EP1562530B1 - Headrest adjustable by means of a motor - Google Patents

Headrest adjustable by means of a motor Download PDF

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Publication number
EP1562530B1
EP1562530B1 EP03789027A EP03789027A EP1562530B1 EP 1562530 B1 EP1562530 B1 EP 1562530B1 EP 03789027 A EP03789027 A EP 03789027A EP 03789027 A EP03789027 A EP 03789027A EP 1562530 B1 EP1562530 B1 EP 1562530B1
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EP
European Patent Office
Prior art keywords
head
support
support shaft
head rest
motor
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
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EP03789027A
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German (de)
French (fr)
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EP1562530A2 (en
Inventor
Guido Koch
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Maquet GmbH
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Maquet GmbH
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G13/00—Operating tables; Auxiliary appliances therefor
    • A61G13/10—Parts, details or accessories
    • A61G13/12—Rests specially adapted therefor; Arrangements of patient-supporting surfaces
    • A61G13/1205—Rests specially adapted therefor; Arrangements of patient-supporting surfaces for specific parts of the body
    • A61G13/121—Head or neck
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
    • A61G15/00—Operating chairs; Dental chairs; Accessories specially adapted therefor, e.g. work stands
    • A61G15/10—Parts, details or accessories
    • A61G15/12—Rests specially adapted therefor, e.g. for the head or feet
    • A61G15/125—Head-rests

