ITVR20120216A1 - EQUIPMENT FOR THE CARE OF THE VERTEBRAL COLUMN - Google Patents

Description

â € œEQUIPMENT FOR THE CARE OF THE VERTEBRAL COLUMNâ €

The present invention refers, in general, to an apparatus for the treatment of a person's spinal column. More specifically, it is an equipment that allows the correction of unnatural curves of the spine, for example of a scoliotic spine.

As is well known, there are many people who suffer from scoliosis, that is an irregular curvature of the vertebral column correlated to a rotation of the vertebrae. This disease causes pain in the back and joints, and causes further ailments due to poor posture.

Numerous techniques are known which aim to cure or at least correct scoliosis. Usually those suffering from scoliosis carry out appropriate exercises, for example postural gymnastics in self-correction, or undergo massages or manipulation techniques. Of course, such practices have limited effectiveness; on the contrary, in many cases, not being able to be carried out correctly, they risk worsening the current situation.

Orthopedic corsets or braces are also used, whose action contrasts the course of the disease, limiting its effects, and at the same time develops new compensation curves and rotations of the pelvis. In fact, corsets do not act directly on the spine, but on soft and flexible surfaces, extremely unstable in space and time, such as skin, fat, muscles in a state of rest and ribs, which by their nature are quite flexible and do not offer the consistency necessary to transmit an effective corrective thrust on the column. Consequently, considering the bust of the patient as a whole, the brace allows to achieve good results from an aesthetic point of view, but the underlying problem, that is the irregular curvature of the spine, remains, with the consequent pain and imbalances in posture and body movements.

In the case of more severe scoliosis, the patient is forced to undergo surgery which involves fixing one or two steel rods to the sides of the portion of the spine subject to scoliosis, binding and locking it. The mobility of the spine is thus guaranteed only by the part of the spine that remains free, with negative consequences for the patient's daily life.

Apparatuses are also known which act directly on the body of a patient suffering from scoliosis. The European patent application EP0008248 illustrates, for example, an equipment comprising means of traction of the body through which the patient tries to straighten his own vertebral column. However, this operation also acts, in an undesirable way, on the natural curves (lordosis and kyphosis) present in the spinal column, generating great instability.

In the event that you go to act directly on the spine, for example with massages or physiotherapy treatments, it must be noted that this action must be distinguished according to the portion of the spine on which it acts.

Furthermore, particular attention in massage and mobilization maneuvers must also be made with regard to the different parts of which each vertebra is composed: the body, the peduncle, the spinous process, the

<5> transverse processes, the facet joints.

So today's solutions provide treatments that are effective from an aesthetic point of view (corsets and surgery), but disabling because they severely limit mobility. The lost functionality is sought later with massages, gymnastics and various other therapies.

<10> One purpose of the invention is to obviate the aforementioned drawbacks and others, thanks to the realization of an apparatus for the care of a person with a scoliotic spine.

Another purpose of the invention is to promote a more correct structure of the body, eliminating the muscular tensions that constrain it and

<15> stimulate at the same time the muscles necessary to maintain a correct posture, acting simultaneously on the various deep muscle chains.

A further purpose of the invention is to create a device that acts precisely on the spinal column,

<20> such as to promote vertebral realignment and counter-rotation of the vertebrae subject to scoliosis, in order to convert the scoliotic curves on the frontal plane into natural curves (lordosis and kyphosis) on the sagittal plane.

Another purpose of the invention is to create a device that precisely relieves the muscular tensions produced by scoliosis without

<25> going to operate unnecessarily on other parts of the body.

A further aim of the invention is that of realizing an apparatus that uses in a precise and differentiated way the different parts of which each vertebra is constituted in order to loosen some deep tensions and promote other antagonists.

These objects and advantages are all achieved, according to the invention, by an apparatus, as claimed in the first claim, for the treatment of the vertebral column on which a person, for example suffering from scoliosis, lies lying and supine, the vertebral column including spinous processes and transverse processes.

The equipment is characterized by the fact that it includes:

- a basic support,

- at least a first pushing device joined to the base support and comprising a first pushing edge positioned under pressure on a first portion of the vertebral column according to a first direction, - at least a second pushing device joined to the base support and comprising a second pushing edge positioned under pressure on a second portion of the vertebral column, adjacent to the first portion of the vertebral column, in a second direction; the first pushing edge and the second pushing edge being arranged and acting on opposite sides of the vertebral column;

- at least a first support plate arranged on the first thrust device and adjacent to the first thrust edge in a more external position with respect to said first thrust edge;

- at least a second support plate arranged on the second thrust device and adjacent to the second thrust edge in a more external position with respect to said second thrust edge;

in which the first support plate and the second support plate act on the transverse processes of the relative portion of the vertebral column, and the first thrusting edge and the second thrusting edge act on the spinous processes of the same portion of the vertebral column.

