RU221086U1 - Scoliometer - Google Patents

Abstract

The utility model relates to medicine, orthopedics, pediatric orthopedics and concerns the improvement of a device - a scoliometer, designed to determine the degree of curvature of the spine. The scoliometer contains a rectangular elongated plate with a wide long frontal edge and four narrow edges perpendicular to it - upper, lower and two end ones, with an arcuate mounting recess on the long narrow lower edge and a digital scale in degrees printed along an arcuate level having an arc directed downward, in the form of a hermetically sealed tube with a movable internal pointer, mounted on the wide front edge of the plate. The elongated plate is made of plastic and equipped with grooves for manual holding, which are located on both end faces of the plate with a pitch of 0.5 cm, a depth of 0.1 cm and oriented perpendicular to the wide front edge of the plate. In this case, the movable pointer is made in the form of a metal ball, and the arcuate mounting recess is made with a bend for the spinous process of the vertebra. The technical result of the proposed utility model is to increase the accuracy of scoliometry results by eliminating the effect of the medical specialist's hands slipping during the measurement process. 2 ill., 1 pr.

Description

The utility model relates to medicine, orthopedics, pediatric orthopedics and concerns the improvement of a device - a scoliometer, designed to determine the degree of curvature of the spine.

State of the art

Scoliometers have been known for more than half a century and almost all of them are created based on the principle of such a device as a building level.

There is a known scoliometer (Willner S. Spinal pantograph - a noninvasive anthropometric device for describing postures and asymmetries of the trunk // J. Pediatr. Ortop., 1983, v.3, p.245-249), which is a plate with a A U-shaped tube containing a metal ball. When installing the plate strictly vertically on the back of the subject, who is in a forward tilt position, the ball deviates to the left or right when there is asymmetry in the paravertebral region due to scoliotic deformity.

A known scoliometer (KR 20200111414 A, SHIN KWANG CHEOL, ICR) includes a housing with a groove open at the front and rear on the lower edge of the housing. Attached to the front of the scoliometer body is a transparent tube that seals liquid. In addition, a ball is placed in the inner part of the tube, the force of gravity of which acts on the liquid. The tube has a shape that is concavely bent upward. A scale indicating the angle along the tube is displayed on the front of the scoliometer body. When the scoliometer body is tilted even slightly, the ball deviates from the zero scale under the influence of gravity.

A device for measuring the angle of rotation of a patient’s torso is also known (US 5181525 A. Scoliosis screening device. BUNNELL WILLIAM P, US). It contains a support plate having a U-shaped groove (groove) in it and a lower edge that contacts the patient during measurement, a U-shaped hole from the specified edge of the specified plate that contacts the patient during measurement. A transparent U-shaped tube is attached to said support plate in a groove (groove). This tube is filled with liquid and contains a ball indicator. The edge of said plate, which is in contact with the patient, is generally straight and has a semicircular recess in it to accommodate the patient's spine. Said plate has markings to indicate the angle of rotation of the torso, which is indicated by the position of a ball indicator in said U-shaped tube. The liquid may be water. The ball is made of stainless steel. The plate is made of polystyrene.

Other types of scoliometers are described similarly. For example, according to https://zdravmedionform.ru/classificator-vidov-meditcinskikh-izdeliy/kod-369720.html, Nomenclature Classification of Medical Devices, a scoliometer is a non-drive, manually controlled measuring device, with a division value in degrees, designed to measure axial rotation spine to evaluate scoliosis. The scoliometer is placed across the patient's back, centered over the spinous process, after the patient bends forward to measure the degree of axial rotation of the spine in different parts (thoracic, lumbar). The device is a plastic rectangular ruler with a curved degree scale, usually with a notch centered above the spine, and contains a small ball that rolls on the scale to indicate the degree of axial rotation of the spine. It is a reusable product (10.22. Medical devices of type 369720 in the State Register of Medical Devices and Organizations engaged in the production and manufacture of medical devices. Medical devices of type 369720 in the Register of Clinical Trials of Medical Devices).

All of the listed products are made, as a rule, of smooth plastic, which makes them quite slippery in the hands of a medical specialist performing scoliometry with the patient tilted anteriorly (Adams test), which, in turn, can cause a decrease in the accuracy of measurements.

As the closest analogue (prototype) of the proposed scoliometer, we considered the well-known scoliometer (Fig. 1), produced with the support of RASMIRBI - Russian Association for Sports Medicine and Rehabilitation of the Sick and Disabled (https://skolios.ru/skoliometriva. Electronic resource: saved online 20.03 .2023 on the web archive website https://web.archive.org/web/20230320120442/https://skolios.ru/skoliometriya.

