Abstract:
A head support system for use with a patient support. The head support system has a support structure with a crossbar extending transverse to, and connected to, the patient support. A head support device is removably mountable to a portion of the support structure exclusive of the crossbar and provides a static support for the patient&#39;s head. A head stabilization device is removably mountable to the crossbar of the support structure and stabilizes the patient&#39;s head.

Description:
This application claims the benefit of U.S. Provisional Application No. 60/526,047, filed on Dec. 1, 2003 and U.S. Provisional Application No. 60/544,863, filed on Feb. 13, 2004, all of which are hereby expressly incorporated by reference herein 

   FIELD OF THE INVENTION 
   This invention relates to surgical equipment and more particularly, a head support system. 
   BACKGROUND OF THE INVENTION 
   During surgical procedures, one or more devices may be used to support a patient&#39;s head. For example, there may be a need to provide a static support for a patient&#39;s head; and typically, a static head support includes one or more pads that provide a static subjacent support of the patient&#39;s head in a prone or supine position. Such a static head support is mounted on a crossbar that extends transversely off the end of a patient support such as an operating table. Alternatively, a stabilization device, such as a skull clamp, is also used to support and stabilize a patient&#39;s head, and such a skull clamp is also mounted on the crossbar. In some applications, both static head support and skull clamp stabilization are desired, and then both devices must be mounted on the crossbar. In those situations where both subjacent support and lateral stabilization are required, having to mount both devices from the same crossbar member is complicated, inflexible and inconvenient. Therefore, there is a need to provide a support structure for a head support and a stabilization device that is more convenient and flexible to use. 
   In the process of supporting or stabilizing the patient&#39;s head, surgical draping is applied in a known manner to the patient and portions of the structure supporting the head support or stabilization device. Depending on the surgery being performed, it may be required to lower the head support out of contact with the patient&#39;s head and subsequently, raise the head support back into contact with the patient&#39;s head. Known head supports often use a pawl pin or locking screw to control elevation, and such pawl pin or locking screw are centrally located and difficult to reach beneath the surgical draping. Further, any adjustments in elevation require two hands, one to operate the pawl or screw and one to lift or lower the head support. As can be appreciated, the presence of the draping makes such adjustments more difficult, time consuming and a distraction from the surgical procedure. Therefore, there is a need for a head support that can be easily adjusted and locked in a desired elevation with a minimum of disturbance to the surgical draping and a minimum of distraction from the surgical procedure being performed. 
   Therefore, there is a need to provide structure for more flexibly mounting head support and stabilization devices. 
   SUMMARY OF THE INVENTION 
   The present invention provides head support systems that are highly flexible and can be used with a wide range of imaging, neuro-navigational and surgical procedures. The head support systems of the present invention provide both static head support, for example, a horseshoe pad, other pads, pins, etc., and head stabilization, for example, a skull clamp or other devices. The head support systems of the present invention permit a head support to be adjusted and simultaneously locked at any elevation with a motion of only one hand. Further, the components of the head support systems of the present invention are easily disassembled for ease of cleaning. Such a combination of static load support and stabilization is especially useful when working with pediatric patients and in plastic surgery. 
   In accordance with the principles of the present invention and in accordance with the described embodiments, the present invention provides a head support system for use with a patient support, which provides support and stabilization for a patient&#39;s head. The head support system has a support structure with a crossbar extending transverse to, and connected to, the patient support. A head support is removably mountable to a portion of the support structure exclusive of the crossbar and provides a static support for the patient&#39;s head. A head stabilization device is removably mountable to the crossbar of the support structure and stabilizes the patient&#39;s head. 
   In a further embodiment of the invention, the head support system has a gear box mounted on the support structure. The gear box is connected to the head support; and a crank rod operates the gear box to move the head support to, and simultaneously lock the head support at, a desired vertical position. A gear rack is connected to the gear box, and a ball-and-socket joint connects the head support to the gear rack, thereby permitting the head support to pivot with respect to the gear rack. 
   These and other objects and advantages of the present invention will become more readily apparent during the following detailed description taken in conjunction with the drawings herein. 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
       FIG. 1  is a perspective view of a first embodiment of a head support system in accordance with the principles of the present invention. 
       FIG. 2  is a perspective view of a lower portion of the head support system shown in  FIG. 1 , which is suspended from supported shafts. 
       FIG. 3  is a schematic side elevation view of several interior components of a gear box used with the head support system of  FIG. 1 . 
       FIG. 4  is a schematic top view of locking components of the gear box used with the head support system of  FIG. 1 . 
       FIG. 5  is a perspective view of a rocker head support used with the head support system of  FIG. 1 . 
