WO2017098463A1

WO2017098463A1 - Cervical spine traction apparatus

Info

Publication number: WO2017098463A1
Application number: PCT/IB2016/057488
Authority: WO
Inventors: De la Rey Hertzog Scheepers BADENHORST; Johannes Hendrik Davis
Original assignee: Stellenbosch University
Priority date: 2015-12-09
Filing date: 2016-12-09
Publication date: 2017-06-15

Abstract

A cervical spine traction apparatus is provided. The apparatus includes a bed (3) with a head end (5) and a foot end and is characterised in that an arm assembly (9) is pivotally secured to the bed at or near the head end (5). A traction device (25) is located at or near the free end of the arm assembly and is configured to apply a tractive force to a patient's head (102) in a direction from the bed end towards the free end of the arm. Pivoting module (50) is provided to operatively pivot the arm assembly relative to the bed while a tractive force is being applied by the traction device. A cervical spine traction unit comprising an arm assembly, a traction device and a pivoting module is also provided.

Description

CERVICAL SPINE TRACTION APPARATUS

CROSS-REFERENCE(S) TO RELATED APPLICATIONS

This application claims priority from South African provisional patent application number 2015/08967 filed on 9 December 2015, which is incorporated by reference herein.

FIELD OF THE INVENTION

This invention relates to cervical spine traction apparatus which can be used to cause distraction of the vertebrae to enable reduction of these through flexion and extension.

BACKGROUND TO THE INVENTION

Neck injuries often result in the misalignment of the cervical vertebrae. If untreated this condition can lead to permanent paralysis, yet the treatment can be fairly simple. In what is referred to as distraction, traction is used to extend the patient's neck to separate the joint surfaces of the cervical vertebrae without rupture of their binding ligaments and without displacement of the vertebrae. Reduction then takes place by flexing the neck to cause disengagement of the vertebrae. Hereafter the neck is straightened and then allowed to resume its relaxed condition with a consequent realignment of the vertebrae.

In practice this is achieved by laying the patient in a bed and securing a head clamp to his head. The head clamp typically has a pair of pins which secure to the skull of the patient on opposite sides of his head. A rope is then secured to the clamp, fed over a pulley, and weights then secured to the free end of the rope while holding the patient's feet to prevent him being pulled up the bed. With sufficient weight added, extension of the neck can be achieved and, while under extension, the head lifted to cause flexion of the neck. Although relatively effective, this method of performing neck distraction suffers the disadvantages that it cannot be accurately controlled or reproducibly performed.

The preceding discussion of the background to the invention is intended only to facilitate an understanding of the present invention. It should be appreciated that the discussion is not an acknowledgment or admission that any of the material referred to was part of the common general knowledge in the art as at the priority date of the application. SUMMARY OF THE INVENTION

In accordance with this invention there is provided a cervical spine traction apparatus including a bed with a head end and a foot end and characterised in that an arm assembly is pivotally secured to the bed at or near the head end such that a free end of the arm assembly is remote from the bed, with a traction device at or near the free end of the arm assembly and configured to apply a tractive force to a patient's head in a direction from the bed towards the free end of the arm, and a pivoting module operable to pivot the arm assembly relative to the bed while a tractive force is being applied by the traction device.

Further features of the invention provide for the traction device to include a measuring component to measure and display the tractive force being applied; and for there to be a control unit to maintain a user determined tractive force during pivoting of the arm assembly. Still further features of the invention provide for a head support to be provided which extends from the head end of the bed; and for the head support to be movable in a generally upward direction.

A yet further feature of the invention provides for the arm assembly to be non-occlusive to laterally directed cervical X-rays of a patient on the bed; and.

According to one embodiment of the invention the arm assembly includes a pair arms, each pivotally secured to a side of the bed.

According to a further embodiment of the invention the arm assembly is made of a substantially X-ray transparent material.

Still further features of the invention provide for the traction device to be electrically operated; and for the measuring component to include one or more load cells for measuring the applied tractive force.

Even further features provide for the pivoting module to pivot the arm assembly through an electrically operated device; for the electrically operated device to be programmable by the user to define its parameters of operation; for the parameters of operation to be selected from the maximum tractive force and the maximum limit to travel of the arm assembly.