This device allows you to objectively and quantitatively diagnose rotational changes in the spine both in the early stages of diagnosis (detection and initial diagnosis) and during treatment and follow-up (screening).

This device also has smooth plastic surfaces, including the side (end) surfaces, by which the device is held by a medical specialist when taking measurements (Fig. 2).

Thus, the technical problem lies in improving the parameters of the known scoliometer, namely, in eliminating the effect of the medical specialist’s hands slipping while using the scoliometer by making the side surfaces (narrow end faces) of this device corrugated - with transverse notches applied to them that prevent the hands from sliding along the narrow end faces of the scoliometer.

Disclosure of the essence of the utility model

The technical result of the proposed utility model is to increase the accuracy of scoliometry results by eliminating the effect of the medical specialist's hands slipping during the measurement process.

To achieve this technical result, this utility model is proposed.

The proposed scoliometer contains a rectangular elongated plate with a wide long frontal edge and four narrow edges perpendicular to it - upper, lower and two end ones, with an arcuate mounting recess on the long narrow lower edge and a digital scale in degrees printed along an arcuate level having an arc directed downward , in the form of a hermetically sealed tube with a movable internal pointer, mounted on the wide front edge of the plate.

Moreover, the elongated plate is made of plastic and equipped with grooves for manual holding, which are located on both end faces of the plate with a pitch of 0.5 cm, a depth of 0.1 cm and oriented perpendicular to the wide front edge of the plate.

In this case, the movable pointer is made in the form of a metal ball, and the arcuate mounting recess is made with a bend for the spinous process of the vertebra.

This useful model is based on the well-known RASMIRBI scoliometer, improved by applying transverse notches (corrugations) during its production to its narrow end faces with a step of 0.5 cm, a corrugation depth of 0.1 cm. This step is the most convenient when setting parameters molding the device from plastic, and ensuring that the medical specialist’s hands do not slip during the process of scoliometry, since it requires time-extended movement of the device along the entire spine over the spinous processes of the vertebrae when the patient performs a forward bend (Adams test), with the specialist recording the measurement results in degrees, which are displayed on the instrument scale.

It is advisable to make notches on not one, but both narrow end faces of the scoliometer, taking into account the fact that when conducting scoliometry, it may be more convenient for a medical specialist to hold the device with both the left and right hand.

Otherwise, this scoliometer is a copy of the famous prototype from RASMIRBI.

Brief description of drawings

Figure 1 shows a view of the wide, long frontal edge, narrow lower and end edges of the prototype scoliometer. All surfaces of this device are made of smooth plastic.

Figure 2 shows the moment of measurement of spinal curvature when a patient performs the Adams test using a prototype device. In this case, the measurement result shows a deviation of the instrument scale by 7.5 degrees, which indicates the presence of scoliosis in the studied part of the spine. A medical specialist, standing at the side and behind the patient, holds the device by its left narrow end edge when taking measurements.

Implementation of a utility model

The proposed corrugated scoliometer can be produced by producing plastic products by injection molding. Thus, mass production of plastic parts involves a technological process of injecting molten plastic under high pressure into a prepared injection mold made of metal. The liquid mass evenly fills the volume and crystallizes, acquiring the required shape. Almost half of the polymer parts are produced using this method. Thermoplastic granules and thermosetting powders are used as raw materials for the production process, giving the finished products the required physical and performance qualities. Thermoplastic components retain their parameters during recycling, while thermosetting components undergo irreversible chemical reactions and form an infusible material [Electronic resource: Plastic injection molding technology, 10.25.2019, https://delfaservice.ru/blog/tehnologiva-litya-plastmass-pod -davleniem/, date of posting in the online environment: 06.23.2023, web archive address: https.7/web.archive.org/web/20230610011840/https://delfaservice.ru/blog/tehnologiya-litya-plastmass-pod- davlemem/]. Components for medical equipment are also produced this way. Plastic injection molding technology is characterized by high casting precision. Thanks to the injection of the molten mass at an increased speed, uniform filling of the mold, including microscopic elements, is ensured. The method makes it possible to produce products of any geometric shape and degree of complexity, as well as thin-walled parts. The complexity of the design depends on the mold, which is highly detailed and takes into account all the bends and holes of the future product.