       FIG. 6  is a perspective view of a second embodiment of a head support system in accordance with the principles of the present invention. 
       FIG. 7  is a perspective view of a horseshoe post assembly used with the head support system of  FIG. 6 . 
       FIG. 8  is a perspective view of a third embodiment of a head support system in accordance with the principles of the present invention. 
       FIG. 9  is a perspective view of a fourth embodiment of a head support system in accordance with the principles of the present invention. 
   

   DETAILED DESCRIPTION OF THE INVENTION 
   Referring to  FIGS. 1 and 2 , in a first embodiment, a head support system  20  is mounted on spaced-apart support shafts  22   a ,  22   b  that are connected to an end of a patient support (not shown), for example, an operating table in a known manner. The support shafts  22   a ,  22   b  extend substantially parallel with a length of the patient support. First and second support posts  24 ,  26  have respective bores  25 ,  27  that receive respective support shafts  22   a ,  22   b , and the support posts  24 ,  26  can be locked at a desired position by means of respective locking screws  28 ,  30 . Upper and lower guide rods  32 ,  34  have first ends fixed in a lower portion of the first support post  24 . Opposite ends of the guide rods  32 ,  34  are supported in a lower portion of the second support post  26 . The guide rods  32 ,  34  extend through a gear box housing  36 , and thus, the housing  36  is slidable longitudinally along the guide rods  32 ,  34  but cannot rotate with respect thereto. Also extending through the housing  36  is a gear rack  38  which is used to raise and lower a head support device, for example, pads  108   a ,  108   b , by rotating the crank rod  40 . The crank rod  40  is supported by a bracket  41  rigidly connected to the support post  26 . 
   Referring to  FIG. 3 , within the gear box  36  a worm  42  is mounted on an end of the crank rod  40 . The worm  42  meshes with worm gear  44  that is fixed on a shaft  46  that, in turn, also carries a spur gear  48 . The spur gear  48  meshes with the gear rack  38 . Thus, rotation of the crank rod  40  rotates the worm  42  that, in turn, rotates the worm gear  44  and spur gear  48 , thereby moving the gear rack  38  either up or down depending on the direction of rotation of the crank shaft  40 . The worm  42  and worm gear  44  hold the gear rack  38  in its desired position without the need for a further mechanical lock. The gear box  36  is securable on the guide rods  32 ,  34  by means of a locking bar  50  and lock screw  52  that is threaded into the locking bar  50 . The locking bar  50  is also mounted on the guide rods  32 ,  34  and, as shown in  FIG. 4 , is mounted in a slot  54  of the gear box housing  36 . With the lock screw  52  in the position illustrated in  FIGS. 3 and 4 , the gear box  36  is free to be moved over the length of the guide rods  32 ,  34 . However, rotation of the lock screw  52  in a direction advancing the lock screw  52  through the locking bar  50 , results in the lock screw  52  contacting the bottom surface  56  of the slot  54 . Further, rotation of the lock screw  52  in the same direction pushes the locking bar  50  outward, that is, to the right, as illustrated in  FIG. 4 , thereby pressing the locking bar  50  tightly against the guide rods  32 ,  34  and securing the gear box  36  in a desired position with respect thereto. 
   The posts  24 ,  26 , guide rods  32 ,  34 , gear box  36  and gear rack  38  function as a support structure for head support and stabilization devices as will be subsequently described. Referring back to  FIG. 2 , a cage  56  is fixed to an upper end of the rack  38  and contains a socket  60  having a split  61 . The socket  60  is pinned in the cage  56  and is sized slightly smaller than a ball  62 . The split  61  spreads to permit the ball  62  to snap into an annular concave surface  63  of the socket  60 , thereby forming a ball and socket joint  58 . A locking screw  64  extends through the cage  56  and a clearance hole in a first end  66  of the socket  60 . The locking screw  64  is threaded into an opposite end  68  of the socket  60 . With the locking screw  64  loosened, the ball  62  is freely pivotable with respect to the socket  60  and can be locked at any desired orientation therewith by tightening the locking screw  64 . As shown in  FIG. 5 , the ball  62  is fixed to a lower end of a support column  70 . A rocker arm  72  is rotatably mounted on a pin (not shown) having its ends secured at an upper end of the support column  70 , thereby permitting the rocker arm  72  to pivot through a small angle, for example, of about 30 degrees. The rocker arm  72  contains a plurality of holes  74  into which pins or pads can be mounted to provide a desired support of the occiput portion of the patient&#39;s head. The plurality of holes  74  permit the pins or pads to be mounted at different locations on the rocker arm  72 . Alternatively, as will be appreciated, the rocker arm  72  can be rigidly fastened to the upper end of the support column  70 . 