Yet further features provide for the traction device and pivoting module to be operated through a control unit interface located on the bed or remote therefrom. The invention also provides a cervical spine traction unit comprising an arm assembly, a traction device and a pivoting module, characterised in that the arm assembly is pivotally securable to a bed at or near the head end of the bed, the traction device is connectable to the arm assembly at or near a free end thereof and is configured to operatively apply a tractive force to a patient's head in a direction from the bed end towards the free end of the arm assembly, and the pivoting module is operable to pivot the arm assembly relative to the bed while a tractive force is being applied by the traction device.

Further features of the invention provide for the cervical spine traction unit to be releasably securable to a bed; for the traction device to include an electric motor configured to apply the tractive force by electromechanical means; and for the traction device to include one or more load cells for measuring the applied tractive force.

An embodiment of the invention will now be described, by way of example only, with reference to the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings:

Figure 1 is a side elevation of a first embodiment of a cervical spine traction apparatus in use with a patient; and

Figure 2 is a side elevation of the cervical spine traction apparatus in Figure 1 ;

Figure 3 is a top plan view of the head end of the cervical spine traction apparatus in Figure 1 ; and

Figure 4 is a top plan view of the head end of a second embodiment of a cervical spine traction apparatus with a control unit and user interface and a tractive device which includes an electric motor.

DETAILED DESCRIPTION WITH REFERENCE TO THE DRAWINGS A cervical spine traction apparatus is provided for performing neck distraction and reduction in a safe, controlled and reproducible manner. The apparatus includes a bed with a head end and a foot end and an arm assembly pivotally secured to the bed at or near the head end. The arm assembly may be secured to the bed at a proximal end with a distal, free end of the arm assembly remote from the bed. A traction device is secured at or near the free end of the arm assembly. The traction device is configured to apply a tractive force to a patient's head in a direction from the bed end towards the free end of the arm assembly and may be hand operated or electrically operated. By "electrically operated" is meant a mechanism which requires the use of electricity to some degree, including hydraulic systems employing electrically operated hydraulic pumps, and mechanical gears or similar mechanisms operated by an electric motor.

A pivoting module is provided to operably pivot the arm assembly relative to the bed while the tractive force is being applied by the traction device.

The traction device may include a measuring component to measure and display the tractive force being applied. The measuring component may be in the form of a scale or balance which may be either mechanical or electronic. A control unit may be provided to maintain a user determined tractive force during pivoting of the arm assembly. The control unit may be an electrical controller in communication with the traction device. In other embodiments the control unit may be any suitable mechanical means for maintaining the tractive force, such as a tension controller. The apparatus may include a head support for supporting a patient's head during the neck distraction process. The head support may be movable in a generally upward direction and may extend from the head end of the bed.

The arm assembly may include a pair of arms with each arm pivotally secured to a side of the bed. In other embodiments, the arm assembly may be secured to one or more positions at or near the head end of the bed. For example, the arm assembly may include two arms pivotally secured to the head of the bed which are spaced apart in order to accommodate a patient's head therebetween. In further embodiments, the arm assembly may include one arm pivotally secured at or near the head of the bed, or alternatively, more than two arms.

The pivoting module which acts on the arm assembly may be electrically operated, including through mechanical and hydraulic actuators. In other embodiments, however, the pivoting module may be manually operable, for example, by way of a hand operated hydraulic jack. The pivoting module and traction device may be programmable, through the control unit, by the user to define their parameters of operation which may be selected from the maximum tractive force and the maximum limit to travel of the arm assembly. The cervical spine traction apparatus may be provided in the form of a unit which includes an arm assembly, a traction device and a pivoting module, which unit may be releasably securable to a bed at or near the head end. The apparatus can thus be moved between beds. The arm assembly of the unit may be pivotally securable to the bed at or near the head end with a free end of the arm assembly remote from the bed, in an analogous manner to the apparatus described above. The traction device may be connectable to the arm assembly at or near the free end and may be configured to apply a tractive force to a patient's head in a direction from the bed end towards the free end of the arm assembly. A pivoting module may be operable to pivot the arm assembly relative to the bed while the tractive force is being applied by the traction device. In the unit, the traction device may include an electric motor for applying the tractive force.

One embodiment of a cervical spine traction apparatus (1 ) is shown in Figures 1 to 3 and includes a bed (3) which as a head end (5) and a foot end (7). An arm assembly (9) is pivotally secured to the head end (5) of the bed (3). In this embodiment the arm assembly (9) includes a pair of arms (1 1 ) secured to opposite sides of the bed (3) each through a shaft (13) which extends normally from the proximal end (15) of each arm (1 1 ) and is secured through a bearing assembly (17) to the bed (3). The shafts (13) provide a pivot point or access for the arm assembly (9).

