strap 3 and to the trailing end 32 of the strap 3.

[0148] As illustrated in Figure 2f, the tensile sutures 10 are subsequently attached to a lock 9 (e.g. a button), thereby interconnecting the leading end 31 and the trailing end 32 of the strap 3 and completing the second loop 6. The lock 9 may be used to tension the tensile sutures 10, thereby applying a tensile force between the spinous processes of the first vertebra 21 and the second vertebra 22. Notably, as illustrated in Figure 2f, the spinal implant 1 serves to elastically limit flexion, but has only a minimal to no impact on other directions of spinal motion, e.g. extension.

[0149] Figure 3 shows a further embodiment of a spinal implant 1. Generally speaking, the implant is a specific example of a group of embodiments in which the first strap interface 33 is releasably attached to the first auxiliary interface 43 (of an auxiliary filament 4) and to the first traction interface 71 (of a first traction filament 7), e.g. by a crimp connection, and in which the second strap interface 34 is releasably attached to a third traction interface 81 (of a second traction filament 8), e.g. by a crimp connection. In the specific embodiment illustrated in Figure 3, furthermore, the strap 3 is formed by a graft, e.g. an allograft. P29012PC00 08.12.2025

[0150] 30 / 36

[0151] Figure 4 shows a further embodiment of a spinal implant 1 similar to the embodiment shows in Figure 1. Figure 4 is focused on illustrating in further detail a length in longitudinal direction of the spinal implant 1 , as well as load-bearing surfaces 35.

[0152] The distance illustrated as d1 in Fig. 4 illustrates a vertebral distance. More specifically, because the spinal implant 1 is configured to be passed around the spinous processes of the first vertebra 21 and of the second vertebra 22, the vertebral distance refers to the distance between a cranial edge of the spinous process of the cranial vertebra 21 and a caudal edge of the spinous process of the caudal vertebra 22. It is understood that the vertebral distance d1 refers to a neutral position of the spine.

[0153] The spinal implant 1 illustrated in Figure 4 comprises a strap 3 attached with its leading end 31 to a first traction filament 7. The first traction filament 7 interconnects the strap 3 and an auxiliary filament 4. Furthermore, a trailing end 32 of the strap 3 is attached to a second traction filament 8.

[0154] Along its length, the strap 3 comprises a plurality of load-bearing surfaces 35, namely a first load-bearing surface 351 , a second load-bearing surface 352, a third load-bearing surface 353 and a fourth load-bearing surface 354. The four load-bearing surfaces 35 are arranged behind each other in longitudinal direction and are arranged on the same lateral side of the strap 3. Furthermore, they are regularly interspaced and a distance between two adjacent load-bearing surfaces 35 is indicated by d2. This distance d2 is typically selected in the range from 80% of d1 to 100% of d1 . Preferably, d2 is from 90% of d1 to 100% of d1 . For example, d2 may be essentially equal to d1 . In some embodiments in which the strap is configured to be pre-tensioned during use, d2 may be slightly smaller than d1 in order to accommodate any lengthening of the strap as a result of apply the pre-tension. P29012PC00 08.12.2025

[0155] 31 / 36

[0156] LIST OF DESIGNATIONS

[0157] 1 spinal implant 43 first auxiliary interface

[0158] 21 first vertebra 5 first loop

[0159] 22 second vertebra 6 second loop

[0160] 3 strap 7 first traction filament

[0161] 31 leading end of the strap 71 first traction interface (of first

[0162] 32 trailing end of the strap traction filament)

[0163] 33 first strap interface 72 second traction interface (of

[0164] 34 second strap interface first traction filament)

[0165] 35 load-bearing surfaces 8 second traction filament

[0166] 351 first load-bearing surface 81 third traction interface (of sec

[0167] 352 second load-bearing surface ond traction filament)

[0168] 353 third load-bearing surface 82 fourth traction interface (of

[0169] 354 fourth load-bearing surface second traction filament)

[0170] 4 auxiliary filament 9 lock

[0171] 41 leading end of the auxiliary fil10 tensile sutures ament 11 initial pilot suture

[0172] 42 trailing end of the auxiliary fila- ment

Claims

P29012PC00 08.12.202532 / 36PATENT CLAIMS1 . Spinal implant (1 ) for interconnecting in a mounted position a first vertebra (21 ) and a second vertebra (22) with respect to each other by at least a first loop (5) and a second loop (6), comprising: a. a strap (3) extending in a longitudinal direction from a leading end (31 ) to a trailing end (32), wherein the strap (3) is configured to be passed during mounting in a first step with its leading end (31 ) in a first mounting direction around the first and second vertebra (22), thereby at least partially forming the first loop (5); b. a thereto unidirectionally arranged auxiliary filament (4) configured to be interconnected to the leading or trailing end (32) of the strap (3), for pulling in a second step the leading end (31 ) respectively trailing end (32) of the strap (3) by the auxiliary filament (4) around the first and second vertebra (22); and c. wherein the leading end (31 ) and the trailing end (32) of the strap (3) are configured to be interconnected to each other in a third step, thereby forming the second loop (6).