Definitions

  • the invention relates to a motor-adjustable headrest for operating tables, comprising a top plate, which is arranged at one end of a curved support spar, which is guided in an adjustable direction perpendicular to the axis of curvature on a connectable to the operating table carrier between three rollers adjustable in the direction of adjustment a distance have each other.
  • Existing headrest systems can be subdivided into headrests that can be manually adjusted in position and those that support the lifting movement by external energy, e.g. an electric motor or a hydraulic drive.
  • Particularly simple embodiments are limited to a juxtaposition of several mutually rotatable members, which are braced against each other when the correct position is found.
  • the load of the headstock must be borne by the operator, requiring the use of both hands.
  • Such an arrangement is unsuitable for intraoperative adjustments.
  • the vertical lifting power can, as already mentioned, also be provided by external energy. Depending on the chosen system can be dispensed with the self-locking, so that the weight load acts directly on the actuators.
  • the head is mounted on a boom, which is connected via two parallel links to the fixed points in the back of the patient.
  • the head describes a purely translational path, which corresponds to a circular arc.
  • the head is received on a boom which is rotatably mounted at a point below the patient and therefore describes a circular path when it is adjusted.
  • the largest possible boom length is sought in order to realize an approximately linear lifting movement of the head.
  • the support beam is formed by a circular ring segment, which is guided by three bearing rollers and is driven via a toothing on the circular ring segment. Through this guide, it is possible to move the center of the rotational movement of the head in the area above the patient support surface.
  • a similar headrest is from the US-A-4 515 406 known.
  • All the known headrest systems have in common that the adjusting movement can be realized by very simple forms of movement which describe quasi-linear or circular paths in consideration of mechanical boundary conditions.
  • these tracks do not correspond to the human anatomy, so that compensatory movements of the head must take place. If this compensation movement is prevented, e.g. by storing the head in a head cap, the patient is stressed depending on the direction of adjustment to compression or extension. An alert patient will temporarily lift his head under the onset of pain and thus bring about a compensation.
  • a relaxed patient does not have this option and remains in the respective voltage situation.
  • the invention has the object of providing a motor-adjustable headrest of the type mentioned in such a way that the head of a lying on the patient support surface of the operating table patient when lifting and lowering the top plate can follow an anatomically correct path.
  • the solution according to the invention is based on an analysis of the anatomically correct movement of the head and the realization that the vertebral column connecting the head to the body can be regarded as a link chain for the technical realization of the head support system.
  • the spine thus corresponds to the juxtaposition of individual links, which are rotatably connected to each other at appropriate intervals and each of which allows for a certain rotation, wherein the resistance, which is opposite to a rotation, increases with increasing angle of rotation.
  • the stretched straight aligned position is chosen as the middle position and initial position of the following considerations.
  • In the middle position are all members of the affected area arranged in a straight line. If the head is now raised from this position, this will initially lead to a rotational movement in the farthest from the head rotary member, because there the force acts on the largest lever and causes the smallest twist. With increasing rotation, however, the voltage in this rotary member exceeds that of the head adjacent to the rotary member, so that this now undergoes a rotation. Thus, as the head is raised, the center of rotation advances from the furthest point toward the head.
  • the curve describing the link chain corresponds to a spiral that curves upwards starting in the horizontal direction with decreasing radius.
  • the continuous movement of the fulcrum on the center-point spiral can also be represented in discrete rotations about defined pivot points for simplification of the technical solution, with the pivot points lying on the center-point spiral.
  • the path of the head is then represented by a series of circular arcs, which connect tangentially to each other to achieve a steady movement and whose radii of curvature are getting smaller and smaller from the middle position towards the end position.
  • a movement curve of the head can be represented by a guide element acting on the head, which is guided on at least two locations on location-specific different curve functions.
  • this principle is now realized in that the support beam is clamped between three rollers whose trained on the support rail raceways also have a different shape due to the different positions of the rollers.
  • the shapes of the raceways are derived from the desired movement of the head.
  • the rotational movement of the head about one pivot point on the above-described center-point spiral is represented by a rolling movement of the rollers on the raceways, whose respective instantaneous center of curvature or center of curvature coincides with this pivot point of the head. If at least two points of the load-bearing support rail are guided on concentric circular paths (realized by the respective raceways with the associated rollers), then all the points which are firmly connected to the support rail and thus also to the patient's head move around the same on circular path sections turning center.
  • the third roller prevents lifting of the support Holmes of the two rollers mentioned in the case of changing load direction and is preferably biased to compensate for manufacturing inaccuracies in the direction of the support beam.
  • the carrier is in the form of a rigidly connectable to the operating table housing in which the rollers are mounted and the support spar is guided.
  • the support spar carry a tooth trace, in which engages a drivable by a motor pinion.
  • the tooth trace is formed on a side surface perpendicular to the axis of curvature of the support spar, wherein the drive device comprising the motor and the pinion is movably supported in the carrier about an axis pivotable toward the side surface.
  • the drive device comprises a rotatable by means of a motor threaded spindle, which is supported on the carrier and engages in a movably mounted on the support spar nut.
  • the drive device comprises a tension member, which is attached to or near the two ends of the support spar and is guided over a driven by a motor drive wheel.
  • the tension member may be a chain or a toothed belt, so that a slip-free adjustment of the support Holmes is possible.
  • the drive device could also be formed by a hydraulic cylinder which engages the support beam and is supported on a table-fixed support.
  • This embodiment is particularly suitable for a headrest that is permanently connected to a hydraulically adjustable operating table.
  • FIGS. 1a-c show the curvature of the spine during the up and down movement of the head of a patient lying on his back.
  • the patient support surface of a surgical table is referred to, on which a head plate 12 is arranged adjustable.
  • a head plate 12 On the top plate 12 rests the head 14 of a lying on the patient support surface 10 patients 16.
  • the center of gravity of the head is designated.
  • FIG. 1b shows the patient 16 in its extended position with the head plate 12 in alignment with the patient support surface 10 and the patient's spine 20 forming a straight line.
  • the spine curves according to the path 20 'in FIG FIG. 1a , If the head 14 is moved downward by lowering the head plate 12, the spine follows the web 20 "in Figure 1c , It can be seen that the spine does not pivot about a fixed center of rotation and that the tracks 20 'and 20 "are curved differently.
  • FIGS. 2 and 3 Let it be explained how the head plate 12 can be adjusted so that the center of gravity 18 of the head 14 when lifting and lowering the head plate 12 follows its anatomically correct path, which in the FIGS. 2 and 3 designated 22.
  • the top plate 12 is attached to the one end of a support spar 24 which is slidably guided between 3 rollers 26, 28 and 30 in the plane of the drawing.
  • the rollers 26, 28, 30 rest on raceways 32, 34 and 36, which are formed on the support beam 24.
  • These tracks 32, 34, 36 are made of individual Composed of sections that are found as in FIG. 2 is explained schematically.
  • FIG. 2 shows a certain position of the head or a timing of the adjusting movement of the head, to which the head center 18 'at the in FIG. 2 shown point on the trajectory 22 is located.
  • the associated center of rotation in the spine ie, "located on the web 20 at the MOM designated Z point.
  • the head center of gravity 18 is on the head plate rigidly connected to the support shaft 24 in FIG. 3 connected.
  • the rollers 26, 28, 30 are each in a point 26 ', 28', 30 'on the associated track 32, 34, 36 on.
  • the four points 18 ', 26', 28 'and 30' can only perform a common rotational movement about the instantaneous center of rotation Z mom , if the current centers of curvature of the tracks 32, 34, 36 coincide with the current center of rotation Z mom , ie the Rollers 26, 28, 30 run at any time on concentric circular path sections with the center Z mom .
  • FIGS. 4 to 7 now show a schematic representation of a preferred embodiment, the technical realization of the headrest according to the invention.
  • a generally designated 38 housing which consists essentially of two mutually parallel plates 40, 42 which are held by bolts 44 at a distance from each other and connected to each other.
  • the rollers 26, 28 and 30 rotatably mounted about the plates 40 and 42 perpendicular axes, between which the support rail 24 is guided.
  • the support beam 24 carries at one end a bar 46, at which the in the FIGS. 4 to 7 not shown top plate 12 can be attached.
  • a handle 48 is attached to this end of the support Holmes 24, with which the support beam can be moved by hand.
  • a handle 48 is attached to this end of the support Holmes 24, with which the support beam can be moved by hand.
  • Above the roller 28 is an in FIG. 6 recognizable cover plate 50, which is intended to prevent objects, in particular hair of a patient can be detected by the roller 28 and pulled into the housing 38.
  • the support roller 30 is biased by a spring 52 in the direction of the track 36.
  • the drive for the adjustment of the support member 24 is in FIG. 7 explained.
  • the support beam 24 carries on its one longitudinal side a tooth trace 54, in which a toothed pinion 56 engages, which is driven by a worm drive 58 by a motor 60.
  • the consisting of the motor 60, the worm gear 58 and the pinion 56 driving device or assembly is mounted in a plate 62 which is screwed to the outside of the housing plate 42 by means of a turntable 64 about an axis 66 pivotally, so that the pinion 56 of the can change in the adjustment of the support Holmes 24 changing direction of the teeth of the tooth trace 54 can follow.
  • the drive device is covered in practice by a cover, not shown, which is fixed to the plate 62.
  • the housing 38 may be secured to the frame of an operating table or patient support surface 10 by means of a support, not shown.

Abstract

A motor-adjustable head rest for operating tables comprises a head plate ( 12 ) which is arranged at one end of a curved support shaft ( 24 ) which, in a plane which is perpendicular with respect to the axis of curvature, is guided in an adjustable manner on a support between three rollers ( 26, 28, 30 ) which are spaced from one another in the direction of adjustment, which support can be connected to the operating table. The tracks ( 32, 34, 36 ) for the rollers ( 26, 28, 30 ) which are formed on the support shaft ( 24 ) are shaped such that their instantaneous curvature centers in each position of the support shaft ( 24 ) coincide with the instantaneous center of rotation of the head movement during the lifting and the lowering of the patient's head ( 14 ) resting on the head plate ( 12 ).

