Patent Publication Number: US-2020281788-A1

Title: Surgical frame having translating lower beam and moveable linkage or surgical equipment attached thereto and method for use thereof

Description:
The present application is a continuation of U.S. application Ser. No. 16/107,788, filed Aug. 21, 2018; all of which is incorporated by reference herein. 
    
    
     BACKGROUND OF THE INVENTION 
     Field of the Invention 
     The present invention relates to a surgical frame and a method for use thereof incorporating a translating lower beam and a linkage and/or surgical equipment supportively and moveably attached thereto. More particularly, the present invention relates to a surgical frame and a method for use thereof, where the surgical frame includes a translating lower beam that is moveable with respect to the remainder of the surgical frame, and a linkage and/or surgical equipment that are moveable relative to the translating lower beam. More specifically, the present invention relates to a surgical frame and a method for use thereof, where the surgical frame includes a translating lower beam that can be positioned and repositioned relative to the surgical frame, and the surgical frame further includes a linear movement mechanism for positioning and repositioning a linkage and/or surgical equipment supportively and moveably attached to the translating lower beam or interconnected with the translating lower beam via the linkage relative to the translating lower beam. 
     DESCRIPTION OF THE PRIOR ART 
     Surgical frames used to support patients thereon can include translating lower beams that can move relative to the remainder of the surgical frames. Such translating lower beams afford greater access to a patient receiving area to facilitate transfer to and from the surgical frame, and afford greater access to a patient by a surgeon and/or surgical assistant during surgery. Surgical equipment requiring support by moveable carts is oftentimes used during spinal surgery. Surgical equipment is oftentimes also attached directly to the surgical frames. However, moveable carts and surgical equipment attached directly to the surgical frames could potentially interfere with movement of a main beam or a translating lower beam during surgery. Therefore, there is need for a surgical frame moveably incorporating a linkage and/or surgical equipment supportively and moveably attached to the translating lower beam or interconnected with the translating lower beam via the linkage. For example, the interconnection of a cart with the translating lower beam via the linkage could allow the cart and any surgical equipment supported thereby to move so as to avoid interference with the main beam or the translating lower beam. The surgical frame could also include a linear movement mechanism facilitating movement of the linkage and/or the surgical equipment along the translating lower beam to afford movement thereof relative to the translating lower beam. 
     SUMMARY OF THE INVENTION 
     The present invention in one preferred embodiment contemplates a method of reconfiguring a surgical frame and positioning a cart interconnected with the surgical frame before, during, or after surgery including providing the surgical frame, the surgical frame including a support platform, a first support portion, a second support portion, and a main beam spaced from the ground by the support platform, the first support portion, and the second support portion, the support platform including a translating beam moveable relative to portions of the support platform between a first position at or adjacent a first lateral side of the surgical frame and a second position at or adjacent a second lateral side of the surgical frame, the support platform including a linkage for interconnecting the cart with the surgical frame, the linkage being moveable with respect to the translating beam between a first position at or adjacent a first end of the translating beam and a second position at or adjacent a second end of the translating beam, the main beam being configured to receive a patient thereon, the main beam and the patient received thereon being rotatable relative to the support platform, the first support portion, and the second support portion; providing the cart, the cart being interconnected with the surgical frame via the linkage, the cart being moveable via movement of the translating beam and the linkage, the cart supporting surgical equipment thereon; supporting the patient in a prone position by the main beam of the surgical frame; rotating the main beam from at least a first position supporting the patient in the prone position to a second position supporting the patient in one of an angled position and a lateral position; and moving the translating beam relative to the portions of the support platform and moving the linkage relative to the translating beam to prevent the cart from interfering with the rotation of the main beam. 
     The present invention in another preferred embodiment contemplates a method of reconfiguring a surgical frame and positioning a cart interconnected with the surgical frame before, during, or after surgery including providing the surgical frame, the surgical frame including at least a support platform and a moveable main beam, the support platform having a translating beam moveable relative to portions of the support platform between a first position at or adjacent a first lateral side of the surgical frame and a second position at or adjacent a second lateral side of the surgical frame, the support platform including a linkage for interconnecting the cart with the surgical frame, the linkage being moveable with respect to the translating beam between a first position at or adjacent a first end of the translating beam and a second position at or adjacent a second end of the translating beam, the main beam being configured to receive a patient thereon, the main beam and the patient received thereon being rotatable relative to the support platform; providing the cart, the cart being interconnected with the surgical frame via the linkage, the cart being moveable via movement of the translating beam and the linkage, the cart supporting surgical equipment thereon; supporting the patient in a prone position by the main beam of the surgical frame; rotating the main beam from at least a first position supporting the patient in the prone position to a second position supporting the patient in one of an angled position and a lateral position; and moving the translating beam relative to the portions of the support platform and moving the linkage relative to the translating beam to prevent the cart from interfering with the rotation of the main beam. 
     The present invention in yet another preferred embodiment contemplates a reconfigurable surgical frame and a surgical cart interconnected with the reconfigurable surgical frame, where the reconfigurable surgical frame includes a support platform, a first support portion, a second support portion, and a main beam spaced from the ground by the support platform, the first support portion, and the second support portion, the support platform including a translating beam moveable relative to portions of the support platform between a first position at or adjacent a first lateral side of the surgical frame and a second position at or adjacent a second lateral side of the surgical frame, and the support platform including a linkage and a linear movement mechanism, the linkage being moveable via actuation of the linear movement mechanism between a first position at or adjacent a first end of the translating beam and a second position at or adjacent a second end of the translating beam, the main beam being configured to receive a patient thereon, the main beam and the patient received thereon being rotatable relative to the support platform, the first support portion, and the second support portion from at least a first position supporting the patient in the prone position to a second position supporting the patient in one of an angled position and a lateral position; where the surgical cart is interconnected to the translating beam via the linkage, and the surgical cart including one or more casters affording movement thereof, and surgical robot supported thereon; and where, during rotation of the main beam between the first position and the second position thereof, the translating beam is moveable relative to the portions of the support platform and the linkage is moveable relative to the translating beam to prevent the cart from interfering with the rotation of the main beam. 