   Extending laterally from each side of the support column  70  is one of a pair of mounting brackets  76 ,  78 . The mounting brackets  76 ,  78  have respective threaded holes  80 ,  82  for receiving mounting screws  84   a ,  84   b  ( FIG. 1 ) of articulated arms  86   a ,  86   b . The size and shape of the brackets  76 ,  78  and the number and location of respective mounting holes  80 ,  82  will change depending on the type of device being connected to the brackets  76 ,  78 . The mounting brackets  76 ,  78  have respective threaded holes  80 ,  82  for receiving mounting screws  84   a ,  84   b  ( FIG. 1 ) of articulated arms  86   a ,  86   b . As shown in  FIG. 1 , the articulated arms  86   a ,  86   b  have lower ball and socket joints  88   a ,  88   b ,  90   a ,  90   b  that are substantially identical in construction to the previously described ball and socket joint  58 . Lower ends of first arm  92   a ,  92   b  are fixed to respective sockets  90   a ,  90   b ; and second balls  94   a ,  94   b  are fixed to upper ends of respective first arms  92   a ,  92   b . The second balls  94   a ,  94   b  are disposed in respective second sockets  96   a ,  96   b  to form second ball and socket joints substantially identical in construction to the ball and socket joint  58  previously described. Second arms  98   a ,  98   b  are rigidly attached to respective second sockets  96   a ,  96   b . The sockets  96   a ,  96   b  are split and have respective locking screws  102   a ,  102   b  that are used to release and secure the respective first and second arms  92   a ,  92   b  and  98   a ,  98   b  at desired orientations. 
   Mounting posts  104   a ,  104   b  are frictionally secured within distal ends of the second arms  98   a ,  98   b , respectively. Pads  106   a ,  106   b  are pivotally mounted to respective bases  107   a ,  107   b  in a known manner; and the bases  107   a ,  107   b  are attached to lower ends of the mounting posts  104   a ,  104   b , respectively. Further in  FIG. 1 , occiput pads  108   a ,  108   b  are pivotally mounted to respective bases (not shown), that, in turn, are attached to the rocker arm  72 . Thus, the occiput pads  108   a ,  108   b  support an occiput portion of the patient&#39;s head, and the pads  106   a ,  106   b  help stabilize the patient&#39;s head. The pivoting motion of the pads  106   a ,  106   b ,  108   a ,  108   b  permit them to be adjusted for optimum patient comfort and support. 
   A second embodiment of the head support  20  is shown in  FIGS. 6 and 7 , wherein components identical to the components shown in, and described with respect to,  FIGS. 1 and 2  are identically numbered. The support  70 , rocker arm  72  and occiput pads  108  of  FIG. 1  are replaced by a horseshoe support  110  having pads  136 ,  138  for supporting a patient&#39;s head. A ball  112  is attached to a fixed horseshoe bracket  114  and is sized to snap into the socket  60  to form a ball and socket joint identical to the ball and socket joint  58  previously described. Thus, the horseshoe support  110  is pivotable with respect to the socket  60  and can be locked at any desired orientation by tightening the locking screw  64 . 
   Referring to  FIG. 7 , a horseshoe slide arm  116  is slidable within the fixed horseshoe bracket  114 . Thus, the spacing or distance between left and right horseshoe arms  118 ,  120  can be adjusted. A locking screw  122  is threaded through the fixed horseshoe bracket  114  and can be brought to bear against the slide arm  116 , thereby securing the slide arm  116  and the right horseshoe arm  120  at a desired location with respect to the left horseshoe arm  118 . The left and right horseshoe arms  118 ,  120  are fixed on the upper ends of respective mounting posts  124 ,  126 . The lower ends of the mounting posts  124 ,  126  are fixed in the horseshoe bracket  114  and slide arm  116 , respectively. Mounting blocks  128 ,  130  have respective threaded holes  132 ,  134  that receive screws (not shown), so that head stabilization devices, for example, articulated arms, etc., can be mounted to the horseshoe support  110 . The horseshoe pads  136 ,  138  are mounted to the respective horseshoe arms  118 ,  120  in a known manner. 
