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A portion of the disclosure of this patent document contains material that is subject to copyright protection. The copyright owner has no objection to the facsimile reproduction by anyone of the patent document or patent disclosure as it appears in the Patent and Trademark Office, patent file or records, but otherwise reserves all copyright rights whatsoever.
The present invention relates generally to medical equipment. More particularly, the invention relates to means for rigid radiolucent anatomic positioning that alleviates density artifact while maintaining strength.
Medical procedures involving the cervical spine, particularly surgery, require correct visualization of the vertebrae during radiography (e.g., X-Ray, fluoroscopy, CT, MRI). Typically, a subject's shoulders obscure the lateral imaging of the cervical vertebrae. It is therefore an objective of the present invention to provide means for positioning the subject's shoulders during radiography that migrate the shoulders out of the line of sight of the lateral image of the cervical vertebrae.
Traditionally, said migration of a subject's shoulders is effected via the following means. One traditional method of migrating the subject's shoulders involves Kurlix Bandages that are wrapped around the forearms or wrists of the subject and pulled upon forcefully during live radiography for the purpose of temporary distal migration of the shoulder structures. This method results in temporary migration of the shoulders and unimpeded radiographic visualization of the cervical vertebral structures. However, this method may also result in injury for example, without limitation, Brachial Plexus injury or insult to the subject's shoulder capsule due to over-application of distal migratory force. Another traditional method of moving the subject's shoulders involves taping down the subject's shoulder's and trapezius muscles for the entirety of the procedure. Using this method, the shoulders migrate for the entirety of the procedure allowing for unimpeded radiographic visualization of the cervical vertebral structures. However, some unintended results of this method includes incidence of, without limitation, sore trapezius, nerve damage, tingling hands, reduced digital sensation, and numbness for the subject upon awakening as a consequence of extended unnatural positioning for the entirety of the procedure.
Currently, almost all anatomic positioning for purposes of radiography is performed with foam, which is radiolucent and sufficient to position and fixate portions of the anatomy for example, without limitation, supporting a raised head or immobilizing the head into a certain position. However, foam is incapable of being utilized to migrate portions of the anatomy for example, without limitation, moving and holding the shoulders. Foam lacks the mechanical rigidity and strength needed to migrate portions of the anatomy and merely compresses when subjected to motive pressure. For purposes of variable migration and placement of portions of the anatomy, it is necessary to utilize a rigid radiolucent structure, as opposed to a soft structure. This is much more difficult than one would suppose. The difficulty lies in the actual manufacture of a rigid radiolucent positioning device that is strong enough and radiolucent enough. An object is radiolucent if it creates little interference with the X-Rays or other types of radiography. Except for various “halo” style radiolucent head positioners designed specifically for the fixation of the head during surgery, as opposed to variable positioning or migration, at present there do not exist means for rigid radiolucent anatomic positioning other than a shoulder pusher.
THE Shoulder Pusher is a rigid radiolucent positioning device utilized for migrating the shoulders. The Shoulder Pusher is a radiolucent U shaped member that is positioned on the shoulders to transmit motive force. However, the structure of this device does not have a method of construction that can accomplish this feat effectively. The difficulty of construction of such a device stems from the occurrence of an artifact, which refers to the obscuration of radiography via structural density. Dense objects cause an opaque shadow during X-ray which obscure a clear view of pertinent structures necessary for diagnostic and intra-operative radiography. Additionally, none of the prior arts which have been cited in reference to the Shoulder Pusher involved any radiolucent function as a pertinent part of their designs. They are all merely simple uniform density arches which shared a simple external appearance to the arch as illustrated in the shoulder pusher. In regards to these prior arts, even if they are constructed from a radiolucent material, they would fail for the same reason the shoulder pusher fails; too much density is generated by the structure. Simply constructing something from radiolucent materials does not render it radiolucent. Furthermore, simply reducing the density of the structures of the shoulder pusher as described does not result in a workable remedy, as it lacks sufficient strength while still directly overlaying the vertebral column.
Through study of radiographic views obtained from various surgeons, it has been determined that this artifact originated directly from three specific portions of shoulder pusher 100, resulting in the simultaneous introduction a small yet significant artifact directly in the optimum line of site, even as shoulder pusher 100 alleviated the majority of the artifact caused by the shoulders via migration of the structures of the shoulders. These three causes of artifact are as follows: direct/partial obscuration of the cervical vertebral structures due to line of sight positional overlayment and interference of pusher tube 105 as viewed from the crucial lateral perspective, direct/partial obscuration of the lower vertebral structures by arch 103, and direct/partial obscuration of the critical vertebral structures due to the direct overlayment of carbon/glue interface 107.