     These and other objects of the present invention will be apparent from review of the following specification and the accompanying drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a top perspective view of a prior art surgical frame with a patient positioned thereon in a prone position; 
         FIG. 2  is a side elevational view of the surgical frame of  FIG. 1  with the patient positioned thereon in a prone position; 
         FIG. 3  is another side elevational view of the surgical frame of  FIG. 1  with the patient positioned thereon in a prone position; 
         FIG. 4  is a top plan view of the surgical frame of  FIG. 1  with the patient positioned thereon in a prone position; 
         FIG. 5  is a top perspective view of the surgical frame of  FIG. 1  with the patient positioned thereon in a lateral position; 
         FIG. 6  is a top perspective view of portions of the surgical frame of  FIG. 1  showing an area of access to the head of the patient positioned thereon in a prone position; 
         FIG. 7  is a side elevational view of the surgical frame of  FIG. 1  showing a torso-lift support supporting the patient in a lifted position; 
         FIG. 8  is another side elevational view of the surgical frame of  FIG. 1  showing the torso-lift support supporting the patient in the lifted position; 
         FIG. 9  is an enlarged top perspective view of portions of the surgical frame of  FIG. 1  showing the torso-lift support supporting the patient in an unlifted position; 
         FIG. 10  is an enlarged top perspective view of portions of the surgical frame of  FIG. 1  showing the torso-lift support supporting the patient in the lifted position; 
         FIG. 11  is an enlarged top perspective view of componentry of the torso-lift support in the unlifted position; 
         FIG. 12  is an enlarged top perspective view of the componentry of the torso-lift support in the lifted position; 
         FIG. 13A  is a perspective view of an embodiment of a structural offset main beam for use with another embodiment of a torso-lift support showing the torso-lift support in a retracted position; 
         FIG. 13B  is a perspective view similar to  FIG. 13A  showing the torso-lift support at half travel; 
         FIG. 13C  is a perspective view similar to  FIGS. 13A and 13B  showing the torso-lift support at full travel; 
         FIG. 14  is a perspective view of a chest support lift mechanism of the torso-lift support of  FIGS. 13A-13C  with actuators thereof retracted; 
         FIG. 15  is another perspective view of a chest support lift mechanism of the torso-lift support of  FIGS. 13A-13C  with the actuators thereof extended; 
         FIG. 16  is a top perspective view of the surgical frame of  FIG. 5 ; 
         FIG. 17  is an enlarged top perspective view of portions of the surgical frame of  FIG. 1  showing a sagittal adjustment assembly including a pelvic-tilt mechanism and leg adjustment mechanism; 
         FIG. 18  is an enlarged side elevational view of portions of the surgical frame of  FIG. 1  showing the pelvic-tilt mechanism; 
         FIG. 19  is an enlarged perspective view of componentry of the pelvic-tilt mechanism; 
         FIG. 20  is an enlarged perspective view of a captured rack and a worm gear assembly of the componentry of the pelvic-tilt mechanism; 
         FIG. 21  is an enlarged perspective view of the worm gear assembly of  FIG. 20 ; 
         FIG. 22  is a side elevational view of portions of the surgical frame of  FIG. 1  showing the patient positioned thereon and the pelvic-tilt mechanism of the sagittal adjustment assembly in the flexed position; 
         FIG. 23  is another side elevational view of portions of the surgical frame of  FIG. 1  showing the patient positioned thereon and the pelvic-tilt mechanism of the sagittal adjustment assembly in the fully extended position; 
         FIG. 24  is an enlarged top perspective view of portions of the surgical frame of  FIG. 1  showing a coronal adjustment assembly; 
         FIG. 25  is a top perspective view of portions of the surgical frame of  FIG. 1  showing operation of the coronal adjustment assembly; 
         FIG. 26  is a top perspective view of a portion of the surgical frame of  FIG. 1  showing operation of the coronal adjustment assembly; 
         FIG. 27  is a top perspective view of a surgical frame in accordance with an embodiment of the present invention with the patient positioned thereon in a prone position showing a translating beam thereof in a first position; 
         FIG. 28  is another top perspective view of the surgical frame of  FIG. 27  with the patient in a prone position showing the translating beam thereof in a second position; 
         FIG. 29  is yet another top perspective view of the surgical frame of  FIG. 27  with the patient in a lateral position showing the translating beam thereof in a third position; 
         FIG. 30  is top plan view of the surgical frame of  FIG. 27  with the patient in a lateral position showing the translating beam thereof in the third position; 
         FIG. 31  is a top side perspective view of a surgical cart supporting a surgical robot thereon, a linkage attached to the surgical cart, and a portion of a linear movement mechanism attached to the linkage and to a portion of a translating beam of a surgical frame; 
         FIG. 32  is a top side perspective view from a first side of a surgical frame with a patient positioned thereon in a prone position, the surgical frame including the translating beam and the linear movement mechanism, the translating beam being located in a first position, and the linear movement mechanism being located in a first linear position; 
         FIG. 33  is a top side perspective view from the first side of the surgical frame of  FIG. 32  with the patient positioned thereon in the prone position, the translating beam being located in the first position, and the linear movement mechanism being located in a second linear position; 
         FIG. 34  is a top side perspective view from the second side of the surgical frame of  FIG. 32  with the patient positioned thereon in the prone position, the translating beam being located in a second position, and the linear movement mechanism being located in the second linear position, the second position of the translating beam and the second position of the linear movement mechanism locating the surgical robot for surgery on the patient in the prone position; 
         FIG. 35  is a top side perspective view from a second side of the surgical frame of  FIG. 32  with the patient positioned thereon in the prone position, the translating beam being located in the second position, the linear movement mechanism being located in the second linear position, and the surgical robot being located to assist with surgery on the patient in the prone position; 
         FIG. 36  is a top side perspective view from the second side of the surgical frame of  FIG. 32  with the patient positioned thereon in a first angled position, the translating beam being located in a third position between the first and second positions, the linear movement mechanism being located in the second linear position, and the surgical robot being positioned to assist with surgery on the patient in the first angled position; 
         FIG. 37  is a top side perspective view from the second side of the surgical frame of  FIG. 32  with the patient positioned thereon in a second angled position, the translating beam being located in the third position, the linear movement mechanism being located in the second linear position, and the surgical robot being positioned to assist with surgery on the patient in the second angled position; 
         FIG. 38  is a top side perspective view from the second side of the surgical frame of  FIG. 32  with the patient positioned thereon in a lateral position, the translating beam being located in the third position, the linear movement mechanism being located in the second linear position, and the surgical robot being positioned to assist with surgery on the patient in the lateral position; 
         FIG. 39  is a top side perspective view of a portion of the first side of the surgical frame of  FIG. 32  depicting a first embodiment of a patient support arm supportively and moveably attached to the translating beam thereof; 
         FIG. 39A  is a top side perspective view of a portion of the first side of the surgical frame of  FIG. 32  depicting a second embodiment of a patient support arm supportively and moveably attached to the translating beam thereof; 
         FIG. 40  is a top side perspective view from the first side of the surgical frame of  FIG. 32  with the patient positioned thereon in the prone position, a main beam being located in a first horizontal position at a first height, and the patient support arm being used to support the pelvis of the patient; 
         FIG. 41  is top side perspective view from the first side of the surgical frame of  FIG. 32  with the patient positioned thereon in the prone position, the main beam being located in a first angled position, and the patient support arm being used to support the pelvis of the patient; and 
         FIG. 42  is a top side perspective view from the first side of the surgical frame of  FIG. 32  with the patient positioned thereon in the prone position, the main beam being located in a second horizontal position at a second height, and the patient support arm being used to support the pelvis of the patient. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
       FIGS. 1-26  depict a prior art embodiment and components of a surgical support frame generally indicated by the numeral  10 .  FIGS. 1-26  were previously described in U.S. Ser. No. 15/239,256, which is hereby incorporated by reference herein in its entirety. Furthermore,  FIGS. 27-30  were previously described in U.S. Ser. No. 15/639,080, which is hereby incorporated by reference herein in its entirety. 
     As discussed below, the surgical frame  10  serves as an exoskeleton to support the body of the patient P as the patient&#39;s body is manipulated thereby, and, in doing so, serves to support the patient P such that the patient&#39;s spine does not experience unnecessary torsion. 
     The surgical frame  10  is configured to provide a relatively minimal amount of structure adjacent the patient&#39;s spine to facilitate access thereto and to improve the quality of imaging available before and during surgery. Thus, the surgeon&#39;s workspace and imaging access are thereby increased. Furthermore, radio-lucent or low magnetic susceptibility materials can be used in constructing the structural components adjacent the patient&#39;s spine in order to further enhance imaging quality. 
     The surgical frame  10  has a longitudinal axis and a length therealong. As depicted in  FIGS. 1-5 , for example, the surgical frame  10  includes an offset structural main beam  12  and a support structure  14 . The offset main beam  12  is spaced from the ground by the support structure  14 . As discussed below, the offset main beam  12  is used in supporting the patient P on the surgical frame  10  and various support components of the surgical frame  10  that directly contact the patient P (such as a head support  20 , arm supports  22 A and  22 B, torso-lift supports  24  and  160 , a sagittal adjustment assembly  28  including a pelvic-tilt mechanism  30  and a leg adjustment mechanism  32 , and a coronal adjustment assembly  34 ). As discussed below, an operator such as a surgeon can control actuation of the various support components to manipulate the position of the patient&#39;s body. Soft straps (not shown) are used with these various support components to secure the patient P to the frame and to enable either manipulation or fixation of the patient P. Reusable soft pads can be used on the load-bearing areas of the various support components. 
     The offset main beam  12  is used to facilitate rotation of the patient P. The offset main beam  12  can be rotated a full 360° before and during surgery to facilitate various positions of the patient P to afford various surgical pathways to the patient&#39;s spine depending on the surgery to be performed. For example, the offset main beam  12  can be positioned to place the patient P in a prone position (e.g.,  FIGS. 1-4 ), a lateral position (e.g.,  FIG. 5 ), and in a position 45° between the prone and lateral positions. Furthermore, the offset main beam  12  can be rotated to afford anterior, posterior, lateral, anterolateral, and posterolateral pathways to the spine. As such, the patient&#39;s body can be flipped numerous times before and during surgery without compromising sterility or safety. The various support components of the surgical frame  10  are strategically placed to further manipulate the patient&#39;s body into position before and during surgery. Such intraoperative manipulation and positioning of the patient P affords a surgeon significant access to the patient&#39;s body. To illustrate, when the offset main beam  12  is rotated to position the patient P in a lateral position, as depicted in  FIG. 5 , the head support  20 , the arm supports  22 A and  22 B, the torso-lift support  24 , the sagittal adjustment assembly  28 , and/or the coronal adjustment assembly  34  can be articulated such that the surgical frame  10  is OLIF-capable or DLIF-capable. 