Description

Die Erfindung betrifft eine motorisch verstellbare Kopfstütze für Operationstische, umfassend eine Kopfplatte, die an einem Ende eines gekrümmten Stützholmes angeordnet ist, der in einer zur Krümmungsachse senkrechten Ebene an einem mit dem Operationstisch verbindbaren Träger zwischen drei Laufrollen verstellbar geführt ist, die in Stellrichtung einen Abstand voneinander haben.The invention relates to a motor-adjustable headrest for operating tables, comprising a top plate, which is arranged at one end of a curved support spar, which is guided in an adjustable direction perpendicular to the axis of curvature on a connectable to the operating table carrier between three rollers adjustable in the direction of adjustment a distance have each other.

Bestehende Kopfstützensysteme lassen sich unterteilen in Kopfstützen, die sich manuell in ihrer Position verstellen lassen und solche mit Unterstützung der Hubbewegung durch Fremdenergie, wie z.B. einen Elektromotor oder einen hydraulischen Antrieb. Besonders einfache Ausführungen beschränken sich auf eine Aneinanderreihung mehrerer zueinander drehbarer Glieder, die gegeneinander verspannt werden, wenn die richtige Position gefunden ist. Bei diesen einfachen Systemen muß während der Einstellprozedur die Last der Kopfplatte von der bedienenden Person getragen werden, was den Einsatz beider Hände erfordert. Eine solche Anordnung ist für intraoperative Verstellungen ungeeignet.Existing headrest systems can be subdivided into headrests that can be manually adjusted in position and those that support the lifting movement by external energy, e.g. an electric motor or a hydraulic drive. Particularly simple embodiments are limited to a juxtaposition of several mutually rotatable members, which are braced against each other when the correct position is found. In these simple systems, during the adjustment procedure, the load of the headstock must be borne by the operator, requiring the use of both hands. Such an arrangement is unsuitable for intraoperative adjustments.

Manuelle Systeme, die auch ein Verstellen der Kopfplatte während des Eingriffes ermöglichen, unterstützen die Last kontinuierlich. Die vertikale Hubleistung wird in diesen Fällen durch ein mechanisches Getriebe eingeleitet, das einerseits kleine Verstellkräfte gewährleistet, andererseits von der Lastseite her selbsthemmend ausgeführt ist, um ein unerwünschtes Absinken des Kopfes zu verhindern. Zusätzliche Freiheitsgrade der Kopfplatte, wie z.B. laterale (waagerechte) Verschiebungen oder laterale Schwenkbewegungen sind durch einfache Klemmverbindungen arretierbar, da ihre Verstellung nahezu leistungsfrei erfolgen kann.Manual systems, which also allow adjustment of the top plate during the procedure, support the load continuously. The vertical lifting capacity is introduced in these cases by a mechanical transmission, on the one hand ensures small adjustment forces, on the other hand, is designed to be self-locking from the load side to prevent unwanted drop in the head. Additional degrees of freedom of the top plate, such as lateral (horizontal) displacements or lateral pivoting movements are simple Clamping connections can be locked, as their adjustment can be carried out almost without power.

Die vertikale Hubleistung kann, wie bereits erwähnt, auch durch Fremdenergie erbracht werden. Je nach gewähltem System kann dabei auf die Selbsthemmung verzichtet werden, so daß die Gewichtslast direkt auf die Aktorik wirkt.The vertical lifting power can, as already mentioned, also be provided by external energy. Depending on the chosen system can be dispensed with the self-locking, so that the weight load acts directly on the actuators.

Bei den meisten bekannten Kopfstützensystemen kann die Bahn der Hubbewegung auf folgende Formen zurückgeführt werden:In most known headrest systems, the path of the lifting movement can be reduced to the following forms:

Parallelogrammführung:parallelogram:

Der Kopf ist auf einem Ausleger gelagert, der über zwei parallele Lenker an die Fixpunkte im Rückenbereich des Patienten angebunden ist. Dadurch beschreibt der Kopf eine rein translatorische Bahn, die einem Kreisbogen entspricht.The head is mounted on a boom, which is connected via two parallel links to the fixed points in the back of the patient. As a result, the head describes a purely translational path, which corresponds to a circular arc.

Drehführung:Rotary guide:

Der Kopf wird auf einem Ausleger aufgenommen, der in einem Punkt unterhalb des Patienten drehbar gelagert ist und daher bei seiner Verstellung eine Kreisbahn beschreibt. Dabei wird eine möglichst große Auslegerlänge angestrebt, um eine annähernd lineare Hubbewegung des Kopfes zu realisieren.The head is received on a boom which is rotatably mounted at a point below the patient and therefore describes a circular path when it is adjusted. In this case, the largest possible boom length is sought in order to realize an approximately linear lifting movement of the head.

Haslingier-Kopfstütze:Haslingier Headrest:

Sie entspricht der eingangs beschriebenen Kopfstütze. Um eine annähernd anatomisch korrekte Verstellbewegung des Kopfes zu erzeugen, ist der Stützholm von einem Kreisringsegment gebildet, das durch drei Lagerrollen geführt wird und über eine Verzahnung an dem Kreisringsegment angetrieben wird. Durch diese Führung ist es möglich, das Zentrum der Drehbewegung des Kopfes in den Bereich oberhalb der Patientenlagerfläche zu verlegen. Eine ähnliche Kopfstütze ist aus der US-A-4 515 406 bekannt.It corresponds to the headrest described above. In order to produce an approximately anatomically correct adjustment movement of the head, the support beam is formed by a circular ring segment, which is guided by three bearing rollers and is driven via a toothing on the circular ring segment. Through this guide, it is possible to move the center of the rotational movement of the head in the area above the patient support surface. A similar headrest is from the US-A-4 515 406 known.