In view of the foregoing, there is a need for improved techniques for providing rigid radiolucent anatomic positioning that alleviates line of sight overlayment of the vertebral structures, which reduces or eliminates density artifacts while simultaneously maintaining strength.
The present invention is illustrated by way of example, and not by way of limitation, in the figures of the accompanying drawings and in which like reference numerals refer to similar elements and in which:
Unless otherwise indicated illustrations in the figures are not necessarily drawn to scale.
To achieve the forgoing and other objects and in accordance with the purpose of the invention, an apparatus and method for radiolucent anatomic positioning is presented.
In one embodiment an apparatus includes first means for migrating a first anatomic part. The first migrating means includes first means for applying a motive force, and first means at a distal end of the first applying means for contacting the first anatomic part, wherein the first contacting means is asymmetrically offset from the first applying means. Another embodiment further includes means for strengthening an upper portion of the first contacting means. Yet another embodiment further includes first attachment means for joining the first migrating means to equipment that aids in the use of the first migrating means. Still another embodiment further includes second means for migrating a second anatomic part. The second migrating means includes second means for applying a motive force and second means at a distal end of the second applying means for contacting the second anatomic part, wherein the second contacting means is asymmetrically offset from the second applying means and second attachment means for joining the second migrating means to the equipment.
In another embodiment an apparatus includes a first anatomic positioner for migrating a first anatomic part. The first anatomic positioner includes a first tapered arm for applying a motive force and a first arch at a distal end of the first tapered arm for contacting the first anatomic part. The first arch includes a varying width and a varying density where the first arch is asymmetrically offset from the first tapered arm such that a longitudinal axis of the first tapered arm extends through a lower portion of the first arch. Another embodiment further includes a thin buttress extending from a top of the first tapered arm to an upper portion of the first arch for strengthening the upper portion. In yet another embodiment a middle portion of the first arch is thinner than outer portions. In still another embodiment the first arch includes an eccentric curvilinear shape. In another embodiment a portion of the top of the first tapered arm is below a center line bisecting the first arch. In yet another embodiment the first anatomic positioner is a one-piece radiolucent structure. Still another embodiment further includes first attachment means for joining the first anatomic positioner to equipment that aids in the use of the first anatomic positioner. Another embodiment further includes a cross-bar including a first end and a second end wherein the first end is joined to the first attachment means. A second anatomic positioner migrates a second anatomic part. The second anatomic positioner includes a second tapered arm for applying a motive force and a second arch at a distal end of the second tapered arm for contacting the second anatomic part. The second arch includes a varying width and a varying density where the second arch is asymmetrically offset from the second tapered arm such that a longitudinal axis of the second tapered arm extends through a lower portion of the second arch. Second attachment means joins the second anatomic positioner to the second end.
In another embodiment a method includes the steps of forming a first tapered arm for applying a motive force to migrate a first anatomic part and forming a first arch at a first distal end of the first tapered arm for contacting the first anatomic part. The first arch includes a varying width and a varying density where the first arch is asymmetrically offset from the first tapered arm such that a longitudinal axis of the first tapered arm extends through a lower portion of the first arch. Another embodiment further includes the step of forming a thin buttress extending from a top of the first tapered arm to an upper portion of the first arch for strengthening the upper portion. In yet another embodiment a middle portion of the first arch is thinner than outer portions. In still another embodiment the first arch includes an eccentric curvilinear shape. In another embodiment a portion of the top of the tapered arm is below a center line bisecting the first arch. In yet another embodiment the first tapered arm and the first arch are formed as a one-piece radiolucent structure. Another embodiment further includes the step of joining first attachment means to a second distal end of the first tapered arm for joining to equipment that aids in the migrating of the first anatomic part. Yet another embodiment further includes the steps of fabricating a length adjustable cross-bar for joining a first end of the cross-bar to the first attachment means. A step forms a second tapered arm for applying a motive force to migrate a second anatomic part. A step forms a second arch at a first distal end of the second tapered arm for contacting the second anatomic part. The second arch including a varying width and a varying density where the second arch is asymmetrically offset from the second tapered arm such that a longitudinal axis of the second tapered arm extends through a lower portion of the second arch. A step joins a second attachment means to a second distal end of the second tapered arm for joining a second end of the cross-bar to the second attachment means.
Other features, advantages, and object of the present invention will become more apparent and be more readily understood from the following detailed description, which should be read in conjunction with the accompanying drawings.
The present invention is best understood by reference to the detailed figures and description set forth herein.