The arms (1 1 ) extend generally parallel to the sides of the bed (3) for a short distance from the proximal end (15), whereafter each is bent through approximately 90 ° and inclined towards the other. The arms (1 1 ) are thus generally v-shaped in elevation as illustrated in Figures 1 and 2. A pair of spaced-apart cross members (19, 21 ) extend between the distal or free end (23) of the arms (1 1 ) and a traction device (25) is secured to the cross members (19, 21 ) such that a tractive force may be applied in a direction from the bed towards the free end (23) of the arm assembly (9). A measuring component (39) is provided to measure and display the tractive force applied by the traction device (25).

In the embodiment shown the Figures 1 -3, the traction device (25) includes a plate (27) which extends centrally between the arms (1 1 ) and is secured to the cross members (19, 21 ). A pair of arms (29) extending from the plate (27) carry between them a threaded sleeve (31 ) in which is rotatably mounted a complementarily threaded shaft (33) which extends generally normally to the head end (5) of the bed (3). A cranked handle (35) is secured to the end (37) of the shaft (33) opposite the plate (27). A hanging scale (39) is secured to the free end (41 ) of the shaft (33) through a bearing (43) which permits the shaft (33) to rotate without similarly rotating the hanging scale (39).

A pivoting module (50) is provided and, in this embodiment, includes a hydraulic jack (52) mounted between the legs (54) of the bed (3) adjacent the head end (5) and inclined towards the free end (23) of the arm assembly (1 1 ). A rod (54) is pivotally secured at one end (56) to the cross member (19) at the free end (23) of the arm assembly (9). The opposite end (58) locates on the ram (60) of the hydraulic jack (52) and is held in place by a circumferential flange (62), which extends over the end of the ram (60).

A head support (70) is provided at the head end (5) of the bed (3) and includes a plate (72) carried on an arm (74) which extends centrally from the end (5) of the bed (3) in generally the same plane as the bed (3). The arm (74) is pivotally secured to the bed (3) to be movable in a generally upward and downward direction. In the embodiment illustrated in Figures 1 to 3, the head support is moved up and down through operation of a cranked handle (78) at the foot end (7) of the bed (3) which can be used to rotate a shaft (80) extending the length of the bed which carries a worm gear (82) at its free end which operates a worm wheel (not shown) on the arm (74). In other embodiments, the head support (70) may be moved up and down by an electric motor. Restraining straps (90) are provided and extend generally from the head end (5) to the foot end (7) of the bed (3).

In use, a patient (100) is placed in a supine position on the bed (3) with his head (102) resting on the plate (72). Using the handle (78) the position of the head support (70) is appropriately adjusted. A head clamp (1 10) having a pair of arms (1 12) hingedly secured together is then secured on opposite sides of the patient's head (102) by means of pins or cones (1 14). The restraining straps (90) are secured over the patient's shoulders and the head clamp (1 10) then secured to the scale (39). A tractive force is then applied to the patient's head (102) through the traction device (25). In the embodiment shown in Figures 1 to 3, the tractive force is applied by rotating the handle (35) so as to draw the head (102) towards the free end (23) of the arm assembly (9). In some embodiments, the pivoting module may be driven by an electric motor and may include a geared assembly or a hydraulic assembly.

The tractive force is depicted on the scale (39) and can thus be measured in this manner. The tractive force is gradually increased over a period of time to between 15 and 80 kilograms. The force required to separate the cervical vertebrae (104) varies from patient from patient, but is typically in the region of 15 to 30 kilograms. When sufficient tractive force has been applied to separate the cervical vertebrae (104) sufficiently to cause distraction thereof, the pivoting module (50) is operated to pivot the arm assembly (9) upwardly to cause the patient's head (102) to move upwardly and the neck to bend or flex. During this movement the tractive force is monitored and maintained at a generally constant level. Once full flexion of the cervical vertebrae (104) has been achieved, the arm assembly (9) is moved slowly downwardly once more through the pivoting module (50) until the patient's head (102) is once more horizontal with the body and the tractive force then slowly decreased until zero force is applied. Such extension and flexion of the vertebrae normally has the effect of realigning the misaligned vertebrae resulting in reduction of the cervical vertebrae. This can be confirmed through a lateral X-ray of the neck. The generally V-shape of the arms (1 1 ) facilitates such X-rays being taken and the arms are non-occlusive as they extend downwardly from the pivot point (13) to be below the head support before extending upwardly once more. The shape also facilitates X-rays being taken during flexion of the neck.