All den bekannten Kopfstützensystemen ist gemeinsam, daß die Verstellbewegung durch sehr einfache Bewegungsformen realisiert werden, die in Rücksicht auf mechanische Randbedingungen quasilineare oder kreisförmige Bahnen beschreiben. Diese Bahnen entsprechen jedoch nicht der menschlichen Anatomie, so daß Ausgleichsbewegungen des Kopfes stattfinden müssen. Wird diese Ausgleichsbewegung unterbunden, z.B. durch Lagerung des Kopfes in einer Kopfkalotte, so wird der Patient je nach Stellrichtung auf Stauchung oder Streckung beansprucht. Ein wacher Patient wird unter dem entstehenden Schmerz kurzzeitig den Kopf anheben und somit einen Ausgleich herbeiführen. Ein relaxierter Patient hat diese Möglichkeit jedoch nicht und bleibt in der jeweiligen Spannungslage.All the known headrest systems have in common that the adjusting movement can be realized by very simple forms of movement which describe quasi-linear or circular paths in consideration of mechanical boundary conditions. However, these tracks do not correspond to the human anatomy, so that compensatory movements of the head must take place. If this compensation movement is prevented, e.g. by storing the head in a head cap, the patient is stressed depending on the direction of adjustment to compression or extension. An alert patient will temporarily lift his head under the onset of pain and thus bring about a compensation. However, a relaxed patient does not have this option and remains in the respective voltage situation.

Der Erfindung liegt die Aufgabe zugrunde, eine motorisch verstellbare Kopfstütze der eingangs genannten Art so auszubilden, daß der Kopf eines auf der Patientenlagerfläche des Operationstisches liegenden Patienten beim Heben und Senken der Kopfplatte einer anatomisch korrekten Bahn folgen kann.The invention has the object of providing a motor-adjustable headrest of the type mentioned in such a way that the head of a lying on the patient support surface of the operating table patient when lifting and lowering the top plate can follow an anatomically correct path.

Diese Aufgabe wird erfindungsgemäß durch die im Anspruch 1 angegebenen Merkmale gelöst.This object is achieved by the features specified in claim 1.

Die erfindungsgemäße Lösung beruht auf einer Analyse der anatomisch korrekten Bewegung des Kopfes und der Erkenntnis, daß sich die den Kopf mit dem Körper verbindende Wirbelsäule für die technische Realisierung des Kopfstützensystems als Gliederkette betrachten läßt. Die Wirbelsäule entspricht somit der Aneinanderreihung von einzelnen Gliedern, die in entsprechenden Abständen drehbar miteinander verbunden sind und deren jedes für sich eine gewisse Verdrehung zuläßt, wobei der Widerstand, der einer Verdrehung entgegengesetzt wird, mit zunehmendem Verdrehwinkel steigt.The solution according to the invention is based on an analysis of the anatomically correct movement of the head and the realization that the vertebral column connecting the head to the body can be regarded as a link chain for the technical realization of the head support system. The spine thus corresponds to the juxtaposition of individual links, which are rotatably connected to each other at appropriate intervals and each of which allows for a certain rotation, wherein the resistance, which is opposite to a rotation, increases with increasing angle of rotation.

Die gestreckte gerade ausgerichtete Lage sei als Mittellage und Ausgangslage folgender Betrachtungen gewählt. In der Mittellage sind alle Glieder des beeinflussten Bereiches in einer geraden Linie angeordnet. Wird der Kopf nun aus dieser Position angehoben, so wird dies zunächst zu einer Drehbewegung im vom Kopf am weitesten entfernten Drehglied führen, da dort die Kraft über den größten Hebel angreift und die kleinste Verdrehung hervorruft. Mit zunehmender Drehung übersteigt jedoch die Spannung in diesem Drehglied die des zum Kopf hin benachbarten Drehgliedes, so daß dieses nun eine Verdrehung erfährt. So schreitet der Mittelpunkt der Drehbewegung bei zunehmendem Anheben des Kopfes vom weitest entfernten Punkt in Richtung auf den Kopf hin voran. Die Kurve, welche die Gliederkette beschreibt, entspricht einer Spirale, die in waagerechter Richtung beginnend sich mit abnehmendem Radius nach oben krümmt. Für die Bewegung des Kopfes bedeutet dies, das ausgehend von einer senkrechten Hubbewegung von der Mittellage aus der Kopf idealerweise einer Spirale zunehmender Krümmung folgt, deren Momentanpole oder -zentren auf der beschriebenen Mittelpunktsspirale vom am weitesten entfernten Punkt zum Beginn der Hubbewegung in Richtung des Kopfes wandern.The stretched straight aligned position is chosen as the middle position and initial position of the following considerations. In the middle position are all members of the affected area arranged in a straight line. If the head is now raised from this position, this will initially lead to a rotational movement in the farthest from the head rotary member, because there the force acts on the largest lever and causes the smallest twist. With increasing rotation, however, the voltage in this rotary member exceeds that of the head adjacent to the rotary member, so that this now undergoes a rotation. Thus, as the head is raised, the center of rotation advances from the furthest point toward the head. The curve describing the link chain corresponds to a spiral that curves upwards starting in the horizontal direction with decreasing radius. For the movement of the head this means that, starting from a vertical lifting movement from the central position out of the head, ideally follows a spiral of increasing curvature whose instantaneous poles or centers on the described center-point spiral travel from the farthest point to the beginning of the lifting movement towards the head ,

Beim Absenken des Kopfes aus der Mittellage nach unten gelten die Gesetzmäßigkeiten entsprechend. Die Patientenauflage begrenzt die Anzahl der an der Bewegung beteiligten Glieder jedoch stark, so daß eine Spirale mit deutlich engerem Krümmungsradius entsteht. Der letzte Drehpunkt liegt hier im Wirbelansatz der Schädelbasis.When lowering the head from the middle position down the laws apply accordingly. However, the patient rest greatly limits the number of limbs involved in the movement, resulting in a spiral having a much narrower radius of curvature. The last fulcrum lies here in the vertebral approach of the skull base.