     As depicted in  FIG. 1 , for example, the support structure  14  includes a first support portion  40  and a second support portion  42  interconnected by a cross member  44 . Each of the first and second support portions  40  and  42  include a horizontal portion  46  and a vertical support post  48 . The horizontal portions  46  are connected to the cross member  44 , and casters  50  can be attached to the horizontal portions  46  to facilitate movement of the surgical frame  10 . 
     The vertical support posts  48  can be adjustable to facilitate expansion and contraction of the heights thereof. Expansion and contraction of the vertical support posts  48  facilitates raising and lowering, respectively, of the offset main beam  12 . As such, the vertical support posts  48  can be adjusted to have equal or different heights. For example, the vertical support posts  48  can be adjusted such that the vertical support post  48  of the second support portion  42  is raised 12 inches higher than the vertical support post  48  of the first support portion  40  to place the patient P in a reverse Trendelenburg position. 
     Furthermore, cross member  44  can be adjustable to facilitate expansion and contraction of the length thereof. Expansion and contraction of the cross member  44  facilitates lengthening and shortening, respectively, of the distance between the first and second support portions  40  and  42 . 
     The vertical support post  48  of the first and second support portions  40  and  42  have heights at least affording rotation of the offset main beam  12  and the patient P positioned thereon. Each of the vertical support posts  48  include a clevis  60 , a support block  62  positioned in the clevis  60 , and a pin  64  pinning the clevis  60  to the support block  62 . The support blocks  62  are capable of pivotal movement relative to the clevises  60  to accommodate different heights of the vertical support posts  48 . Furthermore, axles  66  extending outwardly from the offset main beam  12  are received in apertures  68  formed the support blocks  62 . The axles  66  define an axis of rotation of the offset main beam  12 , and the interaction of the axles  66  with the support blocks  62  facilitate rotation of the offset main beam  12 . 
     Furthermore, a servomotor  70  can be interconnected with the axle  66  received in the support block  62  of the first support portion  40 . The servomotor  70  can be computer controlled and/or operated by the operator of the surgical frame  10  to facilitate controlled rotation of the offset main beam  12 . Thus, by controlling actuation of the servomotor  70 , the offset main beam  12  and the patient P supported thereon can be rotated to afford the various surgical pathways to the patient&#39;s spine. 
     As depicted in  FIGS. 1-5 , for example, the offset main beam  12  includes a forward portion  72  and a rear portion  74 . The forward portion  72  supports the head support  20 , the arm supports  22 A and  22 B, the torso-lift support  24 , and the coronal adjustment assembly  34 , and the rear portion  74  supports the sagittal adjustment assembly  28 . The forward and rear portions  72  and  74  are connected to one another by connection member  76  shared therebetween. The forward portion  72  includes a first portion  80 , a second portion  82 , a third portion  84 , and a fourth portion  86 . The first portion  80  extends transversely to the axis of rotation of the offset main beam  12 , and the second and fourth portions  82  and  86  are aligned with the axis of rotation of the offset main beam  12 . The rear portion  74  includes a first portion  90 , a second portion  92 , and a third portion  94 . The first and third portions  90  and  94  are aligned with the axis of rotation of the offset main beam  12 , and the second portion  92  extends transversely to the axis of rotation of the offset main beam  12 . 
     The axles  66  are attached to the first portion  80  of the forward portion  72  and to the third portion  94  of the rear portion  74 . The lengths of the first portion  80  of the forward portion  72  and the second portion  92  of the rear portion  74  serve in offsetting portions of the forward and rear portions  72  and  74  from the axis of rotation of the offset main beam  12 . This offset affords positioning of the cranial-caudal axis of patient P approximately aligned with the axis of rotation of the offset main beam  12 . 
     Programmable settings controlled by a computer controller (not shown) can be used to maintain an ideal patient height for a working position of the surgical frame  10  at a near-constant position through rotation cycles, for example, between the patient positions depicted in  FIGS. 1 and 5 . This allows for a variable axis of rotation between the first portion  40  and the second portion  42 . 
     As depicted in  FIG. 5 , for example, the head support  20  is attached to a chest support plate  100  of the torso-lift support  24  to support the head of the patient P. If the torso-lift support  24  is not used, the head support  20  can be directly attached to the forward portion  72  of the offset main beam  12 . As depicted in  FIGS. 4 and 6 , for example, the head support  20  further includes a facial support cradle  102 , an axially adjustable head support beam  104 , and a temple support portion  106 . Soft straps (not shown) can be used to secure the patient P to the head support  20 . The facial support cradle  102  includes padding across the forehead and cheeks, and provides open access to the mouth of the patient P. The head support  20  also allows for imaging access to the cervical spine. Adjustment of the head support  20  is possible via adjusting the angle and the length of the head support beam  104  and the temple support portion  106 . 
     As depicted in  FIG. 5 , for example, the arm supports  22 A and  22 B contact the forearms and support the remainder of the arms of the patient P, with the first arm support  22 A and the second arm support  22 B attached to the chest support plate  100  of the torso-lift support  24 . If the torso-lift support  24  is not used, the arm supports  22 A and  22 B can both be directly attached to the offset main beam  12 . The arm supports  22 A and  22 B are positioned such that the arms of the patient P are spaced away from the remainder of the patient&#39;s body to provide access ( FIG. 6 ) to at least portions of the face and neck of the patient P, thereby providing greater access to the patient. 
     As depicted in  FIGS. 7-12 , for example, the surgical frame  10  includes a torso-lift capability for lifting and lowering the torso of the patient P between an uplifted position and a lifted position, which is described in detail below with respect to the torso-lift support  24 . As depicted in  FIGS. 7 and 8 , for example, the torso-lift capability has an approximate center of rotation (“COR”)  108  that is located at a position anterior to the patient&#39;s spine about the L2 of the lumbar spine, and is capable of elevating the upper body of the patient at least an additional six inches when measured at the chest support plate  100 . 
     As depicted in  FIGS. 9-12 , for example, the torso-lift support  24  includes a “crawling” four-bar mechanism  110  attached to the chest support plate  100 . Soft straps (not shown) can be used to secure the patient P to the chest support plate  100 . The head support  20  and the arm supports  22 A and  22 B are attached to the chest support plate  100 , thereby moving with the chest support plate  100  as the chest support plate  100  is articulated using the torso-lift support  24 . The fixed COR  108  is defined at the position depicted in  FIGS. 7 and 8 . Appropriate placement of the COR  108  is important so that spinal cord integrity is not compromised (i.e., overly compressed or stretched) during the lift maneuver performed by the torso-lift support  24 . 
     As depicted in  FIGS. 10-12 , for example, the four-bar mechanism  110  includes first links  112  pivotally connected between offset main beam  12  and the chest support plate  100 , and second links  114  pivotally connected between the offset main beam  12  and the chest support plate  100 . As depicted in  FIGS. 11 and 12 , for example, in order to maintain the COR  108  at the desired fixed position, the first and second links  112  and  114  of the four-bar mechanism  110  crawl toward the first support portion  40  of the support structure  14 , when the patient&#39;s upper body is being lifted. The first and second links  112  and  114  are arranged such that neither the surgeon&#39;s workspace nor imaging access are compromised while the patient&#39;s torso is being lifted. 
     As depicted in  FIGS. 11 and 12 , for example, each of the first links  112  define an L-shape, and includes a first pin  116  at a first end  118  thereof. The first pin  116  extends through first elongated slots  120  defined in the offset main beam  12 , and the first pin  116  connects the first links  112  to a dual rack and pinion mechanism  122  via a drive nut  124  provided within the offset main beam  12 , thus defining a lower pivot point thereof. Each of the first links  112  also includes a second pin  126  positioned proximate the corner of the L-shape. The second pin  126  extends through second elongated slots  128  defined in the offset main beam  12 , and is linked to a carriage  130  of rack and pinion mechanism  122 . Each of the first links  112  also includes a third pin  132  at a second end  134  that is pivotally attached to chest support plate  100 , thus defining an upper pivot point thereof. 
