By: 13 September 2021
DIPLOMAT® Deformity – Infralaminar hooks

As part of the DIPLOMAT® system from SIGNUS, the infralaminar hooks LSZ provide the ideal solution for treating deformities.

The LSZ system is based on a unique lamina hook system that is inserted infralaminar – from the caudal direction below the lamina. This avoids problems with subsequent cranial degeneration because

  • the capsular ligament is preserved on the cranial aspect of the segment to be fixed, unlike traditional hook or wiring techniques
  • The hooks are narrower and longer than conventional hooks
  • They are fixed to the lamina using a special screw



When positioning the hook, the caudal part of the vertebral arch in the desired segment is first exposed on the appropriate side and the ligamentum flavum is severed using the raspatory. The spinal canal can then be entered using the Penfield dissector and the ventral side of the lamina of the vertebral arch can be palpated. The hook is now inserted into the spinal canal while maintaining continuous bony contact to the lamina on the ventral side.

The shape of the hook is designed to minimise the risk of hook-induced stenosis.

Once the hook has been positioned, it is secured using the lamina screw. This screw prevents the hook from slipping, enables manipulation of the spine and prevents subsequent reduction losses thanks to improvements in the rotational stability.


Insertion of Rod

As soon as all the implants have been positioned, the rod can be inserted. Because the lamina screw of the hook implant has a long thread on the proximal part, further translation of the instrumented spine on the rod is possible, in the same manner as when using long-head screws. Using uniform force distribution, the spine can be successively corrected from the periphery to the apex on the rod.



Innovative high-end implants made in Germany: For more than 25 years, SIGNUS has been the experienced specialist for comprehensive solutions in the surgical spine care sector. Founded in 1994 in Germany’s Lower Franconian city of Alzenau by Susanne and Uwe Siedler, our family-owned company currently has staff of approx. 80 at sites in Germany and Australia. SIGNUS offers the comprehensive product range of cervical spine to SIG sacroiliac joints, which are predominately manufactured at the nearby production site of ProCon Medizintechnik. In addition to Europe (CE) and the USA (FDA), we sell our certified implants throughout the world on every continent. Target-oriented further development of the products in connection with the continuous exchange with the users as well as international further education and hospitalisation programs make SIGNUS a reliable global partner.

The entire SIGNUS Portfolio with detailed information and descriptions are available for you online at