LUMBAR TRACTION APPARATUS

Abstract: The lumbar traction apparatus comprising; a pair of U-shaped adaptable supports (11, 12) to be attached to the patient under treatment; the said supports are placed into a flexible polyurethane foam casting (24, 25) serving as a polsting; and said supports having each a plurality of pinned free moving links equally spaced at both ends (26, 28), enabling the supports to be fitted to any required measure of a patient undergoing treatment; and having a belt assembly (26, 28) associated with each of the supports for tightening them to the patient; the said belts having each a mechanism (27, 29) to enable tightening of the said supports to a requested position; and having a pair of laterally spaced apart traction control assemblies (49, 50) extending between the said supports, each assembly having a vertically extended rod (36, 40) connected to the top support into a housing (6), casted into the said polyurethane foam; the said housing (6) contains a spring (5) through which the said rod passes (36), and said spring operates a gauge arm (1) mounted on the rod end measuring the traction power; and the other end of the rod is connected to a raising mechanism housed in the said polyurethane foam cast of the lower said support; the said raising mechanism is operated by a lever (42) raising a number of thin metal plates (66) caged telescopically on the said rod pressed down by a spring (65) in the lower section of the said housing; through a second group of such thin caged plates (69) placed at an angle, telescopically on the same said rod, pressed by another spring (64) in the upper section of the said housing; and having a release plate (20) projected out of the housing enabling the user to release the said rod and slide it back to a lower position; when the said lever is applied the raising mechanism causing the upper support to slide up slowly on the said rod thus causing traction; each upper support side can be raised seperately, to a different level thus applying differential traction; and having a plate (46) secured to both of said traction assembly rods (36, 40), extending across the patient's back, between the two said supports, having a pad assembly (47) positioned in any part of said extended plate, to be pressed towards the patients body and remain in such a pressed position for a desired period of time for applying a horizontal force; and having a track (48) casted into the middle of the said lower support (12), also for positioning of the said lordosis enlarging pad (51).

Description: The invention relates to an improved lumbar traction apparatus designed for an improved and more comfortable treatment of low back disorders of disc origin, as well as treatment of patients suffering from dorso-lumbar scoliosis and some vertebral fractures. Several designs of lumbar traction devices have been described in the prior art including such devices developed by the inventor. One such apparatus is described in US Patent No. 2,835,247 wherein the apparatus includes a pair of curved steel bars strapped to a patient, so that a bottom one of the bars rests on the iliac crests of the patient and is not movable; the top one of the bars is situated at 8-9 Th level and is movable. The straps are pulled tight, and a pair of spaced traction control assemblies extending between the supports are operated separately by moving the upper support upwards thus separating the patient's thorax from the pelvis. A problem with this device is the mechanical difficulty in turning a handwheel and locking the wheel in place once the traction has been achieved. The physical location of the handwheel makes it impossible for the patient to apply traction by himself, thus precluding the device from being used for self treatment. The straps design are such that they are difficult to handle and tighten securely. The metal bars, are heavy, and if x-ray is required during traction, it cannot be done, because the rays will not go through metal. Another more modern apparatus is described in US Patent 3,926,182, wherein the apparatus includes a pair of upper and lower rigid u-shaped supports, attached to the upper and lower waist portions of the patient. A belt assembly associated with each of the supports is used for tightening to the patient. Two traction assemblies are spaced apart, extending between the supports, having a vertically extended tube connection, and a tooth rod mounted telescopically, and a rotable shaft carrying a pinion engaged with teeth on the rod, which is driven by a ratchet drive mechanism associated with the end traction control assembly. When the ratchet drive is rotated, it rotates the shaft carrying the pinion in one direction thus moving the rod relative to the tube thereby causing traction in the lumbar region of the patient. The traction power can be measured and visualised by