Die kontinuierliche Bewegung des Drehpunktes auf der Mittelpunktspirale kann zur Vereinfachung der technischen Lösung auch in diskrete Drehungen um definierte Drehpunkte abgebildet werden, wobei die Drehpunkte auf der Mittelpunktspirale liegen. Die Bahn des Kopfes wird dann durch eine Aneinanderreihung von Kreisbögen dargestellt, die zur Erzielung einer stetigen Bewegung tangential aneinander anschließen und deren Krümmungsradien von der Mittellage aus in Richtung Endlage immer kleiner werden.The continuous movement of the fulcrum on the center-point spiral can also be represented in discrete rotations about defined pivot points for simplification of the technical solution, with the pivot points lying on the center-point spiral. The path of the head is then represented by a series of circular arcs, which connect tangentially to each other to achieve a steady movement and whose radii of curvature are getting smaller and smaller from the middle position towards the end position.

Sind zwei Punkte eines Körpers bei einer ebenen Bewegung fixiert, so ist damit jeder weitere Punkt des Körpers in seiner Position festgelegt. Ebenso kann die Kurvenbahn eines Körperpunktes, in diesem Fall der Schwerpunkt des Kopfes, durch die Kurvenbahnen mindestens zweier anderer Körperpunkte beschrieben werden. Damit läßt sich eine Bewegungskurve des Kopfes darstellen durch ein am Kopf angreifendes Führungselement, das an mindestens zwei Stellen auf lagespezifisch unterschiedlichen Kurvenfunktionen geführt wird. Bei der erfindungsgemäßen Lösung wird dieses Prinzip nun dadurch realisiert, daß der Stützholm zwischen drei Laufrollen eingespannt ist, deren an dem Stützholm ausgebildete Laufbahnen aufgrund der unterschiedlichen Positionen der Laufrollen auch eine unterschiedliche Form haben. Die Formen der Laufbahnen sind aus der gewünschten Bewegung des Kopfes hergeleitet. Dabei wird in jedem Punkt die Drehbewegung des Kopfes um einen Drehpunkt auf der oben beschriebenen Mittelpunktspirale durch eine Abrollbewegung der Laufrollen auf den Laufbahnen abgebildet, deren jeweiliger Momentanpol oder Krümmungsmittelpunkt mit diesem Drehpunkt des Kopfes zusammenfällt. Werden mindestens zwei Punkte des tragenden Stützholmes auf konzentrischen Kreisbahnen (realisiert durch die jeweiligen Laufbahnen mit den zugehörigen Laufrollen) geführt, so bewegen sich alle Punkte, die fest mit dem Stützholm und damit auch mit dem Kopf des Patienten verbunden sind, auf Kreisbahnabschnitten um das gleiche Drehzentrum. Die dritte Laufrolle verhindert ein Abheben des Stützholmes von den zwei genannten Laufrollen im Falle wechselnder Lastrichtung und ist vorzugsweise zum Ausgleich von Fertigungsungenauigkeiten in Richtung auf den Stützholm vorgespannt.If two points of a body are fixed in a plane movement, then each additional point of the body is fixed in its position. Likewise, the curved path of a body point, in this case the center of gravity of the head, through the curved paths of at least two other body points are described. Thus, a movement curve of the head can be represented by a guide element acting on the head, which is guided on at least two locations on location-specific different curve functions. In the solution according to the invention, this principle is now realized in that the support beam is clamped between three rollers whose trained on the support rail raceways also have a different shape due to the different positions of the rollers. The shapes of the raceways are derived from the desired movement of the head. In each case, the rotational movement of the head about one pivot point on the above-described center-point spiral is represented by a rolling movement of the rollers on the raceways, whose respective instantaneous center of curvature or center of curvature coincides with this pivot point of the head. If at least two points of the load-bearing support rail are guided on concentric circular paths (realized by the respective raceways with the associated rollers), then all the points which are firmly connected to the support rail and thus also to the patient's head move around the same on circular path sections turning center. The third roller prevents lifting of the support Holmes of the two rollers mentioned in the case of changing load direction and is preferably biased to compensate for manufacturing inaccuracies in the direction of the support beam.

Bei einer bevorzugten Ausführungsform ist der Träger in Form eines mit dem Operationstisch starr verbindbaren Gehäuses ausgebildet, in dem die Laufrollen gelagert sind und der Stützholm geführt ist.In a preferred embodiment, the carrier is in the form of a rigidly connectable to the operating table housing in which the rollers are mounted and the support spar is guided.

Der Antrieb des Stützholmes kann auf unterschiedliche Weise erfolgen. Beispielsweise kann der Stützholm eine Zahnspur tragen, in die ein von einem Motor antreibbares Ritzel eingreift. Bei einer bevorzugten Ausführungsform ist die Zahnspur an einer zur Krümmungsachse des Stützholmes senkrechten Seitenfläche desselben ausgebildet, wobei die den Motor und das Ritzel umfassende Antriebsvorrichtung um eine zur Seitenfläche schwenkbare Achse beweglich in dem Träger gelagert ist.The drive of the support Holmes can be done in different ways. For example, the support spar carry a tooth trace, in which engages a drivable by a motor pinion. In a preferred embodiment, the tooth trace is formed on a side surface perpendicular to the axis of curvature of the support spar, wherein the drive device comprising the motor and the pinion is movably supported in the carrier about an axis pivotable toward the side surface.

Bei einer weiteren Ausführungsform umfaßt die Antriebsvorrichtung eine mittels eines Motors drehbare Gewindespindel, die sich an dem Träger abstützt und in eine an dem Stützholm beweglich gelagerte Mutter eingreift.In a further embodiment, the drive device comprises a rotatable by means of a motor threaded spindle, which is supported on the carrier and engages in a movably mounted on the support spar nut.

Bei einer weiteren Ausführungsform umfaßt die Antriebsvorrichtung ein Zugglied, das an oder nahe den beiden Enden des Stützholmes befestigt ist und über ein mittels eines Motors antreibbares Antriebsrad geführt ist. Das Zugglied kann dabei eine Kette oder ein Zahnriemen sein, so daß eine schlupffreie Verstellung des Stützholmes ermöglicht wird.In a further embodiment, the drive device comprises a tension member, which is attached to or near the two ends of the support spar and is guided over a driven by a motor drive wheel. The tension member may be a chain or a toothed belt, so that a slip-free adjustment of the support Holmes is possible.