Further objects and advantages are achieved, according to the invention, by an apparatus as claimed in the dependent claims.

Further characteristics and details of the invention can be better understood from the following description, given as a non-limiting example, as well as from the attached drawing tables in which:

figure 1 is an axonometric view from above of an apparatus according to the invention, for the treatment of the spinal column;

figure 2 is an axonometric view from the top of the apparatus of figure 1 without some elements so as to make some hidden elements visible;

figure 3 is a top view of the apparatus of figure 2;

figure 4 is an axonometric view of a part of the apparatus of figure 1, ie of the base support of the apparatus;

figure 5 is an axonometric view of a part of the apparatus of fig.

1, that is the seat of the equipment;

figure 6 is an axonometric view of a part of the apparatus of figure 1, ie of the head support of the apparatus;

figure 7 is an axonometric view of a part of the apparatus of figure 1, ie of the control arc of the apparatus;

figures 8, 9 and 9b are respectively axonometric and lateral views of a part of the apparatus of figure 1, ie of a pusher device of the apparatus;

figure 10 is an axonometric view of a part of the apparatus of figure 1, ie of the device retaining device;

figures 11, 12 are respectively axonometric and top views of a part of the apparatus of figure 1, ie of a pusher and support device of the apparatus;

figure 13 is a sectional view of a part of the equipment in action on the patient's torso, at the height of the rib cage.

With reference to the attached figures, in particular to figures 1, 2 and 3, 210 indicates as a whole an apparatus for treating the vertebral column. The apparatus 210 comprises a base support 212 to which a seat 214, a foot support 266, a head support 216, a pusher 218 and a counter-thrust device 220, a pusher and support device 222 are attached, and a restraining device 224.

As shown individually in figure 4, the base support 212 comprises a flat base 226 to which a movable plane 228 is hinged on 227 at the end of which two wheels 230 are rotatably fixed, which, together with two other wheels arranged on the opposite side (not visible in the figures), they are designed to allow the movement of the entire apparatus 210. Two adjustment screws 233 move the flat base 226 and the mobile surface 228 away from each other, thus adjusting the inclination of the entire apparatus 210 with respect to the supporting floor.

A frame 232 is attached to the flat base 226 which acts as an anchoring structure for the various elements listed above, such as the seat 214, the head support 216, the thrust device 218 and the counter-thrust device 220, the thrust and support 222 and the holding device 224.

In particular, two support surfaces 234 are fixed to the frame 232 in a removable way, so that they can be spaced apart. Threaded holes for fastening the thrust device 218 and the counter-thrust device 220, the thrust and support device 222 and the retaining device 224 are formed on the two supporting surfaces 234, elements which are subsequently described.

The frame 232 comprises at the front an adjustment plate 238 on which a first tubular profile 236 can be fixed, arranged vertically with respect to the same plate 238. The head support 216 with adjustable height can be fixed to the tubular profile 236 thanks to the presence of a screw 237. In particular, various holes are made in the adjustment plate 238 in order to vary the position of the tubular section 236, and consequently of the head rest 216, in the longitudinal direction of the apparatus 210.

On the opposite side to the first tubular profile 236, the frame 232 includes three second tubular profiles 240 to which it is possible to fix in a removable way the seat 214. Also in this case, the clamping screws allow the fixing of the seat 214 to the tubular profiles 240 and, consequently, the adjustment of the height from the ground of the same seat 214.

Laterally, the frame 232 comprises wings 242 to which it is possible to fix an arch 244, described below, which surrounds the patient's torso and comprises means for adjusting the thrust device 218.

The base support 212 includes infrared lamps which irradiate the patient's body lying on the apparatus 210 from the bottom upwards and heat his muscles.

The seat 214, illustrated individually in figure 5, comprises a seat surface 246 fixed in a translatable way on slides (not visible in the figure) to three vertical profiles 248 which are coupled to the three tubular profiles 240 of the base support 212. Thanks to the slides and through a screw (not visible in the figures) placed under the seat surface 246 which allows a millimeter adjustment, the same seat surface 246 can be advanced or retracted, so as to adjust its position according to the height of the patient which uses the device 210. Furthermore, the seat surface 246 can be totally released so as to allow controlled traction of the lumbar area.