     As depicted in  FIGS. 11 and 12 , for example, each of the second links  114  includes a first pin  140  at a first end  142  thereof. The first pin  140  extends through the first elongated slot  120  defined in the offset main beam  12 , and the first pin  140  connects the second links  114  to the drive nut  124  of the rack and pinion mechanism  122 , thus defining a lower pivot point thereof. Each of the second links  114  also includes a second pin  144  at a second end  146  that is pivotally connected to the chest support plate  100 , thus defining an upper pivot point thereof. 
     As depicted in  FIGS. 11 and 12 , the rack and pinion mechanism  122  includes a drive screw  148  engaging the drive nut  124 . Coupled gears  150  are attached to the carriage  130 . The larger of the gears  150  engage an upper rack  152  (fixed within the offset main beam  12 ), and the smaller of the gears  150  engage a lower rack  154 . The carriage  130  is defined as a gear assembly that floats between the two racks  152  and  154 . 
     As depicted in  FIGS. 11 and 12 , the rack and pinion mechanism  122  converts rotation of the drive screw  148  into linear translation of the first and second links  112  and  114  in the first and second elongated slots  120  and  128  toward the first portion  40  of the support structure  14 . As the drive nut  124  translates along drive screw  148  (via rotation of the drive screw  148 ), the carriage  130  translates towards the first portion  40  with less travel due to the different gear sizes of the coupled gears  150 . The difference in travel, influenced by different gear ratios, causes the first links  112  pivotally attached thereto to lift the chest support plate  100 . Lowering of the chest support plate  100  is accomplished by performing this operation in reverse. The second links  114  are “idler” links (attached to the drive nut  124  and the chest support plate  100 ) that controls the tilt of the chest support plate  100  as it is being lifted and lowered. All components associated with lifting while tilting the chest plate predetermine where COR  108  resides. Furthermore, a servomotor (not shown) interconnected with the drive screw  148  can be computer controlled and/or operated by the operator of the surgical frame  10  to facilitate controlled lifting and lowering of the chest support plate  100 . A safety feature can be provided, enabling the operator to read and limit a lifting and lowering force applied by the torso-lift support  24  in order to prevent injury to the patient P. Moreover, the torso-lift support  24  can also include safety stops (not shown) to prevent over-extension or compression of the patient P, and sensors (not shown) programmed to send patient position feedback to the safety stops. 
     An alternative preferred embodiment of a torso-lift support is generally indicated by the numeral  160  in  FIGS. 13A-15 . As depicted in  FIGS. 13A-13C , an alternate offset main beam  162  is utilized with the torso-lift support  160 . Furthermore, the torso-lift support  160  has a support plate  164  pivotally linked to the offset main beam  162  by a chest support lift mechanism  166 . An arm support rod/plate  168  is connected to the support plate  164 , and the second arm support  22 B. The support plate  164  is attached to the chest support plate  100 , and the chest support lift mechanism  166  includes various actuators  170 A,  170 B, and  170 C used to facilitate positioning and repositioning of the support plate  164  (and hence, the chest support plate  100 ). 
     As discussed below, the torso-lift support  160  depicted in  FIGS. 13A-15  enables a COR  172  thereof to be programmably altered such that the COR  172  can be a fixed COR or a variable COR. As their names suggest, the fixed COR stays in the same position as the torso-lift support  160  is actuated, and the variable COR moves between a first position and a second position as the torso-lift support  160  is actuated between its initial position and final position at full travel thereof. Appropriate placement of the COR  172  is important so that spinal cord integrity is not compromised (i.e., overly compressed or stretched). Thus, the support plate  164  (and hence, the chest support plate  100 ) follows a path coinciding with a predetermined COR  172  (either fixed or variable).  FIG. 13A  depicts the torso-lift support  160  retracted,  FIG. 13B  depicts the torso-lift support  160  at half travel, and  FIG. 13C  depicts the torso-lift support  160  at full travel. 
     As discussed above, the chest support lift mechanism  166  includes the actuators  170 A,  170 B, and  170 C to position and reposition the support plate  164  (and hence, the chest support plate  100 ). As depicted in  FIGS. 14 and 15 , for example, the first actuator  170 A, the second actuator  1706 , and the third actuator  170 C are provided. Each of the actuators  170 A,  170 B, and  170 C are interconnected with the offset main beam  12  and the support plate  164 , and each of the actuators  170 A,  170 B, and  170 C are moveable between a retracted and extended position. As depicted in  FIGS. 13A-13C , the first actuator  170 A is pinned to the offset main beam  162  using a pin  174  and pinned to the support plate  164  using a pin  176 . Furthermore, the second and third actuators  170 B and  170 C are received within the offset main beam  162 . The second actuator  170 B is interconnected with the offset main beam  162  using a pin  178 , and the third actuator  170 C is interconnected with the offset main beam  162  using a pin  180 . 
     The second actuator  170 B is interconnected with the support plate  164  via first links  182 , and the third actuator  170 C is interconnected with the support plate  164  via second links  184 . First ends  190  of the first links  182  are pinned to the second actuator  170 B and elongated slots  192  formed in the offset main beam  162  using a pin  194 , and first ends  200  of the second links  184  are pinned to the third actuator  170 C and elongated slots  202  formed in the offset main beam  162  using a pin  204 . The pins  194  and  204  are moveable within the elongated slots  192  and  202 . Furthermore, second ends  210  of the first links  182  are pinned to the support plate  164  using the pin  176 , and second ends  212  of the second links  184  are pinned to the support plate  164  using a pin  214 . To limit interference therebetween, as depicted in  FIGS. 13A-13C , the first links  182  are provided on the exterior of the offset main beam  162 , and, depending on the position thereof, the second links  184  are positioned on the interior of the offset main beam  162 . 
     Actuation of the actuators  170 A,  170 B, and  170 C facilitates movement of the support plate  164 . Furthermore, the amount of actuation of the actuators  170 A,  170 B, and  170 C can be varied to affect different positions of the support plate  164 . As such, by varying the amount of actuation of the actuators  170 A,  1706 , and  170 C, the COR  172  thereof can be controlled. As discussed above, the COR  172  can be predetermined, and can be either fixed or varied. Furthermore, the actuation of the actuators  170 A,  170 B, and  170 C can be computer controlled and/or operated by the operator of the surgical frame  10 , such that the COR  172  can be programmed by the operator. As such, an algorithm can be used to determine the rates of extension of the actuators  170 A,  1706 , and  170 C to control the COR  172 , and the computer controls can handle implementation of the algorithm to provide the predetermined COR. A safety feature can be provided, enabling the operator to read and limit a lifting force applied by the actuators  170 A,  170 B, and  170 C in order to prevent injury to the patient P. Moreover, the torso-lift support  160  can also include safety stops (not shown) to prevent over-extension or compression of the patient P, and sensors (not shown) programmed to send patient position feedback to the safety stops. 
       FIGS. 16-23  depict portions of the sagittal adjustment assembly  28 . The sagittal adjustment assembly  28  can be used to distract or compress the patient&#39;s lumbar spine during or after lifting or lowering of the patient&#39;s torso by the torso-lift supports. The sagittal adjustment assembly  28  supports and manipulates the lower portion of the patient&#39;s body. In doing so, the sagittal adjustment assembly  28  is configured to make adjustments in the sagittal plane of the patient&#39;s body, including tilting the pelvis, controlling the position of the upper and lower legs, and lordosing the lumbar spine. 
     As depicted in  FIGS. 16 and 17 , for example, the sagittal adjustment assembly  28  includes the pelvic-tilt mechanism  30  for supporting the thighs and lower legs of the patient P. The pelvic-tilt mechanism  30  includes a thigh cradle  220  configured to support the patient&#39;s thighs, and a lower leg cradle  222  configured to support the patient&#39;s shins. Different sizes of thigh and lower leg cradles can be used to accommodate different sizes of patients, i.e., smaller thigh and lower leg cradles can be used with smaller patients, and larger thigh and lower leg cradles can be used with larger patients. Soft straps (not shown) can be used to secure the patient P to the thigh cradle  220  and the lower leg cradle  222 . The thigh cradle  220  and the lower leg cradle  222  are moveable and pivotal with respect to one another and to the offset main beam  12 . To facilitate rotation of the patient&#39;s hips, the thigh cradle  220  and the lower leg cradle  222  can be positioned anterior and inferior to the patient&#39;s hips. 
