The present disclosure is directed to a device for use in positioning and re-positioning a patient during spinal surgery. More specifically, the present disclosure is related to an adjustable device that provides for adjustability in the coronal plane.
In spinal surgeries, surgeons access the anterior of the spine to remove a disk or other bone structure. The removed bone structure is replaced with a spacer referred to in the art as a cage. In some cases, it may be necessary to access the posterior of the spine to install fixation hardware such as screws and rods. With access to both sides of the spine being required in a single procedure, the patient is generally positioned in a lateral position for the anterior approach. The patient is then repositioned in a prone position on a device that allows the abdomen to hang freely in a decompressed state.
Repositioning of the patient generally requires that the patient be moved relative to a supporting device, such as an operating table, for example. Such repositioning requires considerable effort on the part of caregivers to move the patient without complicating the procedure. A type of surgical table has been developed to assist with this rotation of the patient from the lateral to the prone position while also minimizing frame members to facilitate easy access in both approaches.
However, the need to rotate the patient, and the associated pausing of the surgery and need for adjustment of equipment, lines, and patient position results in extending the length of the time the patient is subjected to anesthesia and potentially problematic support structures. There is also a concern with the safety of the patient and the caregivers in making the patient turn, especially in larger patients.
There is therefore a need to support a patient in a manner that reduces the length of time surgery and the risk of injury to the patient and caregivers during any repositioning. However, it is important that the patient be repositionable while being provided sufficient stability during all facets of the procedure, including providing access to the iliac crest and lower ribs to provide access to the lower lumbar vertebra, adjustment in the coronal plane, and providing counter pressure when working from a lateral approach. A need to address all of these issues is important to providing a viable solution, while also providing radiolucency so that x-rays may be taken during the procedure to confirm proper prosthetic placement and confirming the status of progress of the procedure.
The present disclosure includes one or more of the features recited in the appended claims and/or the following features which, alone or in any combination, may comprise patentable subject matter.
According to a first aspect of the present disclosure, a patient positioning system comprises a first patient positioner and a second patient positioner. The first patient positioner includes a base adapted to be positioned on a pair of laterally spaced rails of a patient support apparatus. The first patient positioner also includes an adjustable platform movable relative to the base between a plurality of positions, and a pair of lateral constraints positionable on the adjustable platform between a plurality of positions to engage the opposite lateral sides of the patient's torso and movable with the adjustable platform as it moves relative to the base. The first patient positioning system further includes a patient support assembly configured to engage the anterior of a patient's torso to provide support for the patient when the patient is positioned in a prone position on the patient positioning system, and a lock configured to selectively lock the adjustable platform relative to the base.
The second patient positioner includes a base adapted to be positioned on the pair of laterally spaced rails of a patient support apparatus. The second patient positioner also includes an adjustable platform movable relative to the base between a plurality of positions, a pair of lateral constraints positionable on the adjustable platform between a plurality of positions to engage the opposite lateral sides of the patient's lower body and movable with the adjustable platform as it moves relative to the base. The second patient positioner further includes a patient support assembly configured to engage the anterior of a patient's lower body to provide support for the patient when the patient is positioned in a prone position on the patient positioning system, and a lock configured to selectively lock the adjustable platform relative to the base.
In some embodiments of the first aspect, the base includes a pair of claims, each clamp configured to secure the base to one of the laterally spaced rails.
In some embodiments of the first aspect, the adjustable platforms of the first patient positioner and the second patient positioner are each rotatable relative to their respective bases. In some embodiments, the adjustable platforms of the first patient positioner and the second patient positioner are each movable along a longitudinal axis of their respective base.
In some embodiments of the first aspect, the adjustable platforms of the first patient positioner and the second patient positioner are each movable along a longitudinal axis of their respective base.
In some embodiments of the first aspect, each base is formed to include a plurality of holes engaged by the lock to secure the respective adjustable platform relative to the base. In some embodiments of the first aspect, the adjustable platforms of the first patient positioner and the second patient positioner are each formed to include a plurality of through-holes which are engaged by the lock such that the lock passes through the adjustable bases and is received in a through-hole of the respective base, the engagement of the lock with the through-holes of the respective adjustable platforms and bases securing the adjustable platform to prevent movement relative to the base. In some embodiments, the lateral constraints each include a base that is sized to be positioned in one of the through-holes of the respective adjustable platform to secure the lateral constraint to the adjustable platform.