a gauge provided on the upper support. The device is also provided optionally with a lordosis pad assembly mounted externally on the lower support, enabling control of the forward convexity of the patient's spine. The supports are metalic (steel) and are padded by foam padding covered by PVC or other suitable cover material. The belt assembly is simmilar to an automatic seat belt strap, tightened by ratchet drive mechanism mounted on each of the support's ends. The disadvantage in this system is that due to the metal pieces in almost each part of the device one can not use x-ray or CT control during traction. The traction assemebly mechanisms, and the lordosis pad mechanism are mounted externally on the supports, thus causing disturbance to the patient's free movement. The belt tightening assembly is cumbersome and awkward to apply. The system does not enable the user to apply differential traction as the teeth mechanism of both traction drive ratchet mechanisms always go up to the same level. The possibility of applying differential traction has great importance in the treatment of patients with sciatic scoliosis and scoliotic patients. The lordosis pad provided in the apparatus can only be moved along a fixed track by slow movement of a screw, and only at a preset position on the back, which therefore limits its use, and for achieving a desirable lordosis enlargement too much time must be spent. It is the purpose of this invention to provide solutions to the above mentioned drawbacks (of the previous design), and introduce several innovations in design and structure of the device thus providing an improved apparatus, enabling the treatment of not only back disorders of disc origin, but also providing treatment for scoliosis patients, and patients with some vertebral fractures; as well as self treatment in chronic cases and as prophylactic measure. The new invention also provides for an apparatus which can be manufactured cheaply in large scale production lines. The apparatus hereby provided is mostly made of plastic reinforced materials, padded with flexible polyurethane foam, thus enables use of x-ray or CT control during treatment. The apparatus is lighter in weight, hence easier to carry by the patients. According to the present invention there is provided a lumbar traction apparatus characterised in that said apparatus comprises in combination; a pair of upper and lower U-shaped supports said supports being constructed from plastic bars cast in polyurethane foam which serves as padding the ends of said supports having a plurality of pinned free moving links equally spaced at both ends and said supports being attachable to a patient under treatment; each of the supports being provided with a belt assembly for engaging it about a patient and each of the belt assemblies having a buckle positional, in use, at the front middle of the patient; each of said belt assemblies being provided with tightening means for tightening it and operable by moving its respective said buckle; a pair of laterally spaced traction assemblies, each, in use, spanning the patient's lumbar region between said supports, with each of the traction assemblies being provided with a vertical rod connected at its upper end to the upper support and extending into a housing being cast in the polyurethane foam of said upper support; each of said traction assemblies being provided with a spring connected between its said rod and the upper support, and each of the springs being provided with a gauge mounted on a rod end for measuring traction; each of the rods having a lower end connected by a raising mechanism to the lower support, said raising mechanism being housed in the polyurethane cast of the lower support; each of the raising mechanisms comprising a lever adapted to engage a plurality of thin metal plates stacked at an angle relative to the rod and mounted telescopically about its respective rod, each plate having a hole through which its respective rod passes, with the stacked plates being retained by a spring located in the upper section of the respective housing of the lower support, said spring abutting against the lower support, whereby when said lever are engaged the raising mechanism causes its rod to be raised relative to the lower support thus raising the upper support; each of the raising mechanisms being provided with a release plate projecting out of the lower support and connected to a second group of thin stacked plates to disengage them from their respective rod for releasing the raising mechanism. an elongate plate slideably mounted on said rods (40, 36) and between said supports with a lordosis pad connected to the plate in any position therealong, and pressing means for pressing the lordosis pad against the patient's back to apply localized force thereagainst; and having a track provided in the middle of said