Patent Application
20220265500
Proper positioning of patients in the lateral decubitus position is extremely important in order to provide good operating conditions and effective access to the operative site. During surgery in the lateral decubitus position, patients are typically placed on their side in positions that are not completely physiologic and need to be stabilized and maintained in those positions for considerable amounts of time. This includes positioning the patient's arms and stabilizing the patient's torso to benefit both the patient and the surgeon. Improper positioning of the patient can lead to complications, resulting in severe patient disability and functional loss.
Patients come in a variety of shapes and sizes, and each therefore has unique positioning needs to provide the best access to the surgical site. The diversity of patient anatomy, as well as the significance of the damage that can result from improper positioning, underscore the challenges involved in patient positioning for the lateral decubitus position.
There are several different spine surgeries that use the lateral decubitus position. The lateral decubitus position is used for lateral approach procedures such as lateral lumbar interbody fusion (LLIF), oblique interbody fusion (OLIF), extreme lateral interbody fusion (XLIF), and direct lateral interbody fusion (DLIF). The lateral position is used less frequently than the prone position but is used for less invasive procedures and appears to be gaining in popularity.
The conventional approaches for lateral spine positioning have several limitations, however. For example, although tape is relatively inexpensive and readily available, its application takes time, it does not position or reposition well, it sticks to itself and is hard to handle, and it is not reusable. Other conventional positioning means include towels, pillows, and sheets. These could deform over time during the procedure, are time intensive to prepare, and may be overly bulky for some applications. The use of inflatable bags, such as IV bags, also involves limitations related to potential deflation, excessive time taken to inflate and position, and potential discomfort if over or under inflated.
The potential complications described above highlight the need for proper and safe patient positioning while also allowing the surgeon to gain effective access in a manner that minimizes procedure time.
Accordingly, there is an ongoing need for improved patient positioning systems. In particular, there is an ongoing need for an improved patient positioning system configured for positioning a patient in a lateral position in preparation for a lateral approach procedure.
Described herein is a lateral arm and torso support device, which can be used and configured to position the patient in the lateral decubitus position and support the arms and stabilize the torso in preparation for a surgery that requires the lateral decubitus position. The disclosed device can be used for any lateral surgery as a non-operative surface and can support not just the arms but can stabilize the torso and prevent it from rolling forward. The clam shell like functionality, having a top and bottom piece, allows for easy rolling of the patient and positioning the patient without having to adjust IV lines on the lower arm.
The lateral arm and torso support device is configured to support the arms of the patient in a position (e.g., generally parallel) extending in the anterior direction away from the torso of the patient. The support device can also support the torso to help maintain the patient in the lateral decubitus position. In one embodiment, the lateral arm and torso support device includes a pair of spaced apart panels with one forming a superior panel and the other forming an inferior panel, an upper arm support surface extending between the upper side of the superior panel and the upper side of the inferior panel, and a lower arm support surface extending between the lower side of the superior panel and the lower side of the inferior panel. The panels have shapes that define an anterior cutout extending from the anterior side of the lateral arm and torso support device towards the posterior side of the support device, beneficially allowing increased visualization and access to the lower arm of a patient.
The lateral arm and torso support device can be adapted for use with other components of a patient positioning system. Other components of a patient positioning system may include one or more of a base section having a head bolster, an axillary bolster, a hip bolster, and a leg bolster, which is positionable between the legs of the patient and configured to support the legs of the patient and space the legs of the patient from one another.
This summary is provided to introduce a selection of concepts in a simplified form that are further described below in the detailed description. This summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used as an indication of the scope of the claimed subject matter.
Various objects, features, characteristics, and advantages of the invention will become apparent and more readily appreciated from the following description of the embodiments, taken in conjunction with the accompanying drawings and the appended claims, all of which form a part of this specification. In the Drawings, like reference numerals may be utilized to designate corresponding or similar parts in the various Figures, and the various elements depicted are not necessarily drawn to scale, wherein:
Disclosed herein is a lateral arm and torso support device that can be used to laterally support and position a patient's arms and torso while lying in the lateral decubitus position, such as during a surgery that requires the patient to be in the lateral decubitus position. The disclosed device can be used for any lateral surgery as a non-operative surface and can support not just the arms but can stabilize the torso and prevent it from rolling forward. The clam shell like functionality, having a top and bottom piece, allows for easy rolling of the patient and positioning the patient without having to adjust IV lines on the lower arm. The lateral arm and torso support device can be used as a component of an overall patient positioning system.