     FIG. 8  illustrates a further embodiment of the head support system  20 , wherein components identical to the components shown in, and described with respect to,  FIGS. 1 and 2  are identically numbered. Brackets  142 ,  144  are connected to outer ends of respective support shafts  22   a ,  22   b  and a crossbar  146  is supported by the brackets  142 ,  144  in a known manner. One end of a base unit handle  148  is mounted on the crossbar  146 , and the base unit handle  148  supports a transitional arm  150  at its opposite end. The base unit handle  148  is simultaneously made pivotable with respect to the crossbar  146  and the transitional arm  150  by releasing a closing handle  152  in a known manner. Securing the closing handle  152  simultaneously locks the orientation of the base unit handle  148  with respect to the crossbar  146  and transitional arm  150 . A swivel adaptor  154  has a lower end releasably fixed to an upper end of the transitional arm  150 , and a skull clamp  156  is releasably mounted to an upper end of the swivel adaptor  154  in a known manner. 
     FIG. 9  illustrates a still further embodiment of the head support system  20 , wherein components identical to the components shown in, and described with respect to,  FIGS. 1 and 2  are identically numbered. In  FIG. 9 , the horseshoe support  110  of  FIG. 8  is removed and replaced by the support column  70  and rocker arm  72  previously described with respect to  FIGS. 1 and 5 . However, the occiput pads  108  of  FIG. 1  are replaced by skull pins  160  ( FIG. 9 ) that are mounted at desired locations in holes  74  ( FIG. 5 ) of the rocker arm  72  to support the patient&#39;s head. 
   In use, referring to  FIGS. 1 ,  6 ,  8  and  9 , prior to surgery, the head support  110  is first adjusted to support the static load of the patient&#39;s head. Thereafter, the skull clamp  156  is applied to the patient to stabilize the patient&#39;s head. In the process of supporting and stabilizing the patient&#39;s head, surgical draping is applied to the patient and portions of the head support system  20  in a known manner. Depending on the surgery being performed, it may be required to lower the head support out of contact with the patient&#39;s head and subsequently, raise the head support back into contact with the patient&#39;s head. With the present invention, the length of the crankrod  40  places the crankrod end at an outer, lateral position, so that it is more accessible and can be reached with minimal disturbance of the surgical draping. Further, the crankrod can be rotated with one hand to lower or raise the head support pads  108 ; and its worm gear construction mechanically locks the head support at a desired elevation without requiring a separate locking pin or screw. 
   The head support systems illustrated and described in  FIGS. 1–9  have the advantage of providing independent and flexible support structures for both a static head support using a horseshoe pad, other pads, pins, etc. and head stabilization, for example, a skull clamp or other device for stabilizing the skull during imaging, neuro-navigational and surgical procedures. The head support systems permit a head support to be adjusted and simultaneously locked at any elevation with a motion of only one hand. Such a combination of static load support and stabilization is especially useful when working with pediatric patients and in plastic surgery. Further, the components of the head support systems are easily disassembled for ease of cleaning. 
   While the present invention has been illustrated by a description of an embodiment, and while such embodiment has been described in considerable detail, there is no intention to restrict, or in any way limit, the scope of the appended claims to such detail. Additional advantages and modifications will readily appear to those skilled in the art. For example, in the described embodiment, the static head support is shown and described as being occiput pads, a horseshoe pad and pins; however, as will be appreciated in alternative embodiments, other head support devices, for example, a single pad, may be used. Further, as will be appreciated, the horseshoe arms  118 ,  120  and respective pads  136 ,  138  may be made to different sizes to accommodate different sizes of patient&#39;s heads. 
   Further, in an alternative embodiment, the vertical posts  24 ,  26  can be inverted when greater elevation is required. This is desirable when the support shafts  22   a ,  22   b  are mounted at a lower location on the patient support or table. In this situation, the gear rack  38  is removed from the gear box  36 ; and the gear box  36  is removed from the guide rods  32 ,  34 . The support posts  24 ,  26  are pivoted to extend upward from respective support shafts  22   a ,  22   b . The gear box is inverted and remounted on the guide rods  32 ,  34 ; and the gear rack  38  is then reinserted in the gear box. In addition, in an alternative embodiment, the two guide rods  32 ,  34  can be replaced by a single guide rod having a noncircular cross-section to prevent rotation of the gear box  36  thereon. 
   In the described embodiment, the skull clamp  156  is one example of a skull clamp design that is often used to stabilize a patient&#39;s head. Again, as will be appreciated, in alternative embodiments, other skull clamp designs, for example, a single piece skull clamp, are equally applicable to provide a desired stabilization function. Similarly, although two articulated arms are illustrated and described, in some applications, a single articulated arm  86  and corresponding pads  106  may be used to stabilize the patient&#39;s head. Further, as will be appreciated, the pads  106  on the end of the articulated arm  86  may have various alternative designs. 
   Therefore, the invention in its broadest aspects is not limited to the specific details shown and described. Consequently, departures may be made from the details described herein without departing from the spirit and scope of the claims which follow.