lower support, for positioning of a second lordosis pad. In the preferred embodiment the lower u-shaped support is curved downward at its centre, and the said lordosis pad's track is secured in the polyurethane foam padding at the centre of the curve. This enables positioning of the lordosis pad when both supports are mounted close to each other. In the preferred embodiment the gauge measuring the traction power is mounted directly on traction rod assembly extending out the housing casted into the upper support, and secured into the housing by a spring (see fig 5 in the accompanied drawings). In the prefered embodiment the lordosis pad mechanism has the following design: A pad mounted on a plate (steel or preferably reinforced plastic), the plate is mounted on a screw-pin by a ball joint, and having on the other end a pressure knob. A hollowed plate is mounted telescopically on the central part of the screw pin having a bored passage for the pin in form of a lower half screw and an upper ellipsoidal enlarged half hole; and having a further steel plate fitted into the hollowed plate secured to the screw pin by a spring placed inside the hollowed plate and having the same shaped bore. So that when pad is placed in position on the track, or onto the curved plate described above, and the pressure knob is pressed towards the body, the screw passes freely through the bored plates until the required pressure is achieved, when the knob is released, the spring in the hollowed plate, passes down the inner plate, which locks the passage by the half screw bore engaging with the screw. To release the pad's pressure the inner plate must be pressed up slightly (against spring's force) thus releasing the screw passage, and releasing the pad. (see drawings Figs 6, 7). The two support inner bars, and the plate carrying the lordosis pad could be constructed of a reinforced plastic material such as a composite of epoxy resins reinforced by either fiber glass or carbon fibers, or a composite of unsaturated polyester resins reinforced by fiberglass or glass fibers matt; or any reinforced thermoplastic material produced by any conventional technique such as extrusion or injection molding. Thus enabling x-ray penetration through the supports when the device is carried by a patient. The traction assembly could be made of steel, but should preferably be made from reinforced plastics or composites, especially the two housings and central rod. This will greatly reduce the weight of the device, and avoid interference during x-rays, or CT control. The lordosis pad mechanism could also be made of steel, but should preferably be of reinforced plastic, so that x-ray and CT control can be applied. In cases of some vertebral fractures having no neurological complications, the said lumber traction apparatus can be used for reposition of the dislocated vertebral fracture; before casting the plaster of Paris, using the enlarging lordosis pad mechanism provided. Horizontal force is then applied. When using a plastic made lordosis pad one can reconfirm position of the said vertebral fracture correction by x-ray or CT. Plaster of Paris cast is then applied, leaving in the case the inner part of the lordosis pad so that pressure could be applied occasionally thus decreasing substantially the number of collapses of the vertebral fractures while the patient is still in cast. In the prefered embodiment the belt strapping tightening mechanism operates as follows: Two metal buckles are connected onto a central common hinge pinion, having on both ends security locking ratchet wheels secured to the said pinion by rivets. The said buckels having spring located ratchet pins mechanisms forcing the pins towards the pinion and a wheel allowing the buckles to move only in one direction. When one of the belt's ends is secured to one of said buckles ends, and the other belt end is passed through a slit in the centre of the said pinion, and any of the buckels is moved towards the other with the free movement of the ratchet wheel the mechanism pulls in the belt (through the pinion slit) not allowing return passage of the belt, thus causing tightening. To release the belts one pulls the buckles apart, thus allowing passage of the belt through the slit. (see Fig 2, 3 in accompanied drawings). An embodiment of the invention is illustrated by way of example in the accompanying drawings; Fig 1 illustrates a general assembly view of the device seen from the back of the patient, when belts are unstrapped. Fig 2 and 3 illustrates the belt tightening mechanism. Fig 4 illustrates the traction assembly Fig 5 illustrates the detail of the traction power gauge. Fig 6 and 7 illustrates a detail of the lordosis pad assembly. Referring now to fig 1 illustrating the traction apparatus. The apparatus comprises a pair of upper and lower U-shaped supports 11, 12, the supports having