A support block 250 with adjustable position is fixed to one end of the seat surface 246, while two sides 254 are connected in an adjustable way to a support structure 252 which can be adjusted in the longitudinal direction and joined to the same seat surface 246. respectively arranged on the sides of the seat. The sides 254 serve to hold the patient's pelvis in the desired position, preventing lateral displacements of the same and orienting the iliac bones longitudinally.

The sides 254 are fixed to the support structure 252 in an adjustable way, so as to be able to adapt to different patients with different pelvis widths.

Furthermore, two support surfaces 418 on which the patient can rest his arms are fixed to the two opposite sides to the support structure 252.

An upper lamella 255 is fixed in an adjustable way to the upper end of each of the two sides 254, so that the patient's pelvis is all included between the support structure 252, the two sides 254 and the upper blade 255.

The upper lamella 255 comprises three pads joined on the side facing the patient: two pads 402 are arranged laterally and shaped so as to adhere to the patient's body from the intermediate line of the iliac crest to the anterior-superior iliac spine; a third pad 403 (indicated in figure 1) is placed in the center so as to adhere and maintain the protrusion of the pubic symphysis in a horizontal line with the anterior-superior iliac spines.

The attachments 404 allow to position the upper lamella 255 according to variable positions thanks to adjustments in the vertical, longitudinal and axial direction (around an axis transverse to the seat 214), so as to recreate a conformation that allows the correction of the position of the iliac bones with respect to to the sacrum (sacral inclination, sliding angle, lumbo-sacral angle, sacral sagittal rotation), on the articulation of the pelvis in anteversion or retroversion and the orientation of the pelvis itself in accordance with the corrections to be obtained on the spine.

In other words, the sacrum is not constrained in the session so it can assume different positions, but at the same time the pelvis is kept blocked without absorbing the corrections of the spine while the muscles tense or relax thanks to the push and counter thrust devices. .

On the seat surface 246 and on the support structure 252 are positioned supports 256 in elastic material to make the patient's lumbar area (sacrum and coccyx) resting on the seat surface 246 more comfortable.

A first presser 258 is fixed to the seat surface 246, at the opposite end with respect to the support block 250. The first presser 258 comprises a thrust body 260 whose position and orientation with respect to the seat surface 246 are adjustable through a regulation structure 262.

The position and orientation of the free end of the thrust body 260 are adjusted so that the same raised end, called thrust edge 261, is under pressure on the outermost portion of the spine of the lumbar area, more precisely on the upper part of the sacrum and on the fourth and fifth lumbar vertebrae, creating an action of lumbar hyperextension.

A second presser 263 is fixed to the seat surface 246, in a symmetrical position with respect to the first presser 258 along an axis longitudinal to the seat 214.

The second presser 263 comprises a thrust body 265 whose position and orientation with respect to the seat surface 246 are adjustable, similarly to what can happen for the first presser 258.

The position and orientation of the free end of the thrust body 265 are adjusted so that the same raised end, called the thrust edge 267, is under pressure on the outermost portion of the vertebral column of the lumbar area, from the opposite on which the pushing edge 261 of the first presser 258 is under pressure.

Furthermore, the upper lamella 255 which strikes with the pads 402 on the anterior-superior iliac spines of the patient and with the pad 403 in action on the pubic symphysis, together with the two sides 254 and the support structure 252, block the patient's pelvis, so that the spinal column of the lumbar region is positioned between the pushing edge 261 of the first presser 258 and the pushing edge 267 of the second presser 263.

Furthermore, the thrust body 260 of the first presser 258 and the thrust edge 267 of the second presser 263 are shaped so as to fit between the sacrum and the iliac bones, allowing them to be corrected independently.

On the first presser 258 and on the second presser 263, adjacent to the thrust bodies 260, 265, there are two support pads 406 for accommodating the lower portion of the patient's hips, more precisely the posterior-inferior and posterior-superior iliac spine, opposite portion with respect to the anterior superior iliac spines oriented by the tampons 402.

A support block 271 is fixed to the seat surface 246, more precisely at the opposite end with respect to the support block 250, at the top of which is joined a pressure element 273 which presses on the corresponding portion of the vertebral column, in particular on the spinous processes of this portion of the vertebral column. Adjacent to the pressure element 273 there is a support plate 275 in elastic material which presses on the thoraco-lumbar band and on the underlying postero-inferior dentate muscle, to act, as a result of the pressure action, on the processes crosspieces of the same portion of the vertebral column.

