Surgical table accessory platform

A support 56, 256, 356 for use with a surgical table 40, 140, 240, 340, 400 includes a first radiolucent beam 58, 258, 464 having a longitudinal axis and a second radiolucent beam 59, 259, 466 having a longitudinal axis. The first beam 58, 258, 464 and second beam 59, 259, 466 are each coupled to the deck 52, 252, 352 and extend outwardly therefrom in a cantilevered configuration.

BACKGROUND OF THE INVENTION

The present disclosure is related to a radiolucent platform for a surgical table. More specifically, the present disclosure is related to a radiolucent structure which attaches to a surgical table in order to support the torso of a patient positioned on the table for improved imaging access during spinal or neurosurgery.

Typical surgical tables used for orthopedic surgery are constructed from two telescoping columns mounted on a cart base and a rectangular-shaped radiolucent tubular support frame. Accessories are available to be mounted to the table frame to provide padded points for supporting a patient.

Other surgical tables used for general surgery have metal accessory rails and generally a metallic framework. The metallic framework limits x-ray imaging of a patient during surgery due to interference of the metallic components.

Extensions and radiolucent attachments have been developed for use with the general surgical tables to provide improved x-ray imaging such as is available on the typical orthopedic surgical tables. A diversity of manufacturers have proliferated a number of different dimensions and standards for accessories to be attached. This reduces the ability of a hospital to use standard accessories across multiple surgical platforms. However, many surgical table manufacturers have standardized rail sizes and widths.

With regard to spinal surgery specifically, the two most common types of lumbar spine surgery procedures are trans-vertebral fusions and inter-body micro-diskectoies. In a trans-vertebral, two vertebrae are fused together, which is best performed when the patient's spine is positioned in a natural “swayback” state. During an interbody micro-disketomy a small portion of the intervertebral disk is removed to alleviate pain; thereby making it beneficial to position the patient in a somewhat fetal or flexed position to stretch open the bony facets of the back.

SUMMARY OF THE INVENTION

In one aspect of this disclosure, a cantilevered support for use with a surgical table includes a first radiolucent beam having a longitudinal axis and a second radiolucent beam having a longitudinal axis. The first beam and second beam are each coupled to the deck and extend outwardly therefrom in a cantilevered configuration. The longitudinal axis of the second beam is oriented generally parallel to longitudinal axis of the first beam. The first and second beams are configured to cooperate to support a patient support accessory. The cantilevered support also includes means for coupling the cantilevered support to a deck of the surgical table such that substantially all the load borne by the patient-support accessory is transferred through the beams directly to the deck.

In some embodiments, the means for coupling the cantilevered support to the deck comprises first and second receivers coupled to the first and second radiolucent beams respectively. The first and second receivers are configured to engage first and second spars of the surgical table, respectively, to support the cantilevered portion from the deck.

In other embodiments, the means for coupling the cantilevered support to the deck comprises a first coupler coupled to the first beam and a second coupler coupled to the second beam. The first and second couplers are configured to engage a portion of a deck of the surgical table to secure the cantilevered support to the deck. The first and second couplers each comprise a clamp mechanism including a manual actuator configured to adjust the pressure of the clamp mechanism to secure the coupler to the deck. In some embodiments, the clamp mechanism comprises a first grip and a second grip movable relative to the first grip the second grip including a tapered surface for locating the coupler on an accessory rail of the deck.

In another aspect of the present disclosure, a patient-support apparatus comprises an adjustable pedestal and a deck, the deck formed to include a main portion secured to the pedestal and a cantilevered portion. The cantilevered portion includes a first radiolucent beam having a longitudinal axis and secured to the main portion so that the first radiolucent beam extends outwardly from the main portion in a cantilevered configuration. The cantilevered portion also includes a second radiolucent beam having a longitudinal axis and secured to the main portion so that the second radiolucent beam extends outwardly from the main portion in a cantilevered configuration. The longitudinal axis of the second beam is oriented generally parallel to longitudinal axis of the first beam. The first and second beams are configured to cooperate to support a patient support accessory such that substantially all the load borne by the patient-support accessory is transferred through the beams directly to the main portion.