internal reinforced plastic bars cast in flexible polyurethane foamed plastic bars cast in flexible polyurethane foamed padding 24, 25. The ends of the supports having two pairs of pinned free moving links not shown. Strapping belts extended from each of the supports ends 26 for the upper support, and 28 for the lower support. The belts end buckles 27, and 29, and tightening mechanisms not shown are tightened on the patient's front middle. The traction control assemblies shown on both sides 43 and 39 having the two upper housings 32 and 35 casted into the P.U. foam of the supports, having two guages for measuring traction power applied 49 and 50. The rods 36, 40 extend between supports 11 and 12, and go through housings 37 and 41 casted into lower support P.U. foam. The plate lifting mechanisms operated by hand levers 42 and 38 extending out of the P.U. casting which when applied cause traction forces between the supports when they move up the rods 40, 36. Differential traction can be applied when one mechanism (38 or 42) is operated and the other remains static. Release plates 20, 21 extending out of housing 41, 37 release the traction force and allow housings to move down the rods 36, 40 respectively. Plate 44 extends between rods 36, 40 and is secured to them, and the lordosis pad 47 can be fitted into any position along the plate 44, the lordosis pad 47 having a pressing knob 46. A second pad mechanism is placed at the centre of the lower support 12, on the track 48, having also a pad 51 pressed by a knob 52. Fig 2 and 3 illustrates the tightening mechanism applied by the patient in the middle of his front (near the stomach area). Buckles 53 and 54 are mounted on pinion 55 having a central slit 57 through which one of the belt ends 27 is passed and rolled backwards. The other belt end 30 is secured to 54 as shown. The ratchet wheel 58, 59 are mounted on pinion 55, and spring 60 presses plate 61 and allows movement of buckle 54 in one direction only. Plate 62 is secured by spring (not shown) allowing buckle 53 to move in one direction only along teeth of ratchet wheel 58, 59. When buckle is moved from position A to B (as shown in Fig 3) belt end 27 moves through slit and tightens belts on patient body. Fig. 4 illustrates the detail of the traction control mechanism assembly. The rod 36 extends between upper housing 32 (not shown) and lower housing 37. Lever 38 secured to the housing 37 by screw 67 rests on one of the two steel plates 66, which are pressed down by a spring. Thin cages plates 69 (about 11) are placed between plates 66, and between plates 63 and release plate 21 in upper section of housing 37. Screw 68 sets the angle of release plate 21, and a spring presses plate 63 and caged plates 69 on to release plate 21. When lever 38 is raised plate 66 is moved, moving with the caged plates 69 (mounted telescopically on rod 36), the friction applied by the plates caged on the rod 36 cause the rod to slide through second set of cage plates in upper part of the housing, thus lifting the housing 37 upwards away from housing 32 (not shown). When release plate 21 is pulled, the caged plate 63 releases the rod 36, and the housing 37 moves downwards towards housing 32. Fig 5 illustrates the upper housing and traction power guage mechanism. The upper hollowed housing 6 is casted into polyurethane foam of upper support (not shown). The rod 36 end is marked with figures illustrating the applied traction power as shown in 1. The rod 36 is urged by a spring 5 at the end fitted into the housing 6 and pressing rod end away from housing, spring 5 leans on box 2 mounted on the rod telescopically, and secured by screw 4, so that when rod 36 is pressed by raising mechanism into housing 6, spring 5 is compressed and pushes box 2 along rod onto marked section 1 which thus guages the force applied by the rod 36, on to spring 5. Fig 6 and 7 illustrate the lordosis pad mechanism. The pad 47 is mounted on a steel (or reinforced plastic) plate 70, and plate 70 is connected by a ball connection to a screw pin 77, having on the other side a knob 46. A hollowed plate 74 is mounted telescopically on central part of screw pin 77. The pin 77 passes through a bored passage in plate 74 in the form of a lower half screw and an upper elliptical enlarged hole. A further steel plate 75 fitted into hollowed plate secured to the screw pin 77 by spring 76, having the same shaped bore as plate 74. When knob 46 is pressed in, pad 47 is pressed towards the patients body, when pressure on knob is released, spring 76 presses up plate 75 which latches screw-pin 77, and prevents it from moving backward away from patient. To release the pressure, plate 75 is pressed down (against spring 76) and screw pin can move freely backward to release pad's pressure. Fig 7 shows the cross section of plate 74 and 75, with spring 76 action on plate 75.