The foot support 266, illustrated in figures 1, 2, 3, is hinged below one end of the frame 232 of the base support 212, more precisely with two perforated vertical bars 235, as in figures 1 and 4, through a first bar 264 and a second bar 270.

The foot support 266 includes, at the opposite end, a surface 268 with two distinct plates 420 (shown in figure 1) where the patient can comfortably and independently rest his legs from each other . The top 268 is laterally provided with two sides 269 to support the feet laterally.

Each of the two plates 420 is on one side hinged to a hinge (not visible in the figures) and on the other it is fixed to a piston 422 fixed below to a support structure 424 joined to the top 268.

The patient can thus move his own legs in a distinct way and act under pressure with the heels on each of the two plates 420, action opposed by the pistons 422.

The first bar 264 has several holes through which to attach to the two perforated vertical bars 235, so as to vary the inclination and height of the footrest 266 with respect to the seat 214.

The top 268 itself is provided with an adjustment on the underlying part (not visible in the figures) which allows it to be controlled on the horizontal plane.

The position of the foot rest 266 can be adjusted in height so as to provide the correct angle of attack to the thrust body 260 in synergy with the pusher 218, the counter thrust device 220, the pusher and support 222, and the retaining device 224.

The head support 216, illustrated individually in figure 6, includes a tubular pin 272 which is received and fixed in the first tubular profile 236 at different heights thanks to the clamping screw 237, so as to provide the correct attachment point for the nape of the patient.

A first support plane 274 is fixed above the tubular pin 272, above which a second support plane 276 with a rectangular plan is arranged.

Above the second support surface 276 a cushion 282 is fixed in a movable way thanks to the presence of slides. This movement is opposed by the recall action of an elastic element (not visible in the figures) which causes it to withdraw into the central starting position.

On the second support plane 276, four pins 278 are fixed to the four corners, which can slide inside four holes made in the first support plane 274. A gas piston 280 is centrally fixed to the second support plane 276 and received in the tubular pin 272 through a hole made in the first support plane 274.

This small frame structure allows a vertical translation of the second support plane 276, and therefore of the cushion 282, with respect to the first support plane 274, translation guided by the four pins 278 and contrasted from the bottom upwards by the piston 280.

The appropriate adjustment of the aforementioned elements and the combined action of the mechanisms that allow translation in the three spatial directions allows the patient to perform physical exercises with the head and neck, while the thrust device 218, the counter-thrust device 220, the pusher and support device 222, and the retaining device 224 keep the vertebral column in position according to a stable and correct position.

In fact, the nape, by pressing on the device through possible different angles, allows to activate the posterior muscle chains and / or the deep muscles of the rachis in general and of the cervical one in particular. These muscular parts can be easily activated and trained in a healthy person, through simple exercises, while in a scoliosis these same exercises would be counterproductive, as they would accentuate the curves through muscle contraction.

The apparatus 210 according to the invention also allows the patient suffering from scoliosis to be able to perform specific alternative exercises as the spinal column is basically kept in the correct position.

As previously mentioned, the head support 216 can also vary its position in the longitudinal direction thanks to the conformation of the adjustment plate 238 to which the first tubular section 236 can be fixed in various positions and inclinations of its vertical with respect to the Longitudinal axis of the apparatus 210.

The thrust device 218 and the counter thrust device 220 have a similar conformation to each other. Taking into consideration the pusher device 218, illustrated individually in Figures 8, 9 and 9b, it comprises a base 284 which is suitably fixed to one of the anchoring planes 234 of the base support 212 in the desired position according to the patient's build. and areas of the spine on which to intervene.

A movable plane 285 is hinged to the base 284, the inclination of which is adjustable by means of a piston 283. On the movable plane 285, in turn, a push arm 286 is hinged to whose free end an element is fixed in a translatable way. thrust 288. In turn, at the free end of the thrust element 288 there is a thrust edge 290 which is suitably positioned under pressure on the spinal column, more particularly on the outermost and raised edge of the column vertebral, i.e. on the spinous processes of the corresponding portion of the vertebral column.

Also fixed to the thrust element 288 is a support plate 289, placed adjacent to the thrust edge 290 from which it protrudes. The suitably curved support plate 289 pushes on the lateral and non-raised portion of the vertebral column, ie on the transverse processes of the portion of the vertebral column on which the support plate abuts. Naturally, the incidence of the curvature of the support plate 289 can be suitably adjusted, in accordance with the correction to be carried out.