Before describing the lateral arm and torso support device in detail further below, the following is an example background environment that illustrates a lateral positioning system that includes a lateral arm and torso support device as a component thereof. It shall be understood that the lateral arm and torso support device can be used by itself and/or in combination with other components as desired.
The example positioning system 100 can include a torso strap 202 that attaches to the base section 200 and/or operating table 20 and extends up and over the patient's torso to aid in securing the upper body of the patient in the desired lateral position. The positioning system 100 can include a hip strap 204 that attaches to the base section 200 and/or operating table 20 and extends up and over the patient's hip. One or more hip traction straps 206 can be attached to the hip strap 204.
The axillary bolster 240 includes a median surface 244 for supporting the downward facing side of the patient's chest just inferior of the shoulders. As illustrated in
The hip bolster 250 is similar in construction to the axillary bolster 240, and similarly includes a median surface 254, a post 252 posterior to the median surface 254, and a wedge 256 anterior to the median surface 254. The hip bolster 250 is preferably slightly taller and slightly wider than the axillary bolster 240, however.
The base section 200 can include multiple layers, including an upper layer 212, a lower layer 218, a strap support layer 216, and an intermediate layer 214. The intermediate layer 214 includes cavities 215 for receiving soft pieces 213. The bulk of the intermediate layer 214 is formed from a relatively firm foam material to provide support to the base section 200. The soft pieces 213 nest within the corresponding cavities 215 of the intermediate layer 214 to form more cushioned areas for the shoulder and patient legs will be positioned. The soft pieces 213 may be formed from a relatively low 25% indentation load deflection (ILD) foam material.
The strap support layer 216 is preferably formed from two separate pieces to thereby integrate the strap supports 260 into a single structural component for the superior portion and a single structural component for the inferior portion. This beneficially enables forces applied to the strap supports to be better spread across the strap support layer 216 rather than focused at smaller regions immediately adjacent the strap supports 260. The strap support layers 216 may be formed from a relatively rigid material.
The lower layer 218 may be less firm than the intermediate layer 214. For example, the lower layer 218 may have a firmness that allows it to provide some structural support to the overall base section 200 and to pad the strap support layer 216 but to also compress somewhat under typical patient weight. In other embodiments, the lower layer 218 may be formed of a foam material that is relatively more firm, similar to the foam material of the intermediate layer 214.
As with the base section 200, the base section 500 includes a superior portion 510, an inferior portion 520, an axillary bolster 540, and a hip bolster (here formed by two separate bolster pieces 550a and 550b). In this embodiment, one or more of the bolsters 540, 550a, or 550b are operatively associated with a selectively inflatable air bladder. One or more of bolsters 540, 550a, or 550b can include ports and valves that provide connection to one or more pumps (e.g., a hand or foot pump) to enable operating room personnel to control the degree of inflation of the bladders. Personnel can beneficially adjust the amount of axillary and/or hip lifting on the fly without having to readjust padding components and without having to add or remove padding components. This minimizes patient movement during the procedure and allows for faster positioning maneuvers.
As shown in
The illustrated embodiment utilizes two separate bolsters 550a and 550b to function as a hip bolster. Other embodiments utilize a single, integrated air bladder and bolster to function as the hip bolster. There are certain advantages, however, in having separate hip bolster pieces. For example, with two separate bolster pieces, operating room personnel have more granular control over how the hip is supported, such as being able to add more air to the superior hip bolster 550a than the inferior hip bolster 550b, or vice versa.
In the illustrated embodiment, the superior hip bolster 550a is positioned on the superior portion 510 and the inferior hip bolster 550b is positioned on the inferior portion 520. This beneficially allows for a separate hip bolster portion to be positioned on each side of the bend when the base 500 is placed in the “jackknife” position, and thereby provides effective patient positioning control via adjustment of air bladders 533a and 533b as desired.