In some embodiments, the beams are laterally spaced apart to form a space therebetween. The cantilevered portion of the deck extends a sufficient distance from the main portion of the deck to support the upper body of a patient for spinal surgery. In some embodiments, the cantilevered portion is formed to include a cross-member extending between the beams distally from the main portion. The top surfaces of the main portion, the first beam, the second beam and the cross-beam may all be substantially coplanar.

In some embodiments, the deck comprises a carbon-fiber composite material. In some embodiments, each of the beams consists of a carbon-fiber composite material. The patient-support apparatus may further comprise a patient support accessory configured to support a patient in a prone position, the patient support accessory supported on the first and second rails and movable along the longitudinal axis of the rails. For example, the patient support accessory may be a head support. In some embodiments, the patient support accessory is configured to be clamped to the rails. The cantilevered portion of the deck may extend outwardly from the main portion to form a clearance between the cantilevered portion and a floor supporting the patient-support apparatus to provide 360 degrees of imaging access about a patient supported on the cantilevered portion.

In yet another aspect of the present disclosure, a patient-support apparatus comprises an adjustable pedestal, a deck supported on the pedestal, and a cantilevered support coupled to the deck. The cantilevered support includes a first radiolucent beam having a longitudinal axis and a second radiolucent beam having a longitudinal axis. The first and second beams are coupled to the deck and extend outwardly therefrom in a cantilevered configuration. The longitudinal axis of the second beam oriented generally parallel to longitudinal axis of the first beam. The first and second beams configured to cooperate to support a patient support accessory such that substantially all the load borne by the patient-support accessory is transferred through the beams directly to the deck.

In some embodiments, the patient-support apparatus further comprises first and second spars extending from the deck and adjustable relative to the deck and the first and second radiolucent beams are coupled to the first and second spars respectively. The cantilevered portion may include first and second receivers coupled to the first and second radiolucent beams respectively. The first and second receivers may be configured to engage the first and second spars, respectively, to support the cantilevered portion from the deck. The receivers may be formed to include an interior space sized to receive a portion of the spars when the cantilevered portion is coupled to the deck such that the receivers are secured to the spars. The spars may be pivotable relative to the deck.

In some embodiments, the deck includes a main portion supported on the pedestal and an adjustable portion pivotable relative to the main portion. The cantilevered support may be coupled to the adjustable portion of the deck. The cantilevered support may include a first coupler coupled to the first beam and a second coupler coupled to the second beam. The first and second couplers may be configured to engage a portion of the adjustable portion of the deck to secure the cantilevered support to the deck.

The first and second couplers may each comprise a clamp mechanism including a manual actuator configured to adjust the pressure of the clamp mechanism to secure the coupler to the adjustable portion of the deck. The adjustable deck may include an accessory rail and the clamp mechanisms of the first and second couplers may secure the cantilevered support to the accessory rail.

In some embodiments, a clamp mechanism comprises a first grip and a second grip movable relative to the first grip the second grip including a tapered surface for locating the coupler on the accessory rail of the adjustable portion of the deck. The first and second couplers may be configured to position the cantilevered support such that an upper surface of each of the first and second beams is positioned vertically below the upper surface of a portion of the deck when the deck and cantilevered support are in a level position.

In still yet another aspect of the present disclosure, an accessory platform is used with a surgical table having a radiolucent deck section. The platform comprises a plurality of generally parallel radiolucent support beams spaced apart, and a plurality of clamp mechanisms interconnecting the support beams the clamp mechanisms configured to secure the platform to the deck section of the surgical table.

In some embodiments, the support beams each have a longitudinal length and the clamping mechanisms are configured to cooperate to align the longitudinal length of the beams with a longitudinal length of the deck of the surgical table. In some embodiments, the platform includes a patient support accessory supported on the beams. The platform is configured such that the platform supports a patient in a prone position such that a portion of the patient is spaced vertically above an upper surface of the deck of the surgical table.

In some embodiments, the support beams are segmented and hinged to permit the segments to be articulated relative to one another. The segmented support beams may be movable and the movement of the segments relative to one another may be driven.