Furthermore, on the thrust element 288 there is fixed a support 287 on which the scapula of the patient using the apparatus 210 can rest, orienting the correction of the shoulder girdle.

The position of the pushing arm 286, and consequently of the pushing edge 290 and the support plate 289, is adjustable thanks to the adjustment screws 292.

A further adjustment screw 291 rests on an elastic element 293, so as to keep the pushing arm 286 raised; this allows a softer and more comfortable contact between the patient's spine and the equipment and the possibility of driving in progressive correction even scoliosis with a high degree of vertebral rotation.

Furthermore, a further adjustment screw, defined thrust control 294, allows the translation of the thrust element 288, and consequently of the thrust edge 290 and of the support plate 289, in the transverse direction. More precisely, the thrust control 294 makes it possible to increase the pressure of the thrust edge 290 on the portion of the vertebral column, in particular on the corresponding spinous processes, on which the thrust edge 290 abuts.

Similarly to the adjustment screw 291, the thrust control 294 is also connected to the thrust element 288 through an elastic means 295.

Consequently, when the relative portion of the vertebral column rests on the thrust edge 290 and on the support plate 289, the elastic element 293 and the elastic means 295 are progressively compressed and absorb the load both in the vertical direction and in the horizontal direction. . At the same time, the elastic element 293 and the elastic means 295 allow a constant pressure on the column in a progressive way, accompanying the patient's torso in the predetermined position and maintaining an effective and sufficiently comfortable contact during the therapy.

The counter-thrust device 220, indicated in Figures 1, 2, 3, has the same conformation as the thrust device 218. The counter-thrust device 220 has, in fact, a thrust element 301 on which a thrust edge 302, a plate are fixed support 303 and a support 305 having the same functions as the analogous elements of the thrust device 218.

The counter thrust device 220 is adjusted directly by the patient through a thrust command 307, while the thrust command 294 of the thrust device 218 is connected to a return 298 secured to the arch 244.

The thrust device 218 and counter thrust 220 are equipped with two gas pistons 283 adjustable in rebound and compression. Their action causes the movable plane 285 to rise with respect to the base 284, transforming the respective support plates 289, 303 and the support plates 287, 305 into active pressers acting on the respective portions of the shoulder girdle of the back. Their activation is activated once the internal muscular relaxation of the scoliotic curves has been obtained, produced by the choral action of the equipment.

The movable plane in its thrusting action remains in the same position, there is no evident dynamic action that transforms into isometric exercise in the subsequent maintenance of the position, as in the thrust of the heels on the respective plates 420 or of the nape on the nape of the neck. headrest, even if the purpose is the same. In this case the action of the muscle is absolutely involuntary as the shoulder simply maintains its position, counteracting the slight but constant pressure it receives from the underlying plates. On the other hand, the stressed musculature is now the one that generally remained inactive because it was never subjected to contraction, nor until now could it be involved in any other way.

The regulation of the pressures of the pistons 283 will not be the same on both the thrust and counterthrust devices, but functional to the muscular development that will be obtained on the more deficient side, that is, inside the thoracic scoliotic curve. It is also advisable to increase the compression action on the device 293 through the adjustment screw 291, on the thrust or counter thrust device, opposite to the one where there is the greatest load of the piston. The antagonist musculature thus stimulated will oppose the curve and derotation in a completely natural way.

The arch 244, illustrated in figure 7, includes two vertical rods 304 which can be fixed to the wings 242 of the base support 212, and a crosspiece 306 which is fixed to the upper ends of the vertical rods 304 and to which the terminal portion is constrained referral 298.

Connected to the free end of the transmission 298 is a handle 300 which can be rotated so as to rotate the flexible pin included in the transmission 298 which, in turn, rotates the push control 294 and translates the Pusher 288 and the relative pusher edge 290 of pusher 218.

The thrusting edge 290 and the thrusting edge 302 have a conformation homologous to the portion of the vertebral column on which they must act, in particular to the conformation of the spinous processes; similarly, the support plate 289 and the support plate 303 have a conformation homologous to the transverse processes of the same portion of the vertebral column affected by the thrust edges 290, 302.

The conformation of the thrust edges 290, 302 and of the support plates 289, 303 are also elaborated on the basis of the action they must perform on the same column.

Naturally, the two pushing edges and the two support plates can be replaced with similar elements, but of different conformation, according to the shape of the portion of the vertebral column on which they must act and according to the curative action they have to perform.

Similarly, similar replacements can also be made for the other pressure elements which have a pushing or holding action on the respective transverse processes, spinous processes and on the costal areas, located on the pusher and support device 222 and present on the seat 214.