In some embodiments of the first aspect, the adjustable platforms of the first patient positioner and the second patient positioner are each formed to include a plurality of through-holes, and wherein each of the lateral constraints include a base that is sized to be positioned in one of the through-holes of the respective adjustable platform to secure the lateral constraint to the adjustable platform.
In some embodiments of the first aspect, each patient support assembly includes a plurality of patient supports, each patient support including a base configured to engage the adjustable platform to secure the patient support to the adjustable platform, and wherein each patient support includes a cushion supported on the base, the cushion configured to engage the body of a patient. In some embodiments, the cushion of at least on patient support is adjustable to vary the height of the patient support vary the positon of the patient relative to the movable platform. In some embodiments, the adjustable platforms of the first patient positioner and the second patient positioner are each formed to include a plurality of through-holes, and wherein the base of each patient support includes a protrusion that is configured to be received into one of the through-holes of the adjustable platform to secure the patient support to the adjustable platform.
In some embodiments of the first aspect, the components of the patient positioning system are substantially radiolucent.
In some embodiments of the first aspect, the first patient positioner and second patient positioner are adjustable to cooperate to cause adjustment of the patient's spine in the coronal plane when the patient is supported on the patient positioning system in a prone position. In some embodiments, the first patient positioner and second patient positioner are configured to engage the laterally spaced rails to be selectively movable to vary the distance between the first patient positioner and second patient positioner.
According to a second aspect of the present disclosure, a method is used to reposition a patient on a patient positioning system that includes a first patient positioner and a second patient positioner, each of the patient positioners including a base plate, an adjustable platform movable relative to the base plate, a support assembly supported on the adjustable platform, a lateral constraint assembly positioned on the adjustable platform, and a position lock operable to selectively lock the adjustable platform relative to the base plate. The method comprises the steps of positioning the first and second patient positioners on a patient support apparatus, positioning a patient on the first patient positioner and the second patient positioner in a prone position, the first patient positioner supporting a portion of the patient's torso and the second patient positioner supporting a portion of the patient's lower body. The method further includes the steps of positioning the lateral constraint assembly of the first patient positioner to engage the lateral sides of the patient's torso to secure the patient's torso from lateral movement relative to the first patient positioner and positioning the lateral constraint assembly of the second patient positioner to engage the lateral sides of the patient's lower body to secure the patient's lower body from lateral movement relative to the first patient positioner. The method still further includes the steps of adjusting the adjustable platform of either the first patient positioner or second patient positioner to a first position relative to the respective base plate and engaging the position lock of the respective first patient positioner or second patient positioner to stabilize the patient in a first position relative to the respective first patient positioner or second patient positioner and adjusting the adjustable platform of the other of the first patient positioner or second patient positioner to a first position relative to the respective base plate to adjust the patient's spine in the coronal plane. The method still further includes the step of engaging the position lock of the other of the first patient positioner or second patient positioner to secure the respective first or second patient positioner in the position that adjusts the patient's spine in the coronal plane.
In some embodiments, the method of second aspect further includes the step of adjusting the height of a portion of one of the support assemblies to adjust a portion of the patient's spine in the sagittal plane.
In some embodiments, the method of second aspect further includes the steps of releasing the position lock of one of the first and second patient positioners, moving the adjustable platform of the released first or second patient positioner to a new position to re-adjust the position of the patient's spine in the coronal plane, re-engaging the position lock of the released first or second patient positioner to secure the first or second positioner in the new position.
In some embodiments, the step of adjusting the position of an adjustable platform of either of the first and second patient positioners includes rotating the adjustable platform about a rotation axis of the adjustable platform and moving the rotation axis of the respective adjustable platform linearly relative to the base plate.