In some embodiments, the clamp mechanism includes a first grip secured to a first beam, a block secured to a second beam, a cross-beam connecting the first grip and the block, the cross-beam generally perpendicular to the first and second beams, and a second grip coupled to the block. The second grip may be movable relative thereto vary a distance between the first and second grips to secure the platform to the deck of the surgical table. The clamp mechanism may include an actuator for moving the second grip relative to the block. The actuator may include a threaded rod and a spherical portion, and wherein the threaded rod is received in the block and rotation of the threaded rod causes the spherical portion to act on the second grip to vary the distance between the first and second grips.

Additional features, which alone or in combination with any other feature(s), including those listed above and those listed in the claims, may comprise patentable subject matter and will become apparent to those skilled in the art upon consideration of the following detailed description of illustrative embodiments exemplifying the best mode of carrying out the invention as presently perceived.

DETAILED DESCRIPTION OF THE DRAWINGS

A patient-support apparatus40illustratively embodied as a surgical table40includes a pedestal44and a radiolucent deck52as shown inFIG. 1. The radiolucent deck52may be removed and replaced with a traditional surgical table deck as will be discussed below. The surgical table40is similar to the type known as the Jupiter™ table available from Trumpf Medical Systems, Inc. of Charleston, S.C. which includes a carbon-fiber top. The surgical table40further includes a base42which supports pedestal44. Pedestal44includes a lower portion46and an upper portion48movable relative to the lower portion46to position the deck52in any of a variety of positions.

The surgical table40is configured such that a cantilevered portion54of the deck52extends from a main portion50of the deck52so that the cantilevered portion54is not supported from directly beneath the cantilevered portion54. The cantilevered configuration of the deck52permits access for imaging equipment, such as radiographic equipment, for example, to have unobstructed access to the cantilevered portion54of the deck52. This allows a surgeon, to perform a procedure on a patient supported on the surgical table40with full access of imaging during the procedure. Various pads, cushions, or mattresses may be placed on the deck52. Positioning of a patient on the deck52is often accomplished by placement of the various cushions or pads.

In the illustrative embodiment ofFIG. 1, the surgical table40is shown with a surgical table accessory platform56mounted to the deck52. The platform56is configured to permit improved positioning of a patient on the surgical table40, especially for spinal surgery. The platform56comprises two lateral beams58and59, two brackets60coupled to the lateral beam58and configured to support the beam58as shown inFIG. 1. The brackets60are coupled to two cross-beams62and63, which are coupled to two clamps64for coupling the platform56to the surgical table40as shown inFIG. 1.

As shown inFIG. 2, two accessories66,66are supported on the platform56. The accessory66is illustratively a body support assembly as disclosed in U.S. patent application Ser. No. 11/402,327, filed Apr. 11, 2006 and titled BODY SUPPORT APPARATUS FOR SPINAL SURGERY. It should be understood that any of a number of other accessories may be supported on the platform56. Each accessory66is movable along the longitudinal length of the beams58and59to vary the position of each of the accessories66.

In the illustrative embodiment, the cross-beam62, bracket60, and clamps64cooperate to define an adjustable width clamp mechanism70that enables the platform56to be secured to the outer edges68and69of the radiolucent surgical table40. In some embodiments, a hook and loop style fastener system (not shown) may be employed to secure the table accessory platform56to the radiolucent surgical table40.

The adjustable width clamp mechanism70is activated by an actuator72on the clamp64to move a grip74in the direction of an arrow76inFIG. 4. Actuator72includes a spherical portion78that is received in a concave portion80of the grip74(best seen inFIG. 7). A handle82of actuator72extends from the spherical portion78and is shaped to be gripped by a user. A threaded shaft84is coupled to the actuator72by a pin86such that the threaded shaft84is pivotable relative to the actuator72to allow the actuator72to be moved to a position in which the handle82is engaged with a block86of clamp64to keep the actuator72in a position to reduce the potential for the handle82to be contacted by imaging equipment or a caregiver. The spherical portion78is formed to include a channel88sized to permit the threaded shaft84to move freely in the channel88so that the handle may be positioned against the block86.