The example leg bolster 400 includes an upper leg channel 412 extending from the superior end 406 to the inferior end 408 along the upper side 402, and a lower leg channel 414 extending from the superior end 406 to the inferior end 408 along the lower side 404 of the device. A knee flexion structure 410 is disposed between the superior end 406 and inferior end 408. The knee flexion structure 410 is configured to enable a superior portion 416 (the portion between the knee flexion structure 410 and the superior end 406) to flex and bend relative to an inferior portion 418 (the portion between the knee flexion structure 410 and the inferior end 408) in an anterior/posterior direction.
The knee flexion structure 410 includes an expandable element 424 disposed on an anterior side 420 of the device, and a compressible element 426 disposed on a posterior side of the device 422. The expandable element 424 and compressible element 426 function to allow the anterior side of the knee flexion structure 410 to stretch and expand and to allow the posterior side of the knee flexion structure 410 to collapse to allow the knee flexion structure 410 to function as a “joint” and thereby allow the inferior portion 418 and superior portion 416 to move relative to one another.
As shown in
As shown in
In some embodiments, the lateral arm and torso support device includes a pair of spaced apart panels 301, 303 with one forming a superior panel and the other forming an inferior panel. Whether one of panel 301 or panel 303 is the superior panel and the other is the inferior panel typically depends on which side the patient is lying on. As illustrated in
The lateral arm and torso support device 300 further includes an upper arm support surface 302 extending between the upper side of the superior panel 301 and the upper side of the inferior panel 303, and a lower arm support surface 304 extending between the lower side of the superior panel 301 and the lower side of the inferior panel 303. The panels 301, 303 have shapes that define an anterior cutout 306 extending from the anterior side 314 of the lateral arm and torso support device 300 towards the posterior side 312 of the support device 300, beneficially allowing increased visualization and access to the lower arm of a patient.
The lateral arm and torso support device 300 may also include one or more upper arm strap supports 308 for fastening straps used for securing the patient's upper arm to the upper arm support surface 302, and one or more lower strap supports 310 for fastening straps used for securing the arm and torso support device 300 to the operating table (e.g., to the arm board of an operating table).
The upper arm support surface 302 and lower arm support surface 304 may be formed from a relatively soft foam material, such as one having a 25% indentation load deflection (ILD) of about 10 to about 35 pounds (about 4.54-15.88 kg), or more preferably about 15 to about 25 pounds (about 6.8-11.3 kg). The other pieces may be formed of firmer foam materials and may have an ILD of about 50 to about 120 pounds (about 22.7-54.4 kg), for example.
The panels 301, 303 are shaped so as to define an anterior cutout 306 extending from the anterior side 314 of the arm and torso support device 300 towards the posterior side 312 of the support device 300. The anterior cutout 306 provides increased visualization and access to the lower arm of the patient when the arms are positioned on the device, such as for managing intravenous lines. The anterior cutout 306 preferably has a parabolic shape 311, as shown, but may alternatively have other curved or non-curved shapes.
The anterior cutout 306 preferably extends inward posteriorly from the anterior side 314 a distance that is about 75% to about 125% of the height of the support device 300. Additionally, or alternatively, the anterior cutout 306 may extend a distance equal to about 25% to about 75% of the overall width of the support device 300 from anterior side 314 to posterior side 312. For example, the anterior cutout 306 may extend inward from the anterior end 314 a distance of about 6 to about 18 inches (about 15-46 cm), or about 8 to about 16 inches (about 20-40 cm), or about 10 to about 14 inches (about 25-36 cm). Such a cutout depth beneficially provides effective visualization and access to the lower arm of the patient while also maintaining overall structural integrity of the arm and torso support device 300 and maintaining a low-profile design in relation to the overall size of the arm and torso support device 300.
The support device 300 may be made of separate pieces, as shown in
Turning now to
PPNI may be caused by direct trauma to affected nerve fibers or by ischemia of the nerve fibers. Prolonged stretching of peripheral nerves may lead to an increase in intraneural pressure and compression of intraneural capillaries and venules, which leads to a reduction in the perfusion pressure of the nerve fibers and associated disruption of axons and vasa nervosum. Prolonged compression may lead to an increase in intraneural and extraneural pressures, leading to a reduction in perfusion and therefore leading to ischemia and slowing of conduction through the nerve fibers. Prolonged ischemia of nerve fibers leads to demyelination and associated axonal damage. Specific forms of PPNI include ulnar neuropathy, brachial plexus injuries, median neuropathy, and radial neuropathy.