     As depicted in  FIGS. 18 and 25 , for example, a first support strut  224  and second support struts  226  are attached to the thigh cradle  220 . Furthermore, third support struts  228  are attached to the lower leg cradle  222 . The first support strut  224  is pivotally attached to the offset main beam  12  via a support plate  230  and a pin  232 , and the second support struts  226  are pivotally attached to the third support struts  228  via pins  234 . The pins  234  extend through angled end portions  236  and  238  of the second and third support struts  226  and  228 , respectively. Furthermore, the lengths of second and third support struts  226  and  228  are adjustable to facilitate expansion and contraction of the lengths thereof. 
     To accommodate patients with different torso lengths, the position of the thigh cradle  220  can be adjustable by moving the support plate  230  along the offset main beam  12 . Furthermore, to accommodate patients with different thigh and lower leg lengths, the lengths of the second and third support struts  226  and  228  can be adjusted. 
     To control the pivotal angle between the second and third support struts  226  and  228  (and hence, the pivotal angle between the thigh cradle  220  and lower leg cradle  222 ), a link  240  is pivotally connected to a captured rack  242  via a pin  244 . The captured rack  242  includes an elongated slot  246 , through which is inserted a worm gear shaft  248  of a worm gear assembly  250 . The worm gear shaft  248  is attached to a gear  252  provided on the interior of the captured rack  242 . The gear  252  contacts teeth  254  provided inside the captured rack  242 , and rotation of the gear  252  (via contact with the teeth  254 ) causes motion of the captured rack  242  upwardly and downwardly. The worm gear assembly  250 , as depicted in  FIGS. 19-21 , for example, includes worm gears  256  which engage a drive shaft  258 , and which are connected to the worm gear shaft  248 . 
     The worm gear assembly  250  also is configured to function as a brake, which prevents unintentional movement of the sagittal adjustment assembly  28 . Rotation of the drive shaft  258  causes rotation of the worm gears  256 , thereby causing reciprocal vertical motion of the captured rack  242 . The vertical reciprocal motion of the captured rack  242  causes corresponding motion of the link  240 , which in turn pivots the second and third support struts  226  and  228  to correspondingly pivot the thigh cradle  220  and lower leg cradle  222 . A servomotor (not shown) interconnected with the drive shaft  258  can be computer controlled and/or operated by the operator of the surgical frame  10  to facilitate controlled reciprocal motion of the captured rack  242 . 
     The sagittal adjustment assembly  28  also includes the leg adjustment mechanism  32  facilitating articulation of the thigh cradle  220  and the lower leg cradle  222  with respect to one another. In doing so, the leg adjustment mechanism  32  accommodates the lengthening and shortening of the patient&#39;s legs during bending thereof. As depicted in  FIG. 17 , for example, the leg adjustment mechanism  32  includes a first bracket  260  and a second bracket  262  attached to the lower leg cradle  222 . The first bracket  260  is attached to a first carriage portion  264 , and the second bracket  262  is attached to a second carriage portion  266  via pins  270  and  272 , respectively. The first carriage portion  264  is slidable within third portion  94  of the rear portion  74  of the offset main beam  12 , and the second carriage portion  266  is slidable within the first portion  90  of the rear portion  74  of the offset main beam  12 . An elongated slot  274  is provided in the first portion  90  to facilitate engagement of the second bracket  262  and the second carriage portion  266  via the pin  272 . As the thigh cradle  220  and the lower leg cradle  222  articulate with respect to one another (and the patient&#39;s legs bend accordingly), the first carriage  264  and the second carriage  266  can move accordingly to accommodate such movement. 
     The pelvic-tilt mechanism  30  is movable between a flexed position and a fully extended position. As depicted in  FIG. 22 , in the flexed position, the lumbar spine is hypo-lordosed. This opens the posterior boundaries of the lumbar vertebral bodies and allows for easier placement of any interbody devices. The lumbar spine stretches slightly in this position. As depicted in  FIG. 23 , in the extended position, the lumbar spine is lordosed. This compresses the lumbar spine. When posterior fixation devices, such as rods and screws, are placed, optimal sagittal alignment can be achieved. During sagittal alignment, little to negligible angle change occurs between the thighs and the pelvis. The pelvic-tilt mechanism  30  also can hyper-extend the hips as a means of lordosing the spine, in addition to tilting the pelvis. One of ordinary skill will recognize, however, that straightening the patient&#39;s legs does not lordose the spine. Leg straightening is a consequence of rotating the pelvis while maintaining a fixed angle between the pelvis and the thighs. 
     The sagittal adjustment assembly  28 , having the configuration described above, further includes an ability to compress and distract the spine dynamically while in the lordosed or flexed positions. The sagittal adjustment assembly  28  also includes safety stops (not shown) to prevent over-extension or compression of the patient, and sensors (not shown) programmed to send patient position feedback to the safety stops. 
     As depicted in  FIGS. 24-26 , for example, the coronal adjustment assembly  34  is configured to support and manipulate the patient&#39;s torso, and further to correct a spinal deformity, including but not limited to a scoliotic spine. As depicted in  FIGS. 24-26 , for example, the coronal adjustment assembly  34  includes a lever  280  linked to an arcuate radio-lucent paddle  282 . As depicted in  FIGS. 24 and 25 , for example, a rotatable shaft  284  is linked to the lever  280  via a transmission  286 , and the rotatable shaft  284  projects from an end of the chest support plate  100 . Rotation of the rotatable shaft  284  is translated by the transmission  286  into rotation of the lever  280 , causing the paddle  282 , which is linked to the lever  280 , to swing in an arc. Furthermore, a servomotor (not shown) interconnected with the rotatable shaft  284  can be computer controlled and/or operated by the operator of the surgical frame  10  to facilitate controlled rotation of the lever  280 . 
     As depicted in  FIG. 24 , for example, adjustments can be made to the position of the paddle  282  to manipulate the torso and straighten the spine. As depicted in  FIG. 25 , when the offset main beam  12  is positioned such that the patient P is positioned in a lateral position, the coronal adjustment assembly  34  supports the patient&#39;s torso. As further depicted in  FIG. 26 , when the offset main beam  12  is positioned such that the patient P is positioned in a prone position, the coronal adjustment assembly  34  can move the torso laterally, to correct a deformity, including but not limited to a scoliotic spine. When the patient is strapped in via straps (not shown) at the chest and legs, the torso is relatively free to move and can be manipulated. Initially, the paddle  282  is moved by the lever  280  away from the offset main beam  12 . After the paddle  282  has been moved away from the offset main beam  12 , the torso can be pulled with a strap towards the offset main beam  12 . The coronal adjustment assembly  34  also includes safety stops (not shown) to prevent over-extension or compression of the patient, and sensors (not shown) programmed to send patient position feedback to the safety stops. 
     A preferred embodiment of a surgical frame incorporating a translating beam is generally indicated by the numeral  300  in  FIGS. 27-30 . Like the surgical frame  10 , the surgical frame  300  serves as an exoskeleton to support the body of the patient P as the patient&#39;s body is manipulated thereby. In doing so, the surgical frame  300  serves to support the patient P such that the patient&#39;s spine does not experience unnecessary stress/torsion. 
     The surgical frame  300  includes translating beam  302  that is generally indicated by the numeral  302  in  FIGS. 27-30 . The translating beam  302  is capable of translating motion affording it to be positioned and repositioned with respect to portions of the remainder of the surgical frame  300 . As discussed below, the positioning and repositioning of the translating beam  302 , for example, affords greater access to a patient receiving area A defined by the surgical frame  300 , and affords greater access to the patient P by a surgeon and/or a surgical assistant (generally indicated by the letter S in  FIG. 30 ) via access to either of the lateral sides L 1  and L 2  ( FIG. 30 ) of the surgical frame  300 . 