Schließlich könnte die Antriebsvorrichtung auch von einem Hydraulikzylinder gebildet sein, der am Stützholm angreift und sich an einem tischfesten Träger abstützt. Diese Ausführungsform eignet sich besonders für eine Kopfstütze, die dauerhaft mit einem hydraulisch verstellbaren Operationstisch verbunden ist.Finally, the drive device could also be formed by a hydraulic cylinder which engages the support beam and is supported on a table-fixed support. This embodiment is particularly suitable for a headrest that is permanently connected to a hydraulically adjustable operating table.

Weitere Merkmale und Vorteile der Erfindung ergeben sich aus der folgenden Beschreibung, welche in Vebindung mit den beigefügten Zeichnungen die Erfindung anhand eines Ausführungsbeispieles erläutert. Es zeigen:

Figur 1 a-c
Schematische Darstellungen der Kopfbewegung einer auf dem Rücken liegenden Person,
Figur 2
eine graphische Darstellung zur Erläuterung der technischen Realisierung der Bahnkurve für die Verstellbewegung der Kopfplatte,
Figur 3
eine schematische Darstellung des Gesamtkonzeptes für die Bahnkurve des Kopfes und die Führung der Kopfstütze,
Figur 4
eine perspektivische Gesamtansicht der erfindungsgemäßen motorisch verstellbaren Kopfstütze,
Figur 5
eine annähernd der Figur 4 entsprechende Darstellung der Kopfstütze, wobei ein Teil des Gehäuses entfernt ist,
Figur 6
eine der Figur 5 entsprechende Darstellung der Kopfstütze, jedoch von der entgegengesetzten Seite her betrachtet, und
Figur 7
eine perspektivische Darstellung des Holmes und der Antriebsvorrichtung.
Further features and advantages of the invention will become apparent from the following description, which explains the invention with reference to an embodiment in conjunction with the accompanying drawings. Show it:
Figure 1 ac
Schematic illustrations of the head movement of a person lying on his back,
FIG. 2
a graphic representation for explaining the technical realization of the trajectory for the adjustment movement of the top plate,
FIG. 3
a schematic representation of the overall concept for the trajectory of the head and the leadership of the headrest,
FIG. 4
an overall perspective view of the motorized headrest according to the invention,
FIG. 5
a near the FIG. 4 corresponding representation of the headrest, wherein a part of the housing is removed,
FIG. 6
one of the FIG. 5 corresponding view of the headrest, but viewed from the opposite side, and
FIG. 7
a perspective view of the spar and the drive device.

Die Figuren 1a-c zeigen die Krümmung der Wirbelsäule bei der Auf- und Abbewegung des Kopfes eines auf dem Rücken liegenden Patienten. Mit 10 ist die Patientenlagerfläche eines Operationstisches bezeichnet, an dem eine Kopfplatte 12 verstellbar angeordnet ist. Auf der Kopfplatte 12 ruht der Kopf 14 eines auf der Patientenlagerfläche 10 liegenden Patienten 16. Mit 18 ist der Schwerpunkt des Kopfes bezeichnet.The FIGS. 1a-c show the curvature of the spine during the up and down movement of the head of a patient lying on his back. With 10, the patient support surface of a surgical table is referred to, on which a head plate 12 is arranged adjustable. On the top plate 12 rests the head 14 of a lying on the patient support surface 10 patients 16. With 18, the center of gravity of the head is designated.

Die Figur 1b zeigt den Patienten 16 in seiner gestreckten Lage, wobei die Kopfplatte 12 mit der Patientenlagerfläche 10 fluchtet und die Wirbelsäule 20 des Patienten eine gerade Linie bildet. Wird der Kopf 14 des Patienten mittels der Kopfplatte 12 angehoben, so krümmt sich die Wirbelsäule entsprechend der Bahn 20' in Figur 1a. Wird der Kopf 14 durch Absenken der Kopfplatte 12 nach unten bewegt, so folgt die Wirbelsäule der Bahn 20" in Figur 1c. Man erkennt, daß die Wirbelsäule nicht eine Schwenkbewegung um ein festes Drehzentrum macht und daß die Bahnen 20' und 20" unterschiedlich gekrümmt sind.The FIG. 1b shows the patient 16 in its extended position with the head plate 12 in alignment with the patient support surface 10 and the patient's spine 20 forming a straight line. When the head 14 of the patient is raised by means of the head plate 12, the spine curves according to the path 20 'in FIG FIG. 1a , If the head 14 is moved downward by lowering the head plate 12, the spine follows the web 20 "in Figure 1c , It can be seen that the spine does not pivot about a fixed center of rotation and that the tracks 20 'and 20 "are curved differently.

Anhand der Figuren 2 und 3 soll erläutert werden, wie die Kopfplatte 12 so verstellt werden kann, daß der Schwerpunkt 18 des Kopfes 14 beim Anheben und Senken der Kopfplatte 12 seiner anatomisch korrekten Bahn folgt, die in den Figuren 2 und 3 mit 22 bezeichnet ist.Based on FIGS. 2 and 3 Let it be explained how the head plate 12 can be adjusted so that the center of gravity 18 of the head 14 when lifting and lowering the head plate 12 follows its anatomically correct path, which in the FIGS. 2 and 3 designated 22.

Die Kopfplatte 12 ist an dem einen Ende eines Stützholmes 24 befestigt, der zwischen 3 Laufrollen 26, 28 und 30 in der Zeichenebene verschiebbar geführt ist. Die Laufrollen 26, 28, 30 liegen dabei an Laufbahnen 32, 34 bzw. 36 an, die an dem Stützholm 24 ausgebildet sind. Diese Laufbahnen 32, 34, 36 werden aus einzelnen Abschnitten zusammengesetzt, die so aufgefunden werden, wie dies in Figur 2 schematisch erläutert wird.The top plate 12 is attached to the one end of a support spar 24 which is slidably guided between 3 rollers 26, 28 and 30 in the plane of the drawing. The rollers 26, 28, 30 rest on raceways 32, 34 and 36, which are formed on the support beam 24. These tracks 32, 34, 36 are made of individual Composed of sections that are found as in FIG. 2 is explained schematically.