Embodiments of the invention are discussed below with reference to the Figures. However, those skilled in the art will readily appreciate that the detailed description given herein with respect to these figures is for explanatory purposes as the invention extends beyond these limited embodiments. For example, it should be appreciated that those skilled in the art will, in light of the teachings of the present invention, recognize a multiplicity of alternate and suitable approaches, depending upon the needs of the particular application, to implement the functionality of any given detail described herein, beyond the particular implementation choices in the following embodiments described and shown. That is, there are numerous modifications and variations of the invention that are too numerous to be listed but that all fit within the scope of the invention. Also, singular words should be read as plural and vice versa and masculine as feminine and vice versa, where appropriate, and alternative embodiments do not necessarily imply that the two are mutually exclusive.
The present invention will now be described in detail with reference to embodiments thereof as illustrated in the accompanying drawings.
Detailed descriptions of the preferred embodiments are provided herein. It is to be understood, however, that the present invention may be embodied in various forms. Therefore, specific details disclosed herein are not to be interpreted as limiting, but rather as a basis for the claims and as a representative basis for teaching one skilled in the art to employ the present invention in virtually any appropriately detailed system, structure or manner.
It is to be understood that any exact measurements/dimensions or particular construction materials indicated herein are solely provided as examples of suitable configurations and are not intended to be limiting in any way. Depending on the needs of the particular application, those skilled in the art will readily recognize, in light of the following teachings, a multiplicity of suitable alternative implementation details.
One aspect of the present invention is the of identifying and solving problems attendant to prior art approaches is to discover approaches that more optimally achieve a very difficult balance between the competing properties of sufficient strength and sufficient radiolucent properties. Preferred embodiments of the present invention provide means for shoulder migration during radiography that alleviate line of sight overlayment of the vertebral structures while maintaining sufficient strength to exert the motive force necessary to migrate the shoulders. Preferred embodiments are implemented without a carbon/glue interface, which directly overlays the lower cervical vertebral bodies in the prior art. Preferred embodiments also provide density reduction to all structures of the shoulder pusher as compared to the prior art.
In order to further alleviate any artifact introduced into the radiographic visualization of the cervical vertebral column, shoulder pusher 200 incorporates a method to reduce the density in the construction of arch 203 in portions where arch 203 directly overlays the radiographic line of sight of the vertebral column when viewed laterally. In many practical applications, this is achieved via elimination and replacement of the tube component and accompanying carbon/glue interface to the arch portion with a single unified composition planar sheet of radiolucent material as evidenced in 300,303, and 305, to include, without limitation, Carbon Fiber, PEEK, Beryllium, Glass Fiber Reinforced Acrylic, Thermoplastucs, Polycarbonates, Polyketones, and any other such compositions as prove amenable to usage in Rigid Radiolucent Positioning.
In the present embodiment, arch 203 comprises an advanced curvilinear design employing eccentric geometry in order to further reduce density as much as possible. This eccentric geometry uses segments of circles with different centers to create arch 203, rather than an arch that is a composed of a single circle segment with a single center point. Incorporating what may be thought of by analogy to a “Stealth Technology”, this variable density curvilinear architecture is constructed so as to present the thinnest portions of the planar segment to the lateral radiographic view of the cervical vertebral structures, while concurrently widening in the portions outside of the critical beam path, thus distributing the acceptable force load evenly across the shoulders as they are migrated temporarily via the application of distal motive force by the hand-held operator. Additionally, the present embodiment eliminates the carbon/glue plug as a means of fixating the various portions, and instead fashions the entirety of the portions into a one piece composition as referenced above. It is important that strength be preserved in this more gracile design, while simultaneously preserving sufficient thickness so as to not cause overt of pressure to the subject's shoulders during the application of motive force. As previously stated, the original conception of the shoulder pusher arch according to the prior art calls for uniform thickness and density in order to insure strength of the essentially brittle material. Instead, shoulder pusher 200 comprises a thin, radiolucently invisible buttress 207 attached to the top of the thin, eccentric, curvilinear arch 203 for purposes of strength and stability. The present embodiment may also comprise an ergonomic handgrip at the end of pusher tube 205 away from arch 203 for the operator to hold during use. Shoulder pusher 200 is preferably made of carbon fiber; however, other radiolucent materials may be used such as, but not limited to Carbon Fiber, PEEK, Beryllium, Glass Fiber Reinforced Acrylic, Thermoplastics, Polycarbonates, Polyketones, and any other such compositions as prove amenable to usage in Rigid Radiolucent Positioning, etc. Clinical trials of shoulder pushers according to the present embodiment have resulted in vast improvements in radiographic results as artifact is significantly reduced.