The process, organized using injection molding technology, is carried out in stages. Complex work consists of preparatory operations and product formation. Preparatory work involves 3D modeling of future products, after which a prototype is made, which is a sample of the part being produced. To speed up the process, modern equipment is used - printers that perform 3D printing. The manufactured prototype allows you to evaluate, test under extreme loads and test the finished product. If inaccuracies and defects are detected, changes are promptly made to the three-dimensional model until an ideal part is obtained that meets all requirements.

Designing molds. At this stage, all features (lines, bends, etc.) are worked out based on the approved 3D model.

Forms are made to be filled with the molten mass. For this purpose, the three-dimensional model is “broken” into parts. Each resulting element is manufactured separately. At the last stage, the parts are assembled into a form.

When the first piece is cast from plastic, it is carefully checked and tested. If inaccuracies are found, the injection mold is modified.

The process of forming products involves the gradual melting of components and supply of the melt into the mold, creating pressure for the purpose of rapid filling and uniform distribution of the polymer mass over the mold, cooling the filled volume until the plastic completely hardens. The time required for polymer crystallization depends on many parameters: the type of plastic used, melt viscosity, temperature in the mold, etc. For oversized parts, the cooling process lasts for several seconds. After complete cooling, the mold is removed to obtain the part.

Thus, notches (corrugations) should be planned at the stage of preparing the metal mold for smelting the device. Or they can be applied to a finished prototype product by a mechanical method using known products such as files, or by a laser method.

Before performing scoliometry on the patient, the medical specialist treats the scoliometer with a suitable disinfectant. The Adams test is performed - the patient is asked to slowly lean forward as much as possible, after which the scoliometer is installed strictly vertically (with the wide, long frontal plane of the scoliometer perpendicular to the floor) with an arcuate mounting recess above the spinous process of the 7th cervical vertebra and the readings of the instrument scale are recorded in degrees.

Then the device is gradually moved lower along the sections of the spine, installing strictly vertically at specified intervals above the spinous processes of other vertebrae, for example, sequentially 3-4, 7, 12 thoracic, 4 lumbar, each time recording the readings of the device scale in degrees. By the degree of deviation of the movable internal pointer (ball) in the arcuate level on the wide, long frontal edge of the plate, the degree of scoliosis and, accordingly, the planned treatment are judged.

The presence of notches (corrugations) on the end surfaces of the scoliometer with a step of 0.5 cm and a depth of 0.1 cm prevents the hands of a medical specialist from slipping off the device during such measurements, which reduces the risk of inaccuracies in measurements.

Example.

Scoliometry was performed on a 13-year-old teenage girl. The radiograph shows an arc of curvature of the spine to the left with an apex at L3 of 9 degrees, which corresponds to the first degree of scoliosis (according to the classification - up to 10 degrees).

In the process of scoliometry using a prototype device with smooth narrow end faces, its scale at the level of the lumbar spine showed 4 degrees of torsion (deviation), which only refers to poor posture (according to the classification developed for scoliometry, torsion values: up to 2 degrees - normal, range of readings from 3 to 5 - poor posture, more than 5 degrees - scoliotic deformity).

Moreover, when measured using the proposed device with notches (corrugations) on narrow side end edges that prevent the hands of a medical specialist from slipping, the scale readings when examining the lumbar spine corresponded to the presence of scoliotic deformity - 6 degrees of deviation (torsion). That is, such results are more accurate and closer to the readings of the gold standard for diagnosing scoliosis - radiography of the spine. This more accurate screening diagnosis facilitates faster initiation of appropriate therapy to prevent the progression of scoliosis, especially in children and adolescents.

When taking measurements, the medical specialist noted a subjectively more comfortable holding of the device in his hand, which increased his confidence in the accuracy of the measurement results.

Claims (1)

A scoliometer containing a rectangular elongated plate with a wide long frontal edge and four narrow edges perpendicular to it - upper, lower and two end ones, with an arcuate mounting recess on the long narrow lower edge and a digital scale in degrees printed along an arcuate level having an arc directed downward , in the form of a hermetically sealed tube with a movable internal pointer, mounted on the wide front edge of the plate, characterized in that the elongated plate is made of plastic and equipped with grooves for manual holding, which are located on both end faces of the plate with a pitch of 0.5 cm, depth 0 .1 cm and oriented perpendicular to the wide frontal edge of the plate, while the movable pointer is made in the form of a metal ball, and the arcuate mounting recess is made with a bend under the spinous process of the vertebra.