The cervical spine traction apparatus is relatively simple to operate and has proven highly effective at performing neck distraction and reduction in a safe, controlled and reproducible manner. It will be appreciated, however, that many other cervical spine traction apparatuses exist which fall within the scope of the invention, especially as regards the configuration and operation thereof. For example, the arm assembly can have any suitable shape and could be constructed of an X-ray translucent material. Any suitable tractive device can be used. In the embodiment illustrated in Figure 4, an electric motor (1 16) is provided for applying a tractive force by electromechanical means. One or more load cells (not shown) associated with the motor may be provided for measuring the applied tractive force. It is also envisaged that the tractive device (25) and pivoting module (50) could be operated through a control unit (120) which may include a user interface (1 18) located on the bed or remote therefrom which can be used to maintain the tractive force during pivoting of the arm assembly and which may also be programmable by the user to define its parameters of operation, for example, the maximum tractive force and the maximum limit to travel of the arm assembly.

It is also foreseen that the arm assembly, traction device and pivoting module could be supplied as a unit separate from the bed and configured to be releasably securable to a bed. The arm assembly, traction device and pivoting module of the separate unit may independently include any of the aforementioned technical features, including but not limited to an electrical motor for electromechanically applying the tractive force, one or more load cells for measuring the applied tractive force, an electromechanical means, such as a motor, for driving the pivoting module and a control unit for maintaining the tractive force during pivoting of the arm assembly. The control unit may be programmable by the user to define its parameters of operation.

Throughout the specification and claims unless the contents requires otherwise the word 'comprise' or variations such as 'comprises' or 'comprising' will be understood to imply the inclusion of a stated integer or group of integers but not the exclusion of any other integer or group of integers.

Claims

CLAIMS:

1 . A cervical spine traction apparatus including a bed with a head end and a foot end and characterised in that an arm assembly is pivotally secured to the bed at or near the head end to have a freed end remote from the bed with a traction device at or near the free end of the arm assembly, the traction device configured to apply a tractive force to a patient's head in a direction from the bed end towards the free end of the arm, and a pivoting module operable to pivot the arm assembly relative to the bed while a tractive force is being applied by the traction device.

2. A cervical spine traction apparatus as claimed in claim 1 , wherein the traction device includes a measuring component to measure and display the tractive force being applied.

3. A cervical spine traction apparatus as claimed in claim 1 or claim 2 which includes a control unit to maintain a user determined tractive force during pivoting of the arm assembly.

4. A cervical spine traction apparatus as claimed in any one of the preceding claims further comprising a head support which is movable in a generally upward direction and which extends from the head end of the bed.

5. A cervical spine traction apparatus as claimed in any one of the preceding claims, wherein the arm assembly is non-occlusive to laterally directed cervical X-rays of a patient on the bed.

6. A cervical spine traction apparatus as claimed in any one of the preceding claims, wherein the arm assembly includes a pair of arms with each arm pivotally secured to a side of the bed.

7. A cervical spine traction apparatus as claimed in any one of the preceding claims, wherein the arm assembly is made of a substantially X-ray transparent material.

8. A cervical spine traction apparatus as claimed in any one of the preceding claims, wherein the traction device is electrically operated.

9. A cervical spine traction apparatus as claimed in any one of claims 2-8, wherein the measuring component includes one or more load cells.

10. A cervical spine traction apparatus as claimed in any one of the preceding claims, wherein the pivoting module is electrically operated.

1 1 . A cervical spine traction unit which includes an arm assembly with a traction device and a pivoting module thereon, and characterised in that the arm assembly is pivotally securable to a bed at or near the head end of the bed with a free end of the arm assembly remote from the bed and the traction device configured to apply a tractive force to a patient's head in a direction from the bed towards the free end of the arm assembly, and the pivoting module operable to pivot the arm assembly relative to the bed while a tractive force is being applied by the traction device.

12. A cervical spine traction unit as claimed in claim 1 1 which is releasably securable to a bed.

13. A cervical spine traction unit as claimed in claim 1 1 or claim 12, wherein the traction device is electrically operated.

14. A cervical spine traction unit as claimed in any one of claims 1 1 to 13 in which the pivoting module is electrically operated.