     As discussed below, by affording greater access to the patient receiving area A, the surgical frame  300  affords transfer of the patient P from and to a surgical table/gurney. Using the surgical frame  300 , the surgical table/gurney can be conventional, and there is no need to lift the surgical table/gurney over portions of the surgical frame  300  to afford transfer of the patient P thereto. 
     The surgical frame  300  is configured to provide a relatively minimal amount of structure adjacent the patient&#39;s spine to facilitate access thereto and to improve the quality of imaging available before, during, and even after surgery. Thus, the workspace of a surgeon and/or a surgical assistant and imaging access are thereby increased. The workspace, as discussed below, can be further increased by positioning and repositioning the translating beam  302 . Furthermore, radio-lucent or low magnetic susceptibility materials can be used in constructing the structural components adjacent the patient&#39;s spine in order to further enhance imaging quality. 
     The surgical frame  300 , as depicted in  FIGS. 27-30 , is similar to the surgical frame  10  except that surgical frame  300  includes a support structure  304  having a support platform  306  incorporating the translating beam  302 . The surgical frame  300  incorporates the offset main beam  12  and the features associated therewith from the surgical table  300 . As such, the element numbering used to describe the surgical frame  10  is also applicable to portions of the surgical frame  300 . 
     Rather than including the cross member  44 , and the horizontal portions  46  and the vertical portions  48  of the first and second support portions  40  and  42 , the support structure  304  includes the support platform  306 , a first vertical support post  308 A, and a second vertical support post  308 B. As depicted in  FIGS. 27-30 , the support platform  306  extends from adjacent one longitudinal end to adjacent the other longitudinal end of the surgical frame  300 , and the support platform  306  supports the first vertical support post  308 A at the one longitudinal end and supports the second vertical support post  308 B at the other longitudinal end. 
     As depicted in  FIGS. 27-30 , the support platform  306  (in addition to the translating beam  302 ) includes a first end member  310 , a second end member  312 , a first support bracket  314 , and a second support bracket  316 . Casters  318  are attached to the first and second end members  310  and  312 . The first end member  310  and the second end member  312  each include an upper surface  320  and a lower surface  322 . The casters  318  can be attached to the lower surface of each of the first and second end members  310  and  312  at each end thereof, and the casters  318  can be spaced apart from one another to afford stable movement of the surgical frame  300 . Furthermore, the first support bracket  314  supports the first vertical support post  308 A, and the second support bracket  316  supports the vertical second support post  308 B. 
     The translating beam  302  is interconnected with the first and second end members  310  and  312  of the support platform  306 , and as depicted in  FIGS. 27-30 , the translating beam  302  is capable of movement with respect to the first and second end members  310  and  312 . The translating beam  302  includes a first end member  330 , a second end member  332 , a first L-shaped member  334 , a second L-shaped member  336 , and a cross member  338 . The first L-shaped member  334  is attached to the first end member  330  and the cross member  338 , and the second L-shaped member  336  is attached to the second end member  332  and the cross member  338 . Portions of the first and second L-shaped members  334  and  336  extend downwardly relative to the first and second end members  330  and  332  such that the cross member  338  is positioned vertically below the first and second end member  330  and  332 . The vertical position of the cross member  338  relative to the remainder of the surgical frame  300  lowers the center of gravity of the surgical frame  300 , and in doing so, serves in adding to the stability of the surgical frame  300 . 
     The translating beam  302 , as discussed above, is capable of being positioned and repositioned with respect to portions of the remainder of the surgical frame  300 . To that end, the support platform  306  includes a first translation mechanism  340  and a second translation mechanism  342 . The first translation mechanism  340  facilitates attachment between the first end members  310  and  330 , and the second translation mechanism  342  facilitates attachment between the second end members  312  and  332 . The first and second translation mechanism  340  and  342  also facilitate movement of the translating beam  302  relative to the first end member  310  and the second end member  312 . 
     The first and second translation mechanisms  340  and  342  can each include a transmission  350  and a track  352  for facilitating movement of the translating beam  302 . The tracks  352  are provided on the upper surface  320  of the first and second end members  310  and  312 , and the transmissions  350  are interoperable with the tracks  352 . The first and second transmission mechanisms  340  and  342  can each include an electrical motor  354  or a hand crank (not shown) for driving the transmissions  350 . Furthermore, the transmissions  350  can include, for example, gears or wheels driven thereby for contacting the tracks  352 . The interoperability of the transmissions  350 , the tracks  352 , and the motors  354  or hand cranks form a drive train for moving the translating beam  302 . The movement afforded by the first and second translation mechanism  340  and  342  allows the translating beam  302  to be positioned and repositioned relative to the remainder of the surgical frame  300 . 
     The surgical frame  300  can be configured such that operation of the first and second translation mechanism  340  and  342  can be controlled by an operator such as a surgeon and/or a surgical assistant. As such, movement of the translating beam  302  can be effectuated by controlled automation. Furthermore, the surgical frame  300  can be configured such that movement of the translating beam  302  automatically coincides with the rotation of the offset main beam  12 . By tying the position of the translating beam  302  to the rotational position of the offset main beam  12 , the center of gravity of the surgical frame  300  can be maintained in positions advantageous to the stability thereof. 
     During use of the surgical frame  300 , access to the patient receiving area A and the patient P can be increased or decreased by moving the translating beam  302  between the lateral sides L 1  and L 2  of the surgical frame  300 . Affording greater access to the patient receiving area A facilitates transfer of the patient P between the surgical table/gurney and the surgical frame  300 . Furthermore, affording greater access to the patient P facilitates ease of access by a surgeon and/or a surgical assistant to the surgical site on the patient P. 
     The translating beam  302  is moveable using the first and second translation mechanisms  340  and  342  between a first terminal position ( FIG. 28 ) and a second terminal position ( FIGS. 29 and 30 ). The translating beam  302  is positionable at various positions ( FIG. 27 ) between the first and second terminal positions. When the translating beam  302  is in the first terminal position, as depicted in  FIG. 28 , the translating beam  302  and its cross member  338  are positioned on the lateral side L 1  of the surgical frame  300 . Furthermore, when the translating beam  302  is in the second terminal position, as depicted in  FIGS. 29 and 30 , the translating beam  302  and its cross member  338  are positioned in the middle of the surgical frame  300 . 
     With the translating beam  302  and its cross member  338  moved to be positioned at the lateral side L 1 , the surgical table/gurney and the patient P positioned thereon can be positioned under the offset main beam  12  in the patient receiving area A to facilitate transfer of the patient P to or from the offset main beam  12 . As such, the position of the translating beam  302  at the lateral side L 1  enlarges the patient receiving area A so that the surgical table/gurney can be received therein to allow such transfer to or from the offset main beam  12 . 
     Furthermore, with the translating beam  302  and its cross member  338  moved to be in the middle of the surgical frame  300  ( FIGS. 29 and 30 ), a surgeon and/or a surgical assistant can have access to the patient P from either of the lateral sides L 1  or L 2 . As such, the position of the translating beam  302  in the middle of the surgical frame  300  allows a surgeon and/or a surgical assistant to get close to the patient P supported by the surgical frame  300 . As depicted in  FIG. 30 , for example, a surgeon and/or a surgical assistant can get close to the patient P from the lateral side L 2  without interference from the translating beam  302  and its cross member  338 . The position of the translating beam  302  can be selected to accommodate access by both a surgeon and/or a surgical assistant by avoiding contact thereof with the feet and legs of a surgeon and/or a surgical assistant. 
     The position of the translating beam  302  and its cross member  338  can also be changed according to the rotational position of the offset main beam  12 . To illustrate, the offset main beam  12  can be rotated a full 360° before, during, and even after surgery to facilitate various positions of the patient to afford various surgical pathways to the patient&#39;s spine depending on the surgery to be performed. For example, the offset main beam  12  can be positioned by the surgical frame  300  to place the patient P in a prone position (e.g.,  FIGS. 27 and 28 ), lateral positions (e.g.,  FIGS. 29 and 30 ), and in a position 45° between the prone and lateral positions. The translating beam  302  can be positioned to accommodate the rotational position of the offset main beam  12  to aid in the stability of the surgical frame  300 . For example, when the patient P is in the prone position, the translating beam  302  can preferably be moved to the center of the surgical frame  300  underneath the patient P. Furthermore, when the patient P is in one of the lateral positions, the translating beam  302  can be moved toward one of the corresponding lateral sides L 1  and L 2  of the surgical frame  300  to position underneath the patient P. Such positioning of the translating beam  302  can serve to increase the stability of the surgical frame  300 . 