In some embodiments, the step of engaging the position lock of either of the first patient positioner or second patient positioner includes aligning one of a plurality of through-holes formed in the respective adjustable platform with one of a plurality of holes formed in the base plate and positioning the position lock through the aligned through-hole of the adjustable platform and into the aligned hole of the base plate to cause the position lock to simultaneously engage both the adjustable platform and the base plate to prevent movement therebetween.
In some embodiments, the step of positioning the lateral constraint assembly of either of the first patient positioner or second patient positioner includes positioning a portion of the lateral constraint assembly in one of the through-holes of the adjustable platform.
In some embodiments, the step of adjusting the height of a portion of one of the support assemblies to adjust a portion of the patient's spine in the sagittal plane includes inflating a portion of the portion of the support assembly to vary the height of the portion of the support assembly.
According to a third aspect of the present disclosure, a patient positioner comprises a base plate, an adjustable platform movable relative to the base plate, a support assembly supported on the adjustable platform, a lateral constraint assembly positioned on the adjustable platform, and a position lock operable to selectively lock the adjustable platform relative to the base plate.
In some embodiments of the third aspect, the support assembly includes a plurality of adjustable patient supports, the patient supports adjustable to a plurality of positions relative to the adjustable platform. In some embodiments, an adjustable patient support is inflatable to change the height of the adjustable patient support.
In some embodiments of the third aspect, the adjustable platform is formed to include a number of through-holes, the through-holes configured to receive portions of the lateral constraint assembly, patient support assembly, and position lock to allow each of the lateral constraint assembly, patient support assembly, and position lock to be positioned in a plurality of positions relative to the adjustable platform.
In some embodiments of the third aspect, the adjustable platform is movable relative to the base plate about a pivot axis of the adjustable platform. In some embodiments, the adjustable platform is movable relative to the base plate along a linear guide formed in the base plate.
In some embodiments of the third aspect, the base plate is formed to include a plurality of holes which are configured to be aligned with the through-holes in the adjustable platform and when the holes in the base and the through-holes in the adjustable platform are aligned, the position lock is positionable through the aligned through-hole of the adjustable platform and into the aligned hole of the base plate such that the position lock engages both the adjustable platform and the base plate to prevent movement therebetween.
In some embodiments of the third aspect, the each of the components of the patient positioner are substantially radiolucent.
Additional features, which alone or in combination with any other feature(s), such as those listed above and/or those listed in the claims, can comprise patentable subject matter and will become apparent to those skilled in the art upon consideration of the following detailed description of various embodiments exemplifying the best mode of carrying out the embodiments as presently perceived.
The detailed description particularly refers to the accompanying figures in which:
A patient support apparatus 10, according to the present disclosure, is embodied as a spinal surgical table and includes support structure 32 that is supported from two columns 18 and 20. The support structure 32 includes a first support frame 34 and a second support frame 36 which support a pair of radiolucent rails 12 and 14 and extend between the support frames 34 and 36. The columns 18 and 20 are also connected by a base rail 16. The support structure 32 is pivotably coupled to the columns 18 and 20 such that the support structure 32 is rotatable about a longitudinal axis 22 as indicated by an arrow 24. The structure of the spinal surgical table 10 is typical in the art and may be embodied as the patient support apparatus 10 disclosed in U.S. Patent No. 9,498,397 issued November 22, 2016 and titled “DUAL COLUMN SURGICAL SUPPORT SYSTEM,” which is incorporated by reference herein for the disclosure of a patient support apparatus 10 according to the present disclosure.
Referring now to
Referring now to
The base plate 44 is fixed to the rails 12, 14 by a pair of clamps 54, 56 that engage the rails 12, 14 respectively. Once closed, the clamps 54, 56 secure the base plate 44 to the rails 12, 14 with sufficient force to prevent movement of the base plate 44 relative to the rails 12, 14 under normal conditions. Referring now to
To secure the base plate 44 to the rails 12, 14, the clamp arm 66 is pivoted about the pivot pin 64 to cause the key-hole receivers 72, 74 to overlie the pegs 76, 78. The pegs 76, 78 each include a respective cap 82, 84 and the clamp arm 66 is translatable along the pivot pin 64 to cause a narrower region 86 of each of the key-hole receivers 72, 74 to engage the pegs 76, 78 so that the caps 82, 84 each engage a surface 88 of the clamp arm 66. As the narrower region 86 of the key hole receivers 72, 74 engages the pegs, 76, 78, the friction therebetween causes the clamp arm 66 to be secured to the pegs 76, 78 through an interference fit. In some embodiments, the clamp base 58 is flexibly resilient and the force of engaging the receivers 72, 74 with the pegs 76, 78 causes the clamp base 58 to deflect so that the clamp 58 and clamp grip 80 engage the sides of the respective rail 12, 14 to cause a frictional engagement that secures the clamp 54, 56 to the respective rail 12, 14. This prevents the base plate 44 from sliding relative to the rails 12, 14 during surgical procedures.