The construction and manufacture of the embodiment illustrated by way of example in
Referring to
In the present embodiment, arch 303 has an eccentric curvilinear design that also contributes to the low density of shoulder pusher 300. Alternate embodiments of the present invention may have eccentric arches of various different shapes and sizes to accommodate a variety of subjects, such that the density reduction methodologies described herein may be applied to various anatomical structures outside of the cervical vertebral bodies, while still utilizing the single piece planar composition of radiolucent material combined with the eccentric geometry of the variable density arch. One practical embodiment of the variable density arch employs variation in the structural geometry of the arch itself in order to minimize radiographic artifact while still preserving crucial structural strength and integrity. The geometry principles taught by way of example can readily be applied to other portions of the anatomy with relatively strait forward modifications specific to the structures needing to be visualized radiographically. Furthermore some alternate embodiments may be implemented without an eccentric arch, but with a variable density, eccentric curvilinear segments of polygon which most specifically attend to the essential requirements of radiographic visualization. The polygons by way of example, without limitation, may include ovals, triangles, trapezoids, etc. with usage of the variable density/variable geometric components and methods as described herein as regards to the arch. In the present embodiment, shoulder pusher 300 comprises attachment means 309 for a connection tube, a handle, a table mount, or other such equipment that aids in the use of shoulder pusher 300.
In typical use of the present embodiment, two shoulder pushers 300 are used to migrate the shoulders of a subject during a radiographic procedure. Some procedures may only require the use of one shoulder pusher 300 to migrate one shoulder. In cases where two shoulder pushers 300 are used, shoulder pushers 300 may be coupled together, for example, without limitation, with an adjustable connecting tube, as shown by way of example in
The embodiments illustrated and described in the foregoing are hand-held, manually operated devices. However, those skilled in the art, in light of the present teachings, will readily recognize that alternate embodiments may be implemented to be machine operated or otherwise automated. For example, without limitation, one such embodiment may comprise a shoulder pusher that is coupled to a table and operated with a hand crank or ratchet, or that is hand operated yet locks unidirectionally when released, so as to not expose a hand held operator to radiation. Other automated embodiments may be motorized or operated by pneumatics or hydraulics.
It will be further readily apparent to those skilled in the art, in light of the teaching of the present invention, that the foregoing embodiments may be readily configured, depending upon the needs of the particular application, to work as a scoliosis positioner in pushing mode with attachment points to the patient positioning platform for purposes of directing motive force against the Hips and trunk of the patient . . . as a limb positioner in encircling mode with 2 variable density/variable geometry arches facing one another and adjusted and locked via a locking pin at the lower portions. As a suspected subluxation visualizer in the pulling mode with attachment points to a Patient positioning Platform for purposes of migrating the shoulders while NOT interfering with the Foam Stabilizers placed around the Neck for purposes of Fixating a suspected Neck Breakage. in addition to shoulder pushing/pulling, as well as the imaging compatible limb positioners as described. A multiplicity of alternative applications of the present arch as a lateral anatomic rigid radiolucent positioner for clinical/diagnostic/surgical settings will be obvious to those skilled in the art. Examples of which include, without limitation, spinal and hip positioners for usage during surgery to correct for scoliosis, possible usage for pinpoint mammography, head positioners (halos) which would capture and gently fixate the patients head in encircling radiolucent arches without resort to percutaneous pin fixation thru the patients skin. A multiplicity of alternative usages as rigid radiolucent positioners is possible for use throughout the anatomy.
Having fully described at least one embodiment of the present invention, other equivalent or alternative methods of providing a rigid radiolucent anatomic positioning device according to the present invention will be apparent to those skilled in the art. The invention has been described above by way of illustration, and the specific embodiments disclosed are not intended to limit the invention to the particular forms disclosed. For example, the particular implementation of the shoulder pusher may vary depending upon the particular type of material used. The shoulder pushers described in the foregoing were directed to radiolucent implementations; however, similar techniques are to provide shoulder pushers that are made of materials that are not radiolucent such as, but not limited to, plastic or metal for purposes other than radiography, for example, without limitation, holding a subject' shoulders stationary during other types of procedures or while transporting the subject. Non-radiolucent implementations of the present invention are contemplated as within the scope of the present invention. The invention is thus to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the following claims.
Claim elements and steps herein have been numbered and/or lettered solely as an aid in readability and understanding. As such, the numbering and lettering in itself is not intended to and should not be taken to indicate the ordering of elements and/or steps in the claims.
The present continuation-in-part patent application claims priority benefit of the U.S. nonprovisional patent application Ser. No. 11/315,060 filed on Dec. 22, 2005 under 35 U.S.C. 120 and entitled “Shoulder Press”, which is hereby incorporated by reference for all purposes.
Number | Date | Country | |
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Parent | 11315060 | Dec 2005 | US |
Child | 12684934 | US |