The threaded shaft84engages a threaded hole94of a coupler92. Threaded shaft84has an axis90about which threaded shaft84is rotated to cause the threaded shaft84to tighten or loosen the grip74by shortening or lengthening the distance between the grip74and a grip96formed in a block98of the bracket60. The distance between the grips74and96is identified by a reference designator100. Tightening of the clamp64causes the distance between the grips74and96to be reduced such that the grips74and96engage the edges68and69respectively of the deck52. With sufficient pressure applied by the grips74and96, the platform56is secured to the deck52.

The cross-beams62comprise a tubular member102which is coupled to both the couplers92,92and blocks86and98through fasteners104,106and108. The tubular member102in the illustrative embodiment is an extruded aluminum tube. Other suitable materials may be substituted in some embodiments. A cover110is coupled to the upper side112of tubular member102. Fasteners106in both of the blocks86and98engage the lateral beams58and59.

In the illustrative embodiment, beams58and59are substantially radiolucent and are spaced with an inside spacing of approximately 14½ inches. In other embodiments, a different inside spacing may be employed. In some embodiments, clamps64may be omitted and platform56may couple mechanically to surgical table40. In some embodiments, beams58and59may be segmented and/or hinged so that segments of the beams58and59may be articulated relative to other segments of the beams58and59. When the beams58and59are segmented, platform56may have an interface or linkage to allow beam58segments to be driven and locked. Segments may be driven remotely. It is within the scope of this disclosure for the platform56to be either fixed to deck52or removably coupled.

In another embodiment shown inFIGS. 8-10, a surgical table140includes deck152having a main portion150and a cantilevered portion154which extends from the main portion150. The deck152is supported on a pedestal44which is, in turn, supported on the base42of the surgical table140. The surgical table140is similar to surgical table40with the deck52of surgical table40omitted and replaced with the deck152. The main portion150of the deck152is similar to main portion50of the deck52. However, cantilevered portion154includes two lateral beams158and159and159which rigidly extend from main portion150. Lateral beams158and159are generally parallel and spaced apart such that a space160is formed between the beams158and159. Lateral beams158and159comprise a radiolucent carbon-fiber material with sufficient strength to support the load of a patient supported on the lateral beams158and159. One or more of the accessories66is mountable on the lateral beams as shown inFIG. 8. The accessories66permit a patient to be positioned on the surgical table140in a prone position such that the abdomen of the patient may extend downwardly into the space160during spinal surgery.

It should be noted that the beams158and159support a significant portion of the load of the patient supported on the surgical table140and all of the load of the patient applied to the accessories66and other similar accessories is borne by the beams158and159and transferred to the main portion150of the deck152. This cantilevered arrangement provides a region162of access for imaging devices such that a patient may be subjected to imaging procedures without having to be repositioned during the spinal or other neurosurgery activities. Thus, a physician may check for proper placement of repair materials such as implants, or check for proper alignment of spinal structures of the patient throughout a surgical procedure. In the illustrative embodiment, cantilevered portion154further includes a cross-beam164coupled to each of the beams158and159distal from the main portion150. Cross-beam164provides a mounting point for other accessories such as various head supports known in the art. In the illustrative embodiment, a head support166is supported on the beams158and159such that a patient may be placed in a prone position on the accessories66,66with the patient's head resting in the head support166.

In still another embodiment of a surgical table240shown inFIGS. 11-12, a cantilevered support256is mounted to a pair of spars200and202positioned on a traditional surgical table. The spars200and202are pivotable about an axis204such that the cantilevered support256may move relative to the deck252of the surgical table240. The cantilevered support256is movable about the axis204as suggested inFIG. 11. The cantilevered support256includes two receivers262and260which are coupled to a beam assembly264including two beams258and259which extend from the receivers262and260in a manner similar to the cantilevered portion154of the surgical table140. The cantilevered support256is useful to adapt a standard surgical table for use as a spinal surgery table with a patient in a prone position and providing imaging access. It should be understood that beams258and259may, in some cases, have a longer length than that shown in the illustrative embodiments, to extend the length of the cantilevered support256. The cantilevered support256is configured to allow for imaging access of a portion of a patient supported on the cantilevered support256with the imaging access available 360 degrees about the structure.