The arch 244, in addition to including the handle 300 to control the thrust command 294, also acts as a solid anchor to allow the patient to sit on the apparatus 210 and allow the correct positioning of the vertebral column at the edges of thrust 290, 302. In addition, the arch 244 acts as a grip for the patient during the pressure action of the pushing edges on the spinal column.

The pusher and support device 222, illustrated individually in Figures 11, 12, has a similar structure to the pusher device 218 and to the counter-thrust device 220, it comprises a support 308 which is suitably fixed to one of the anchoring planes 234 of the base support 212 in the desired position according to the build of the patient and the areas of the spine on which to intervene.

Hinged to the support 308 is a thrust arm 310 to whose free end a thrust and support structure 314 is fixed in a translatable manner, the position of which with respect to the support 308 can be adjusted by means of suitable adjustment screws.

The thrust and support structure 314 comprises a horizontal base 316 and a vertical base 318, fixed to the horizontal base 316.

A thrust element 312 is adjustably constrained to the vertical base 318, while a thrust element 320 is adjustably constrained to the horizontal base 316 at one end of which a thrust edge 322 is fixed. thrust 320 a support plate 321 is fixed which is adjacent to the thrust edge 322. Both the support plate 321 and the thrust edge 322 develop, in the illustrated case, with three different portions slightly inclined to each other so as to create an overall curved stroke.

An adjustable rib support plate 408 is centrally arranged on the thrust element 320, at the opposite end with respect to the thrust edge 322. Naturally, the dimensions in width, length and thickness can vary depending on the number of ribs that the therapist will want to involve in the correction.

The support plate 321 and the thrusting edge 322 are suitably positioned under pressure on the vertebral column, more particularly the thrusting edge 322 acts on the outermost and raised edge, i.e. on the spinous processes, of the portion of the vertebral column concerned, while the support plate 321 acts on the innermost edge, ie on the transverse processes of the same portion of the vertebral column in synergy with the adjustable rib support plate 408 positioned on the hump.

The horizontal base 316 and the thrust element 320 are moved in the same direction by a thrust command 324 which can be activated directly by the patient through a ratchet wrench with relative bushing, not shown in the figures.

The horizontal base 316, together with the vertical base 318, acts as a support and correction of the dorso-thoracic portion of the vertebral column.

The vertical base 318 is curved and has flexibility characteristics to conform to the costal curvature during the pressure action of the pushing edge 322 and the support plate 321. This flexibility is desired in order to be able to rotate, together with the ™ action of the various pushing edges, the three portions of the trunk (lumbar, thoracic and thoracic-cervical) in the opposite direction to that caused by scoliosis.

Naturally, both the pushing edge 322 and the horizontal base 316 and the vertical base 318 can be replaced by similar elements of different conformation, according to the patient's build and the curative needs.

For example, these elements can be replaced with thrusts obtained directly from the cast of the affected part of the patient's body.

The retaining device 224, illustrated individually in Figure 10, comprises a base 326 for fixing the same retaining device 224 to one of the anchoring planes 234 of the base support 212, depending on the position of the pusher and support device 222 with which forms a single body in the corrective action of the apparatus 210. In particular, the fixing of the base 326 to the anchoring surface 234 is made stable thanks to three C-shaped brackets 327 (one of which is not visible) which grip the same surface anchor 234 and base 326.

A main arm 328 is hinged to the base 326 by means of a connecting element 330. The main arm 328 is pushed by a piston 332 and is locked in a vertical position by a snap mechanism 333.

At the upper end of the main arm 328 there is a retaining base 336 which is fixed by means of a joint 338 to a tubular profile 340. This tubular profile 340 is movably constrained to the main arm 328 and can be fixed in position by means of a fixing screw 342.

The retention base 336, which can be obtained from the cast of the patient's chest, has an arched conformation and has the function of applying slight pressure to the upper side of the patient's chest so as to hold the patient in a precise position in order to allow an effective and safe action to the thrusts and counter-thrusts exerted by the various thrust edges 261, 290, 302, 322 on the spinal column.

In order to make the retaining device 224 act appropriately in collaboration with the pusher and support device 222, there are bands 344 on one side fixed to the retaining base 336 and on the other which can be fixed to the vertical base 318 of the same pusher and support 222. The fixing is obtained thanks to the pegs 346 present on the vertical base 318 which can be inserted in the holes obtained along the bands 344, so as to be able to fix the bands in variable positions according to the needs.