Figur 2 zeigt eine bestimmte Stellung des Kopfes oder einen Zeitpunkt der Stellbewegung des Kopfes, zu dem sich der Kopfschwerpunkt 18' an dem in Figur 2 dargestellten Punkt auf der Bewegungsbahn 22 befindet. Das zugehörige Drehzentrum in der Wirbelsäule, d.h. auf der Bahn 20" befindet sich an dem mit Zmom bezeichneten Punkt. Der Kopfschwerpunkt 18 ist über die Kopfplatte starr mit dem Stützholm 24 in Figur 3 verbunden. Die Laufrollen 26, 28, 30 liegen jeweils in einem Punkt 26', 28', 30' auf der zugehörigen Laufbahn 32, 34, 36 auf. Die Punkte 26', 28', 30' sind auch Punkte des Stützholmes 24 und damit starr mit dem Kopfschwerpunkt 18 verbunden. Die vier Punkte 18', 26', 28'und 30' können also nur dann eine gemeinsame Drehbewegung um das momentane Drehzentrum Zmom ausführen, wenn die momentanen Krümmungsmittelpunkte der Laufbahnen 32, 34, 36 mit dem momentanen Drehzentrum Zmom zusammenfallen, d.h. die Rollen 26, 28, 30 zu jedem Zeitpunkt auf konzentrischen Kreisbahnabschnitten mit dem Zentrum Zmom laufen. FIG. 2 shows a certain position of the head or a timing of the adjusting movement of the head, to which the head center 18 'at the in FIG. 2 shown point on the trajectory 22 is located. The associated center of rotation in the spine, ie, "located on the web 20 at the MOM designated Z point. The head center of gravity 18 is on the head plate rigidly connected to the support shaft 24 in FIG. 3 connected. The rollers 26, 28, 30 are each in a point 26 ', 28', 30 'on the associated track 32, 34, 36 on. The points 26 ', 28', 30 'are also points of the support Holmes 24 and thus rigidly connected to the head center of gravity 18. The four points 18 ', 26', 28 'and 30' can only perform a common rotational movement about the instantaneous center of rotation Z mom , if the current centers of curvature of the tracks 32, 34, 36 coincide with the current center of rotation Z mom , ie the Rollers 26, 28, 30 run at any time on concentric circular path sections with the center Z mom .

Unter dieser Bedingung werden bei Verlagerung des jeweils aktuellen oder momentanen Drehzentrums Zmom entlang den Bahnen 20" und 20' die zugehörigen Abschnitte der Laufbahnen 32, 34, 36 ermittelt. Sie bilden aneinandergereiht die entsprechenden Laufbahnen 32, 34 und 36. Die Laufbahnen sind alle unterschiedlich. In ihrer Kombination ergeben sie jedoch durch die Abrollbewegung auf den entsprechenden Laufrollen 26, 28 bzw. 30 die gewünschte Bewegungsbahn der Kopfplatte 12 und damit des Kopfschwerpunktes 18.Under this condition, when the respective current or instantaneous center of rotation Z mom is displaced along the tracks 20 "and 20 ', the associated sections of the raceways 32, 34, 36 are determined, forming the corresponding raceways 32, 34 and 36 in a row In their combination, however, they give the desired trajectory of the top plate 12 and thus of the head center of gravity 18 by the rolling movement on the corresponding rollers 26, 28 and 30 respectively.

Die Figuren 4 bis 7 zeigen nun in schematischer Darstellung anhand eines bevorzugten Ausführungsbeispieles die technische Realisierung der erfindungsgemäßen Kopfstütze. In den Figuren erkennt man ein allgemein mit 38 bezeichnetes Gehäuse, das im wesentlichen aus zwei zueinander parallelen Platten 40, 42 besteht, die durch Bolzen 44 in einem Abstand voneinander gehalten und miteinander verbunden sind. Zwischen den Platten 40 und 42 sind die Laufrollen 26, 28 und 30 um zu den Platten 40 und 42 senkrechte Achsen drehbar gelagert, zwischen denen der Stützholm 24 geführt ist. In der Figur 6 erkennt man die an dem Stützholm 24 ausgebildeten Laufbahnen 32, 34 und 36 für die Laufrollen 26, 28 bzw. 30. Der Stützholm 24 trägt an einem Ende eine Leiste 46, an der die in den Figuren 4 bis 7 nicht dargestellte Kopfplatte 12 befestigt werden kann. Ferner ist an diesem Ende des Stützholmes 24 ein Handgriff 48 angebracht, mit dem der Stützholm von Hand bewegt werden kann. Oberhalb der Laufrolle 28 befindet sich eine in Figur 6 erkennbare Abdeckplatte 50, die verhindern soll, daß Gegenstände, insbesondere Haare eines Patienten von der Laufrolle 28 erfaßt und in das Gehäuse 38 hineingezogen werden können.The FIGS. 4 to 7 now show a schematic representation of a preferred embodiment, the technical realization of the headrest according to the invention. In the figures can be seen a generally designated 38 housing, which consists essentially of two mutually parallel plates 40, 42 which are held by bolts 44 at a distance from each other and connected to each other. Between the plates 40 and 42, the rollers 26, 28 and 30 rotatably mounted about the plates 40 and 42 perpendicular axes, between which the support rail 24 is guided. In the FIG. 6 recognizes the formed on the support beam 24 raceways 32, 34 and 36 for the rollers 26, 28 and 30. The support beam 24 carries at one end a bar 46, at which the in the FIGS. 4 to 7 not shown top plate 12 can be attached. Further, a handle 48 is attached to this end of the support Holmes 24, with which the support beam can be moved by hand. Above the roller 28 is an in FIG. 6 recognizable cover plate 50, which is intended to prevent objects, in particular hair of a patient can be detected by the roller 28 and pulled into the housing 38.

