A combined apparatus for compression and distraction of a first physical component having a first bone screw and a second physical component having a second bone screw, said apparatus comprising a connected rod fixedly connected to one of the first and second bone screw heads and slidably connected to the other of the first and second bone screw heads, a rod holder comprising a ramp, and A screw head extension comprising an protruding member and an adjusting means, such that when the protruding member is moved vertically, pressure between said protruding member and progressively wider portions of said ramp force an increase in distance between the rod holder and adjacent bone screw head, resulting in compression or distraction as desired of the physical components.