2. Spinal implant (1 ) according to claim 1 , wherein the auxiliary filament (4) is configured to be interconnected to the trailing end (32) of the strap (3), for pulling in the second step the trailing end (32) of the strap (3) by the auxiliary filament (4) around the first vertebra (21 ) and the second vertebra (22) in opposite direction with respect to the first mounting direction of the first loop (5).

3. Spinal implant (1 ) according to any one of the previous claims, wherein the auxiliary filament (4) is configured to be interconnected to the leading end (31 ) of the strap (3), for pulling in the second step the leading end (31 ) of the strap (3) by theP29012PC00 08.12.202533 / 36 auxiliary filament (4) around the first vertebra (21 ) and the second vertebra (22) in a parallel direction with respect to the first mounting direction of the first loop (5).

4. Spinal implant (1 ) according to any one of the previous claims, wherein the leading end (31 ) of the strap (3) is attached to a first traction filament (7) extending in the longitudinal direction beyond the leading end (31 ) of the strap (3), the first traction filament (7) acting as an application aid in at least the first step to control the position of the leading end (31 ) of the strap (3) with respect to the first and the second vertebra (22).

5. Spinal implant (1 ) according to claim 4, wherein the leading end (31 ) of the strap (3) is attached to the first traction filament (7) by interweaving, intersewing, a splice connection, a suture, a hitch, a knot, a weld connection and / or a crimp connection.

6. Spinal implant (1 ) according to claim 4 or 5, wherein the auxiliary filament (4) is configured to be attached in the first step to the first traction filament (7), such that preferably the first traction filament (7) interconnects the strap (3) and the auxiliary filament (4).

7. Spinal implant (1 ) according to any one of claims 4-6, wherein the auxiliary filament (4) comprises a first auxiliary interface (43) configured to be releasably attachable to the first traction filament (7) by a crimp connection, a suture, a hitch, a knot and / or a clip, preferably by a clip.

8. Spinal implant (1 ) according to any one of the previous claims, wherein the trailing end (32) of the strap (3) is attached to a second traction filament (8) extending in the longitudinal direction beyond the trailing end (32) of the strap (3), the second traction filament (8) acting as an application aid in the first and / or second and / or third step to control the position of the trailing end (32) of the strap (3) with respect to the first and the second vertebra (22).P29012PC00 08.12.202534 / 369. Spinal implant (1 ) according to claim 8, wherein the first auxiliary interface (43) is releasably attachable to the second traction filament, preferably by a clip.

10. Spinal implant (1 ) according to any one of the previous claims, wherein the auxiliary filament (4) and the first traction filament (7) and / or the second traction filament (8) are integrally formed.1 1 . Spinal implant (1 ) according to any one of the previous claims, wherein the strap (3) comprises a tendon, a ligament, an allograft, an autograft or a xenograft.

12. Spinal implant (1 ) according to any one of the previous claims, wherein the strap (3) comprises a braid and / or weave and / or stitched material and / or felt.

13. Spinal implant (1 ) according to any one of the previous claims, wherein the strap (3) comprises in the longitudinal direction arranged behind each other: a. A first load-bearing surface (351 ) configured for contacting in the mounted position the first vertebra (21 ), preferably a spinous process of the first vertebra (21 ); b. A second load-bearing surface (352) configured for contacting in the mounted position the second vertebra (22), preferably a spinous process of the second vertebra (22); c. A third load-bearing surface (353) configured for contacting in the mounted position the first vertebra (21 ), preferably the spinous process of the first vertebra (21 ); and d. A fourth load-bearing surface (354) configured for contacting in the mounted position the second vertebra (22), preferably the spinous process of the second vertebra (22).P29012PC00 08.12.202535 / 3614. Spinal implant (1 ) according to any one of the previous claims, wherein the strap (3) has a deformable cross-section.

15. Spinal implant (1 ) according to any one of the previous claims, wherein the strap (3) has a larger cross-section than the auxiliary filament (4).

16. Spinal implant (1 ) according to any one of the previous claims, wherein the leading end (31 ) of the strap (3) is releasably attachable to a leading end (41 ) of the auxiliary filament (4).

17. Spinal implant (1 ) according to any one of the previous claims, wherein the auxiliary filament (4) has a length in longitudinal direction of at least 75%, preferably at least 100%, more preferably at least 125%, of a length in longitudinal direction of the strap (3).

Images