Die Stützrolle 30 wird durch eine Feder 52 in Richtung auf die Laufbahn 36 vorgespannt.The support roller 30 is biased by a spring 52 in the direction of the track 36.

Der Antrieb für die Verstellung des Stützholms 24 ist in Figur 7 erläutert. Der Stützholm 24 trägt auf seiner einen Längsseite eine Zahnspur 54, in die ein Zahnritzel 56 eingreift, das über einen Schneckentrieb 58 von einem Motor 60 angetrieben wird. Die aus dem Motor 60, dem Schneckentrieb 58 und dem Ritzel 56 bestehende Antriebsvorrichtung oder Baugruppe ist in einer Platte 62, die an der Außenseite der Gehäuseplatte 42 angeschraubt ist, mittels einer Drehscheibe 64 um eine Achse 66 schwenkbar gelagert, so daß das Ritzel 56 der sich bei der Verstellung des Stützholmes 24 ändernden Richtung der Zähne der Zahnspur 54 folgen kann. Die Antriebsvorrichtung ist in der Praxis durch einen nicht dargestellten Deckel abgedeckt, der mit der Platte 62 befestigt ist.The drive for the adjustment of the support member 24 is in FIG. 7 explained. The support beam 24 carries on its one longitudinal side a tooth trace 54, in which a toothed pinion 56 engages, which is driven by a worm drive 58 by a motor 60. The consisting of the motor 60, the worm gear 58 and the pinion 56 driving device or assembly is mounted in a plate 62 which is screwed to the outside of the housing plate 42 by means of a turntable 64 about an axis 66 pivotally, so that the pinion 56 of the can change in the adjustment of the support Holmes 24 changing direction of the teeth of the tooth trace 54 can follow. The drive device is covered in practice by a cover, not shown, which is fixed to the plate 62.

Das Gehäuse 38 kann mit Hilfe eines nicht dargestellten Trägers an dem Gestell eines Operationstisches oder der Patientenlagerfläche 10 befestigt werden.The housing 38 may be secured to the frame of an operating table or patient support surface 10 by means of a support, not shown.

Claims (9)

  1. A motor-adjustable head rest for operating tables, comprising a head plate (12) which is arranged at one end of a curved support shaft (24) which, in a plane which is perpendicular with respect to the axis of curvature, is guided in an adjustable manner on a support (38) between three rollers (26, 28, 30) which are spaced from one another in the direction of adjustment, which support (38) can be connected to the operating table, characterized in that the tracks (32 34 36) for the rollers (26, 28, 30) which are formed on the support shaft (24) are all shaped differently and in such a manner that their instantaneous curvature centers of the differently curved tracks (32, 34, 36) in each position of the support shaft (24) coincide with the instantaneous center of rotation Zmom of the spiral movement during the lifting and the lowering of a patient's head (14) which rests on the head plate (12).
  2. The head rest according to claim 1, characterized in that the surfaces of two of the tracks (32, 36) point downward and the surface of one track (34) points upward.
  3. The head rest according to claim 1 or 2, characterized in that one of the rollers (30) supporting the support shaft (24) is biased in the direction towards the support shaft (24) .
  4. The head rest according to one of the claims 1 to 3, characterized in that the support comprises a housing (38) which can be rigidly connected to the operating table and in which the rollers (26, 28, 30) are mounted, and that the support shaft (24) is guided.
  5. The head rest according to one of the claims 1 to 4, characterized in that the support shaft (24) supports a gear track (54) in which a pinion (56) which can be driven by a motor (60) engages.
  6. The head rest according to claim 5, characterized in that the gear track (54) is formed on a side surface of the support shaft which is perpendicular to the axis of curvature of the support shaft (24) and in that the drive device comprising the motor (60) and the pinion (56) is mounted to the support (38) in such a way that it is movable about a pivoting axis (66) which is perpendicular to the side surface.
  7. The head rest according to one of the claims 1 to 4, characterized in that the drive device comprises a threaded spindle which can be rotated by a motor, which rests on the support and which engages in a nut which is movably mounted to the support shaft.
  8. The head rest according to one of the claims 1 to 4, characterized in that the drive device comprises a pulling element, which is attached on or near the two ends of the support shaft and which is guided via a drive wheel which can be driven by a motor.
  9. The head rest according to one of the claims 1 to 4, characterized in that the drive device comprises a hydraulic cylinder which is supported on a support.
EP03789027A 2002-11-19 2003-11-11 Headrest adjustable by means of a motor Expired - Lifetime EP1562530B1 (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE10253863 2002-11-19
DE10253863A DE10253863B4 (en) 2002-11-19 2002-11-19 Motorized adjustable headrest
PCT/EP2003/012588 WO2004045483A2 (en) 2002-11-19 2003-11-11 Headrest adjustable by means of a motor

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EP1562530A2 EP1562530A2 (en) 2005-08-17
EP1562530B1 true EP1562530B1 (en) 2008-09-17

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EP (1) EP1562530B1 (en)
JP (1) JP4303682B2 (en)
AT (1) ATE408390T1 (en)
DE (2) DE10253863B4 (en)
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JP2013048675A (en) * 2011-08-30 2013-03-14 Toshiba Corp Clothing drier
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ES2311750T3 (en) 2009-02-16
JP4303682B2 (en) 2009-07-29
DE10253863A1 (en) 2004-06-03
US7134157B2 (en) 2006-11-14
DE10253863B4 (en) 2008-07-10
WO2004045483A3 (en) 2004-07-22
EP1562530A2 (en) 2005-08-17
DE50310529D1 (en) 2008-10-30
WO2004045483A2 (en) 2004-06-03
JP2006506143A (en) 2006-02-23
US20060150334A1 (en) 2006-07-13
ATE408390T1 (en) 2008-10-15

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