Each of the bands 344 comprises respectively a first wedge 410 and a second wedge 412, both of elastic material. Similarly, the retaining base 336 also has a third wedge 414 of elastic material at one end.

These three wedges 410, 412, 414 increase the derotation action and their adjustment is progressive and incrementable through the adjustment screws 416 placed on the external side of the tubular profile 340 for the third wedge 414, and through the pegs 346 for the first wedge 410 and the second wedge 412.

There is also in a central position on the restraint band, a triangular-shaped pushing edge made of elastic material, indicated in figure 13 with the reference 413. This element is inserted in the hollow area under the sternum and has the function of promoting derotation and prevent the correcting ribs from finding an escape route.

The retaining device 224 further comprises an unlocking device 334 operable by the patient through a handle so as to release the snap mechanism 333, causing the piston 332 to act, which pressures the retaining base 336 on the patient's chest.

A pin 331, placed between the two C-shaped brackets 327, acts as a stop for the connection element 330, so that the main arm 328 and the retaining base 336 are under pressure on the thorax without in any case exceeding a position, defined by the stroke end, which would cause trauma to the chest itself.

As illustrated in Figure 13, the support plate 321 arranged horizontally in the push and support device 222 illustrated in Figure 11 pushes from the bottom upwards on the transverse processes of a portion of vertebrae. This movement allows the vertebrae to be rotated in the opposite direction, which at the end of the movement find the thrusting edge 322 on which to rest the spinous processes vertically.

The ribs on both sides of the rachis are also involved in the movement as they are intimately linked to the transverse processes of the vertebrae that undergo the thrust action and the action of the support plate 408. This movement rotates part of the rib cage restoring its volumes. During the course of the therapy, after having loosened the muscular tensions, a further degree of correction is possible, through the translation of the entire thrust and support structure 314 which acts as a corrective element in the direction of the curve.

The corrective capacity of the thrust and support structure 314 is given by the synergy of the work carried out first by the support plate 321 and immediately following by the thrust edge 322.

Furthermore, the action of the upper lamella 255 is effective since its action is synergistic with the blocking of the pelvis and the first lumbar vertebrae, through the holding action produced by the first presser 258 and the second presser 263.

As indicated in figure 2, to each of the two sides 254 a knob 426 can be removed in a removable way to which the end of a rope 428 is fixed which passes through a passing element fixed to a bar 430 bound at the top to the sides 269 to support the feet.

At the opposite end of the rope 428 is fixed a weight that varies according to the body size 432, so that the patient can grip each knob 426. The holding action of the weights with the hands reproduces the force of gravity on the spine and the relative vertical load, which is missing in the supine position, reactivating the static musculature typical of the upright position but now functional to corrections. Furthermore, this traction of the arms along the body produces a frontal tension of rebalancing, antagonistic to the posterior muscle chains activated simultaneously by the thrust of the heels, the head and or the shoulder blades on the respective pressure devices.

The thrust device 218 and the counter thrust device 220, as well as the thrust and support device 222 and the retaining device 224, can be fixed on the anchoring planes 234 in different positions, even symmetrically inverted with respect to those illustrated in the mode embodiment described above, so that the various pushing edges 261, 290, 302, 322 can act on the portions of the vertebral column chosen according to the patient's needs.

Furthermore, similarly to the thrust edges 261, 290, 302, 322, also the horizontal base 316, together with the thrust element 320, the vertical base 318, the retaining base 336 and the bands 344 can be replaced by similar elements having a different conformation, but effective for the patient to be treated.

A person skilled in the art can foresee further modifications or variations which are to be considered included within the scope of protection of the present invention. For example, the bow may include a return to also control the thrust command of the counter-thrust device.

Furthermore, all the transmissions, mechanisms and commands can be operated by servomotors and / or with electric servo-assistances, operated and adjusted manually and / or assisted and managed by a computer.

It is also possible to insert systems for measuring the pressures exerted by the various components in contact with the patient, to the advantage of better management of the various pressure devices, so as to facilitate the pushing actions automatically or manually, by the patient or by an employee. possibly assisted by a computer.

Furthermore, the various pushing edges and the various support plates can be replaced by the corrective sling or by portions thereof suitably mounted on the devices of the apparatus 210 suitable for controlling its position and movement.