     A preferred embodiment of a surgical frame incorporating a moveable cart ( FIG. 31 ) interconnected with a translating beam are generally indicated by the numeral  400  in  FIGS. 32-38 . Like the surgical frames  10  and  300 , the surgical frame  400  can serve as an exoskeleton to support the body of the patient P as the patient&#39;s body is manipulated thereby. In doing so, the surgical frame  400  serves to support the patient P such that the patient&#39;s spine does not experience unnecessary stress/torsion. Furthermore, while only one cart is depicted in  FIGS. 31-38 , multiple carts can be interconnected with the translating beam  404  in the fashion discussed below. 
     As depicted in  FIGS. 32-38 , the surgical frame  400  includes a support platform  402  including a translating beam  404 . Like the translating beam  302 , the translating beam  404  is capable of translating motion affording it to be positioned and repositioned with respect to portions of the remainder of the surgical frame  400 . To illustrate, the translating beam  404  is moveable between a first terminal position ( FIGS. 32 and 33 ), a second terminal position ( FIGS. 34 and 35 ), and positions therebetween ( FIGS. 36-38 ) relative to the remainder of the surgical frame  400 . The surgical frame  400  includes similar components to the surgical frame  300  and identical numbering is used in  FIGS. 32-38 . Furthermore, the servomotor  70  of the surgical frame  400  can incorporate a transmission, and the servomotor  70  can drive rotation of the main beam  12  via use of the transmission. 
     Additionally, the support platform  402  includes a linkage  406  for interconnecting a surgical cart  408  to the translating beam  404 . As discussed below, the cart  408  can be configured to support surgical equipment thereon, and movement of the translating beam  404  also moves the cart  408 . The cart  408 , for example, can include one or more casters or rollers  410  allowing for movement thereof. As such, the cart  408  can be positioned and repositioned with the translating beam  404  using the linkage  406 . Additional carts  408  also can be interconnected with the linkage  406 . At the very least, the interconnection of the cart  408  with the translating beam  404  allows the cart  408  and the surgical equipment supported thereby to move in unison with one another. 
     As discussed above with respect the translating beam  302 , the surgical frame  400  and the translating beam  404  can similarly include the components of the of the surgical frame  300  affording movement of the translating beam  404 . To illustrate, the surgical frame  400  can be configured such that operation of the first and second translation mechanism  340  and  342  can be controlled by an operator such as a surgeon and/or a surgical assistant. As such, movement of the translating beam  404  can be facilitated by controlled automation. The controlled automation can be either manually or programmably effectuated using various controllers and controls (not shown). To illustrate, the surgical frame  400  can be configured such that movement of the translating beam  404  automatically coincides with the rotation of the main beam  12 . By tying the position of the translating beam  404  to the rotational position of the main beam  12 , the movement and the position of the translating beam  404  and the cart  408  do not interfere with the rotation of the main beam  12 , and the center of gravity of the surgical frame  400  can be maintained in positions advantageous to the stability thereof. Also, by tying the position of the cart  408  with the translating beam  404 , the position of the cart  408  does not interfere with movement of the translating beam  404 . Moreover, such controlled automation can be used to control the position of such components to position the cart  408  relative to the patient. 
     As depicted in  FIGS. 32-38 , the linkage  406  can be moveably attached to the translating beam  404 . To illustrate, the linkage  406  can be moveable linearly along the translating beam  404  between a first terminal linear position and a second terminal linear position using a linear-movement mechanism  412  of the support platform  402 . The first terminal linear position is where the linkage  406  is at or adjacent one end of the translating beam  404 , and the second terminal linear position is where the linkage  406  is at or adjacent the other end of the translating beam  404 . The linear-movement mechanism  412  can employ an electrical servomotor  414  or a hand crank (not shown), a transmission  416 , and a track  418 . The track  418  can be provided on the translating beam  404 , and the transmission  416  is interoperable with the track  418 . The electrical servomotor  414  or hand crank can drive the transmission  416 , and the transmission  416  can include gear(s) or wheel(s) for contacting the track  418 . As such, operation of the electrical servomotor  414  or the hand crank can move the linkage  406  between the first terminal linear position and the second terminal linear position by driving the transmission  416 . Using the linear movement of the linkage  406 , the cart  408  can be moved along the translating beam  404  from at least adjacent one end to at least adjacent the other end thereof. 
     Using the electrical servomotor  414 , the movement of the linkage  406  and the cart  408  relative to the translating beam  404  can be automated. Thus, like movement of the main beam  12  and the translating beam  404 , controlled automation can allow the movement of the linkage  406  and the cart  408  to be controlled by an operator such as a surgeon and/or a surgical assistant. The controlled automation can be either manually or programmably effectuated using various controllers and controls (not shown). As such, along with movement via the translating beam  404 , the linkage  406  and the cart  408  can be positioned and repositioned relative to the translating beam  404  and the patient P during surgery. In addition to the controlled automation controlling the position of the translating beam  404 , controlling the position of the cart  408  relative to the translating beam  404  using the servomotor  414  to move the linkage  406  along the translating beam  404  can be used to prevent interference of the cart  408  with the rotation of the main beam  12  and to maintain an advantageous center of gravity for the stability of the surgical table  400 . Moreover, such controlled automation can be used to control the position of such components to position the cart  408  relative to the patient. 
     Additionally, rather than using the linkage  406 , a telescoping linkage for interconnecting the cart  408  to the translating beam  404  can be used. The telescoping linkage can include a first portion (not shown) that can be fixedly or moveably attached to the translating beam  404  and a second portion (not shown) that can be fixedly attached to the cart  408 . 
     The telescoping linkage can be configured for telescoping movement such that the second portion is capable of moving inwardly and outwardly between a first terminal telescoped position and a second terminal telescoped position with respect to the first portion using a telescoping-movement mechanism (not shown). The first terminal telescoped position is where the second portion is fully retracted relative to the first portion, and the second terminal telescoped position where the second is fully extended relative to the first portion. Similar to the linear movement mechanism  412 , the telescoping-movement mechanism can employ an electrical servomotor (not shown) or hand crank (not shown) for driving a transmission (not shown) facilitating telescoping of the second portion relative to the first portion. The transmission can include, for example, gears or screws for engaging complimentary structures on the second portion in similar fashion to the linear movement mechanism  412 . As such, operation of the electrical servomotor or hand crank can move the telescoping linkage between the first terminal telescoped position and the second terminal telescoped position by driving the transmission. Using the telescoping movement of the telescoping linkage, the cart  408  can be moved inwardly and outwardly relative to the translating beam  404 . 
     Using the electrical servomotor employed with the telescoping linkage, movement of the cart  408  inwardly and outwardly relative to the translating beam  404  can be automated. Thus, like movement of the translating beam  404  and the linkage  406 , controlled automation can allow the movement of the telescoping linkage to be controlled by an operator such as a surgeon and/or a surgical assistant. The controlled automation can be either manually or programmably effectuated using various controllers and controls (not shown). In addition to the controlled automation controlling the position of the translating beam  404 , and controlling the position of the cart  408  relative to the translating beam  404  using the servomotor  414  to move the telescoping linkage along the translating beam  404 , controlling the position of the telescoping linkage inwardly and outwardly can be used to prevent interference of the cart  408  with the rotation of the main beam  12  and to maintain an advantageous center of gravity for the stability of the surgical table  400 . Moreover, such controlled automation can be used to control the position of such components to position the cart  408  relative to the patient. 
     As discussed above, the cart  408  can be configured to support surgical equipment thereon. The surgical equipment can include, for example, a surgical robot  500  thereon. The surgical robot  500  can include a robotic arm  502  and a telescoping shaft  504  supporting the robotic arm  502  that are positionable and repositionable during surgery via controlled automation. The controlled automation can be either manually or programmably effectuated using various controllers and controls (not shown). For example, the telescoping shaft  504  can be moveable upwardly and downwardly with respect to the cart  408  and the patient P, and the robotic arm  502  can be moveable upwardly, downwardly, inwardly, and outwardly with respect to the telescoping shaft  504  and the patient P. Using such movement, the robot arm  502  can be positioned adjacent a surgical site on the patient P. Thus, the movement of the translating beam  404 , movement of the linkage  406  and the cart  408 , and/or movement of the telescoping linkage can be used to generally position the surgical robot  500  relative to the patient P supported by the surgical frame  400 , and the telescoping shaft  504  and the robotic arm  502  can thereafter finely position portions of the surgical robot  500  relative to the patient P. 