As shown in
A lower piece 326 includes grooves 328 into which the panels 301, 303 of the base pieces 318 fit. The base piece 318 may also include notches 330 to coincide with lower strap supports 310. Lower surface piece 324 is placed upon the base piece 318 to form the lower arm support surface 304.
In example uses, if a surgeon or healthcare worker desires greater access to the lower arm and/or needs to move the patient, the patient's upper arm can be first unsecured (e.g., unstrapped) and moved off the upper arm support surface 302. The upper sections of the support device 300, including the upper support surface 302 and panels 301, 303 may then be readily detached from the lower arm support surface 304 and moved out of the way. The patient's lower arm can then fully exposed and attended to and/or moved off of the lower arm support surface 304. The arm and torso support device 300 thus allows independent movement of the patient's upper arm or lower arm off of its respective support surface 302, 304 without requiring that the other arm be moved off its support surface at the same time.
Although the lateral arm and torso support device 300 is described herein in relation to the overall lateral decubitus patient positioning system 100, it may be used in other applications not necessarily limited to lateral decubitus position spine procedures and can be used alone or as part of another auxiliary patient positioning system. The lateral arm and torso support device 300 can be used for any procedure where it is beneficial or desired to support one or both of the patient's arms in an anteriorly extended position and support the torso in a lateral decubitus position.
While certain embodiments of the present disclosure have been described in detail, with reference to specific configurations, parameters, components, elements, etcetera, the descriptions are illustrative and are not to be construed as limiting the scope of the claimed invention.
Furthermore, it should be understood that for any given element of component of a described embodiment, any of the possible alternatives listed for that element or component may generally be used individually or in combination with one another, unless implicitly or explicitly stated otherwise.
In addition, unless otherwise indicated, numbers expressing quantities, constituents, distances, or other measurements used in the specification and claims are to be understood as optionally being modified by the term “about” or its synonyms. When the terms “about,” “approximately,” “substantially,” or the like are used in conjunction with a stated amount, value, or condition, it may be taken to mean an amount, value or condition that deviates by less than 20%, less than 10%, less than 5%, or less than 1% of the stated amount, value, or condition. At the very least, and not as an attempt to limit the application of the doctrine of equivalents to the scope of the claims, each numerical parameter should be construed in light of the number of reported significant digits and by applying ordinary rounding techniques.
Any headings and subheadings used herein are for organizational purposes only and are not meant to be used to limit the scope of the description or the claims.
It will also be noted that, as used in this specification and the appended claims, the singular forms “a,” “an,” and “the” do not exclude plural referents unless the context clearly dictates otherwise. Thus, for example, an embodiment referencing a singular referent (e.g., “widget”) may also include two or more such referents.
It will also be appreciated that embodiments described herein may include properties, features (e.g., ingredients, components, members, elements, parts, and/or portions) described in other embodiments described herein. Accordingly, the various features of a given embodiment can be combined with and/or incorporated into other embodiments of the present disclosure. Thus, disclosure of certain features relative to a specific embodiment of the present disclosure should not be construed as limiting application or inclusion of said features to the specific embodiment. Rather, it will be appreciated that other embodiments can also include such features.
This application is a continuation-in-part of U.S. patent application Ser. No. 17/180,648, filed Feb. 19, 2021, which claims the benefit of U.S. Provisional Application No. 62/979,614, filed Feb. 21, 2020, and also a continuation-in-part of U.S. Design application No. 29/728,091, filed Mar. 16, 2020. The foregoing applications are incorporated herein by reference in their entirety.
| Number | Date | Country | |
|---|---|---|---|
| 62979614 | Feb 2020 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 17180648 | Feb 2021 | US |
| Child | 17684539 | US | |
| Parent | 29728091 | Mar 2020 | US |
| Child | 17180648 | US |