Claims (1)

CLAIMS 1) Apparatus (210) for the treatment of the vertebral column on which a person, for example suffering from scoliosis, lies lying down and supine, being the vertebral column comprising spinous processes and transverse processes, characterized by the fact of including: - a basic support (212), - at least a first thrust device (218, 258) joined to the base support (212) and comprising a first thrust edge (290, 261, 273) positioned under pressure on a first portion of the vertebral column in a first direction, - at least a second thrust device (220, 222) joined to the base support (212) and comprising a second thrust edge (302, 322) positioned under pressure on a second portion of the vertebral column, adjacent to the first portion of the vertebral column , according to a second direction; being the first pushing edge (290, 261, 273) and the second pushing edge (302, 322) arranged and acting on opposite sides of the vertebral column - at least a first support plate (289, 260, 275) arranged on the first thrust device (218, 258) and adjacent to the first thrust edge (290, 261, 273) in a more external position than said first thrust edge (290, 261, 273); - at least a second support plate (303, 321) arranged on the second thrust device (220, 222) and adjacent to the second thrust edge (302, 322) in a more external position than said second thrust edge (302, 322) ; in which the first support plate (289, 260, 275) and the second support plate (303, 321) act on the transverse processes of the relative portion of the vertebral column, and the first pushing edge (290, 261, 273) and the second pushing edge (302, 322) act on the spinous processes of the same portion of the vertebral column. 2) Apparatus (210) according to claim 1, wherein at least one of said first thrust device (218, 258) and second thrust device (220, 222) comprises at least one thrust control (294, 324) also adapted to adjust the position of at least one of said first pushing edge (290, 261, 273), second pushing edge (302, 322), first support plate (289, 260, 275) and second support plate (303 , 321), with respect to the base support (212), so as to vary the pressure carried out by the first pushing edge (290, 261, 273), and / or by the second pushing edge (302, 322), and / or from the first support plate (289, 260, 275) and / or from the second support plate (303, 321) on the respective portion of the vertebral column. 3) Apparatus (210) according to claim 2, in which transmission means (298) connected to at least one thrust control (294, 324) are included, said transmission means (298) being able to control the at least one push control (294, 324) and operated by the person lying on the equipment (210). 4) Apparatus (210) according to one of the preceding claims, comprising a seat (214) adjustably fixed to the base support (212) and comprising: - a seat surface (246) fixed in a movable way to the seat (214) and on which the person can rest the pelvis, - at least two side rails (254), which can be positioned in an adjustable way, to contain the pelvis laterally, - an upper blade (255) fixed in an adjustable way to the upper extremity of each of the two sides (254), so that the patient's pelvis is all included between the seat surface (246), the two sides (254) and the upper lamella (255). 5) Apparatus (210) according to one of the preceding claims, wherein at least one of said first thrust device (218, 258) and second thrust device (220, 222) comprises a support structure (316, 318) so shaped homologous to the torso portion corresponding to the portion of the vertebral column on which the first pushing edge (290, 261, 273) and / or the second pushing edge (302, 322) and / or the first support plate (289, 260 , 275) and / or the second support plate (303, 321) act. 6) Apparatus (210) according to one of the preceding claims, comprising a retaining device (224) adjustably fixed to the base support (212) and comprising a retaining base (336) acting under pressure on a portion of the torso corresponding to the portion of the vertebral column on which the first pushing edge (290, 261, 273) and / or the second pushing edge (302, 322) and / or the first support plate (289, 260, 275) and / or the second support plate (303, 321) act. 7) Apparatus (210) according to claim 6, wherein the retaining device (224) comprises elastic means (332) adapted to pressurize the retaining base (336) on the torso portion and control means (334) adapted to to activate or deactivate the elastic means (332). 8) Apparatus (210) according to the preceding claim, wherein a foot rest (266) is included, movably fastened to the base support (212) and connected to the seating surface (246). 9) Apparatus (210) according to one of the preceding claims, in which a head support (216) is included, fixed in an adjustable manner to the base support (212) and comprising: - a first support plane (274) fixed to the base support (212) in an adjustable way; - a second support plane (276) movably constrained to the first support plane (274) so as to be able to translate in a vertical direction with respect to the base support (212), - a cushion (282) fixed in a translatable way to the second support surface (276) by means of slides; - an elastic element able to oppose the movement of the cushion (282) with respect to the second support plane (276). 10) Apparatus (210) according to one of the preceding claims, wherein at least one tampon (287, 402, 403, 408, 410, 412, 413, 414) made of elastic material suitable for contacting the patient's body is included and to assist the action of the first pushing edge (290, 261, 273), and / or the second pushing edge (302, 322) and / or the first support plate (289, 260, 275) and / or of the second support plate (303, 321).