It should also be understood that the spars200and202may be positioned below the upper surface210of the remainder of the surgical table240. In addition, while the spars200and202are shown as male members and the receivers260and262are shown as female members, the sexes of the spars200,202and receivers260,262could be reversed in some embodiments.

In the illustrative embodiment ofFIG. 11, a head support206is supported on an adjustable structure208. The adjustable structure208is of the type disclosed in U.S. patent application Ser. No. 11/865,337 filed Oct. 1, 2007 titled MODULAR SYSTEM FOR PATIENT POSITIONING DURING MEDICAL PROCEDURES, the disclosure of which is hereby incorporated by reference herein.

Referring now toFIG. 13, yet another embodiment of a surgical table340is shown with a deck352including an adjustable deck section354and a cantilevered support356supported from the deck section354. Surgical table340is shown inFIG. 13with the adjustable deck section354in position where the adjustable deck section354is lower than horizontal. In this position, when a patient is in a prone position on the surgical table340, the patient's back is arched to place the spine in a better position for surgical procedures. As shown inFIGS. 13 and 14, cantilevered support356is configured to support a patient support structure. In the illustrative embodiment, head support206is mounted on adjustable structure208. It should be understood that any of a number of different patient support structures may be mounted to cantilevered support356.

The cantilevered support356includes two couplers358and359which are configured to secure the cantilevered support356to the adjustable deck section354. The adjustable deck section354is pivotable relative the remainder of the deck352about an axis360which is transverse to the longitudinal length of the deck352. The adjustable deck section356is movable relative to the deck352between a lowered position shown inFIG. 13and a raised position shown inFIG. 14. The couplers358,359each secure the cantilevered support356to two accessory rails362,363positioned on the adjustable deck section354.

The cantilevered support356is shown inFIG. 15with yet another embodiment of surgical table440which a traditional surgical table having a deck452with a pair of accessory rails462,463extending along a portion of the lateral sides of the deck452. The couplers358,359are configured to secure the cantilevered support356to the accessory rails462,463respectively. The cantilevered support356includes a pair of elongate beams464and466and a pair of cross-beams468,470extending between the beams464and466in alignment with the couplers358and359. The beams464and466are radiolucent and are spaced laterally apart to provide a space472therebetween.

Referring now toFIGS. 16 and 17, coupler358is secured to beam464by a fastener474which passes through a lower surface478of beam464and acts on a flat surface482of a rod484of coupler358(best seen inFIG. 18). When fastener474is disengaged from flat surface482, coupler358may be removed from rail464. It should be noted that couplers358and359are similar and that coupler359is secured to rail466with a fastener476acting through surface480of beam466. The rods484and486extend from a body488and are received in a block490housed within the rails464and466. The rods484and486are each received in a coupler492in one of the respective lateral beams468and470. Thus, the couplers358and359, through rods484and486, couple blocks490housed in each of the beams464and466and couplers492,492,492,492housed in each of the cross-beams468,470such that cantilevered support356is coupled together.

The manner of attachment of couplers358and359to beams464and466is the same manner that the receivers260and262are attached to the beams358and359.

Each of the couplers358and359include a clamping mechanism500as shown inFIG. 18with respect to coupler358. The clamping mechanism500includes a lower portion510formed in body488. An upper portion508is movable relative to the lower portion510such that a space514formed therebetween can be reduced to grip an accessory rail such as accessory rail462shown in phantom inFIG. 18. A pair of shafts504,504are positioned between upper portion508and lower portion510to guide movement of upper portion508. Each of the shafts504retain a spring506which biases upper portion508away from lower portion510. A manual actuator502includes a threaded shaft (not shown) that is received in lower portion510. Movement of the actuator502causes the upper portion508to move relative to the lower portion510to change the spacing between an upper grip512and a lower grip516. A tapered surface518of upper grip512facilitates positioning of the accessory rail462in the clamping mechanism500.