Referring to
With reference to
To secure the adjustable platform 46 relative to the base plate 44, the position lock 52 is positioned to engage both the adjustable platform 46 and the base plate 44. The action of the position lock 52 in combination with the pivot rod 98 precludes movement of the adjustable platform 46 relative to the base plate 44. As shown in
The position lock 52 is formed to include a collar 112 which limits the movement of the shaft 114 into the adjustable platform 46. A body 116 of the position lock 52 has a rounded top to prevent injury to the patient 38 during repositioning. The body 116 acts as a handle when the position lock 52 is being positioned into the through-holes 108 and 110. Once the position lock 52 is positioned to secure the adjustable platform 46 to the base plate 44, any movement is limited to pivoting about an axis 118 of the position lock 52. However, because the pivot rod 98 is also engage with both the adjustable platform 46 and base plate 44, the adjustable platform 46 is precluded from pivoting about the axis 118 and, thereby, is prevented from any movement relative to the base plate 44. Through proper sizing and distribution of the through-holes 108 and 110, the position of the adjustable platform 46 can be moved to any of a number of positions to allow for adjustment of the patient 38 in the coronal plane. It should be understood that the size of the through-holes 108, 110 and the pattern of the through-holes 108 or 110 may be varied to vary the number of positions of the adjustable platform 46 relative to the base plate 44 and the arrangement disclosed in the figures is for illustrative purposes only. Likewise, the size and shape of the channel 96 and pivot rod 98 could also be varied to vary the available positions. For example, in some embodiments, the channel 96 may have a curvilinear shape.
Referring again to
Referring again to
The support assembly 130 further includes a central patient support 146 that is positionable between the lateral patient supports 134, 134 to provide additional support to the torso 42 of the patient 38 as suggested in
The cushions 138 and 150 of the lateral patient support 134 and central patient support 146 comprise encapsulated foam as is known in the art of spinal surgery. However, in some embodiments, the cushions 138 and 150 may include or be fully embodied as air bladders that allow adjustment of the height of the cushions 138, 150 during a procedure. For example, an optional air system 154, shown in
With this understanding of the patient positioners 26 and 28, a brief description of the use case for the patient positioners 26 and 28 can be provided. As shown in
Once the patient 38 is positioned on the positioners 26 and 28, as shown in
Once the patient is properly positioned and secured as depicted in
While the present disclosure details a specific embodiment, it should be understood that the motions provided by the patient positioning system 30 during a procedure may accomplished using other structures for controlling the motion between the base plate 44 and the adjustable platform 46. For example, the position lock 52 may be omitted and a releasable frictional or suction lock may be implemented to secure the adjustable platform 46 from movement relative to the base plate 44. The motions may also be mechanized by either electrical or hydraulic actuators which provide internal locking. Still further, a combination of actuators may be used such that one rotates the adjustable platform 46 and another moves the adjustable platform 46 laterally relative to the base plate 44.
The disclosed embodiment is contemplated to be substantially radiolucent using components and materials well known in the art. However, one or more of the components may not be radiolucent depending on the application.
Although this disclosure refers to specific embodiments, it will be understood by those skilled in the art that various changes in form and detail may be made without departing from the subject matter set forth in the accompanying claims.
This application claims priority under 35 U.S.C. § 119(e) to U.S. Provisional Application No. 63/157,036, filed Mar. 5, 2021, which is expressly incorporated by reference herein.
Number | Date | Country | |
---|---|---|---|
63157036 | Mar 2021 | US |