Claims: 1. A lumbar traction apparatus, said apparatus comprising in combination; a pair of upper and lower U-shaped supports (11, 12) said supports being constructed from plastic bars cast in polyurethane foam which serves as padding (24, 25), the ends of said supports having a plurality of pinned free moving links equally spaced at both ends and said supports being attachable to a patient under treatment; each of the supports being provided with a belt assembly (26, 28) for engaging it about a patient and each of the belt assemblies having a buckle (27, 29) positional, in use, at the front middle of the patient; each of said belt assemblies (26, 28) being provided with tightening means for tightening it and operable by moving its respective said buckle; a pair of laterally spaced traction assemblies (43, 39), each, in use, spanning the patient's lumbar region between said supports (11, 12), with each of the traction assemblies being provided with a vertical rod (40, 36) connected at its upper end to the upper support (11) and extending into a housing (35, 32) being cast in the polyurethane foam of said upper support; each of said traction assemblies (43, 39) being provided with a spring (5) connected between its said rod (40, 36) and the upper support (11), and each of the springs (5) being provided with a gauge mounted on a rod end for measuring traction; each of the rods (40, 36) having a lower end connected by a raising mechanism to the lower support (12), said raising mechanism being housed in the polyurethane cast of the lower support (12); each of the raising mechanisms comprising a lever (42, 38) adapted to engage a plurality of thin metal plates (66) stacked at an angle relative to the rod and mounted about its respective rod (40, 36), each plate (66) having a hole through which its respective rod (40, 36) passes, with the stacked plates (66) being retained by a spring (64) located in the upper section of the respective housing (37, 41) of the lower support (12), said spring abutting against the lower support (12), whereby when said levers (42, 38) are engaged the raising mechanism causes its rod (40, 36) to be raised relative to the lower support (12) thus raising the upper support (11); each of the raising mechanisms being provided with a release plate (20, 21) projecting out of the lower support (12) and connected to a second group of thin stacked plates (69) to disengage them from their respective rod (40, 36) for releasing the raising mechanism. an elongate plate (44) slideably mounted on said rods (40, 36) and between said supports with a lordosis pad (47) connected to the plate (44) in any position therealong, and pressing means for pressing the lordosis pad (47) against the patient's back to apply localized force thereagainst; and having a track provided in the middle of said lower support (12), for positioning of a second lordosis pad (51). 2. A lumbar traction apparatus as claimed in claim 1, characterised in that said plastic bars are made of a material which is transparent to x-ray and CT. 3. A lumbar traction apparatus as claimed in claim 1 or 2, characterised in that said plastic bars and plate are made of epoxy resins reinforced by glass fibers or carbon fibers. 4. A lumbar traction apparatus as claimed in claim 1 or 2, characterised in that said plastic bars and plate are made of polyester resins reinforced by glass fibers. 5. A lumbar traction apparatus as claimed in claim 1 or 2, characterised in that said plastic bars and plate are made of a reinforced thermo-plastic material, made by extrusion or injection moulding. 6. A lumbar traction apparatus as claimed in any preceding claim characterised in that each of the gauges is mounted on the upper housing (32, 35) of the traction mechanism. 7. A lumbar traction apparatus as claimed in any preceding claim characterised in that the lordosis pad (47) is mounted on a socket (70) which engages pivotally about a ball (71) mounted on a threaded shaft (77), the shaft passing telescopically through a sleeve (75) into which it screwably engages, the sleeve (75) being connected fixedly to an arm (74) mounted on the elongate plate, the shaft (77) having an end remote from the pad (47) with a knob (46) thereon for rotating the shaft (77) and thereby engaging or disengaging the pad (47), the arm (74) defining a chamber with a latch therein, a spring (76) connected between the arm and the latch to urge the latch from a first position to a second position, the latch provided with a hole through which the sleeve (75) passes, the latch also being provided with a projection extending out of the arm whereby the projection can be pressed to move the latch from the second position to the first position, the sleeve (75) having an opening through which the latch is passable to engage the shaft (77); in the first position the latch engaging the shaft (77) to lock the pad (47) in a desired position; in the second position the latch being out of engagement from the shaft (77) so that the position of the pad (47) can be changed by turning the knob (46). 8. A lumbar traction apparatus as claimed in any preceding claim, characterised in that said traction assembly as well as the lordosis pad are made of reinforced plastics material.

Inventors: STABHOLZ, LUDWIG
Applicants: MEDITRAC LTD.
Application year: 1988
Main classification: A61H1
IPC codes: A44B11, A61F5, A61H1