       FIGS. 32-38  illustrate use of the surgical frame  400 , the cart  408 , and the surgical robot  500 . The same illustrated uses of the surgical frame  400  are also applicable to the surgical frame  400  incorporating the telescoping linkage, except that use of the telescoping linkage affords inward and outward movement of the cart  408  relative to the translating beam  404 . The illustrated movement of the main beam  12 , the translating beam  404 , and the first linkage  406  can be effectuated by controlled automation via input from an operator such as a surgeon and/or a surgical assistant. 
       FIG. 32  depicts the patient P positioned in the prone position on the surgical frame  400 , the main beam  12  in a first position M 1  supporting the patient P in the prone position, the translating beam  404  positioned in a first position B 1  collocated with the first terminal position thereof, and the linkage  406  (and surgical cart  408  attached thereto) positioned in a first linear position L 1  collocated with the first terminal linear position thereof. From the first position B 1 , the translating beam  404  can be moved toward the second terminal position, and from the first linear position L 1 , the linkage  406  (and the cart  408  attached thereto) can be moved toward the second terminal linear position. 
       FIG. 33  depicts the patient P positioned in the prone position on the surgical frame  400 , the main beam  12  in the first position M 1  supporting the patient in the prone position, the translating beam  404  positioned in the first position B 1 , and the linkage  406  (and surgical cart  408  attached thereto) positioned in a second linear position L 2 . 
       FIGS. 34 and 35  depict the patient P positioned in the prone position on the surgical frame  400 , the main beam  12  in the first position M 1  supporting the patient P in the prone position, the translating beam  404  positioned in a second position B 2  collocated with the second terminal position thereof, and the linkage  406  positioned in the second linear position L 2 . The movement of the translating beam  404  from the first position B 1  to the second position B 2  brings the surgical robot  500  into close proximity to the patient P. 
       FIGS. 36 and 37  depict the patient P in a first angled position and a second angled position, respectively, the main beam  12  in a second position M 2  and a third position M 3 , respectively, supporting the patient P in the first angled position and the second angled position, the translating beam  404  positioned in a third position B 3  and the linkage  406  positioned in the second linear position L 2 . The movement of the translating beam  404  from the second position B 2  ( FIGS. 36 and 37 ) to the third position B 3  prevents interference of the cart  408  with the rotation of the main beam  12  from the first position M 1  to the second position M 2  to the third position M 3 . The movement of the translating beam  404  from the second position B 2  to the third position B 3  also serves in maintaining the position of the surgical robot  500  in close proximity to the patient P. 
       FIG. 38  depicts the patient P in a lateral position, the main beam  12  in a fourth position M 4  supporting the patient P in the lateral position, the translating beam  404  positioned in the third position B 3 , and the linkage  406  positioned in the second linear position L 2 . The position of the translating beam  404  in the third position B 3  again prevents interference of the cart  408  with the rotation of the main beam  12  from the third position M 3  to the fourth position M 4 . The position of the translating beam  404  in the third position B 3  also serves in maintaining the position of the surgical robot  500  in close proximity to the patient P. 
     As discussed above, the controlled automation of the main beam  12 , the translating beam  404 , the linkage  406 , and the telescoping linkage can ensure that the movement of these components do not interfere with one another and with the main beam  12 , while simultaneously maintaining an advantageous center of gravity for the stability of the surgical table  400 . Such movement, as discussed above, also facilitates positioning of the surgical cart  408  and/or the surgical robot  500  relative to the patient P. Furthermore, during or after movement of the main beam  12 , the translating beam  404 , the linkage  406 , and/or the telescoping linkage, the telescoping shaft  504  can be moveable upwardly and downwardly with respect to the cart  408  and the patient P, and the robotic arm  502  can be moveable upwardly, downwardly, inwardly, and outwardly with respect to the telescoping shaft  504  and the patient P. To illustrate, in  FIGS. 35-38 , the telescoping shaft  504  is progressively lowered to position the surgical arm  502  adjacent a selected portion of the patient P, and the surgical arm  502  is progressively extended toward the selected portion of the patient P. 
     While the linkage  406  and the telescoping linkage in preferred embodiments thereof are used in association with the translating beam  404 , it is appreciated that the linkage  404  and the telescoping linkage described herein also have applicability with surgical frames without a translating beam. The linkage  406  and the telescoping linkage in other embodiments may be supportively and moveably attached to a lower beam, even if the lower beam does not have translating capabilities. In yet other alternative embodiments, the linkage  406  and the telescoping linkage have applicability with surgical frames with or without a lower beam by being supportively and moveably attached to another portion of the surgical frames permitting the linkage  406  and the telescoping linkage to move the cart  408 . 
     As depicted in  FIGS. 39-42 , the support platform  402  of the surgical frame  400  can also include a patient support arm  600  or a patient support arm  600 A. The patient support arm  600  and the patent support arm  600 A can be used in place of or in addition to the linkage  406  and the linear movement mechanism  412 . Rather than being interconnected with the translating beam  404  via the linkage  406 , surgical equipment such as the patient support arm  600  and the patient support art  600 A can be supportively and moveably attached to the translating beam  404 . 
     As depicted in  FIGS. 39 and 40-42 , the patient support arm  600  is supported by and manually moveable with respect to the translating beam  404 , and as depicted in  FIG. 39A , the patient support arm  600 A is supported by and moveable with respect to the translating beam using a linear movement mechanism  630 . To illustrate with respect to  FIGS. 39 and 40-42 , the patient support arm  600  is supported by and is moveable linearly along the translating beam  404  via manual adjustment. The patient support arm  600  can be fixedly supported by the translating beam  404  at various increments along the translating beam  404  between a first terminal linear position and a second terminal linear position, and the surgeon and/or surgical assistant can manually adjust the patient support arm  600  to a selected position therealong. Furthermore, to illustrate with respect to  FIG. 39A , the patient support arm  600 A is supported by and is moveable linearly along the translating beam  404  via actuation of the linear movement mechanism  630  using controlled automation or manual operation. The patient support arm  600 A of  FIG. 39A  can be fixedly supported by a portion of the linear movement mechanism  630 , and the portion of the linear movement mechanism  630  can be moved along the translating beam  404  between a first terminal position and a second terminal position via actuation thereof. The first terminal linear positions are where the patient support arm  600  or the patient support arm  600 A are at or adjacent one end of the translating beam  404 , and the second terminal linear positions are where the patient support arm  600  are at or adjacent the other end of the translating beam  404 . 
     Similarly, additional surgical equipment can be supportively and moveably attached to the translating beam  404  in similar fashion to the patient support arm  600  as depicted in  FIGS. 39 and 40-42  and the patient support arm  600 A as depicted in  FIG. 39A . For example, like the patient support arm  600 , a C-arm (not shown) facilitating fluoroscopic imaging at least before and during surgery can be supportively and moveably attached to the translating beam  404 . 
     The patient support  600  and the patient support  600 A are provided to support portions of the patient P at different rotational positions and heights/angles of the main beam  12 . As discussed above, the patient P can be rotated on the main beam  12  between various rotational positions M 1 , M 2 , M 3 , and M 4 , and the patient support  600  and the patient support  600 A can be used to support, for example, the patient P, in these different rotational positions. Furthermore, the height/angle of the main beam  12  can be varied by adjusting the height of the first vertical support post  308 A and the second vertical support post  308 B, and the patient support arm  600  and the patient support arm  600 A can be used to support, for example, the patient P at these different heights/angles as depicted in  FIGS. 40-42 . To illustrate, the first vertical support post  308 A has a greater height than the second vertical support post  308 B in  FIG. 40 ; the second vertical support post  308 B has a greater height than the first vertical support post  308 A in  FIG. 41 ; and the first vertical support post  308 A and the second vertical support post  308 B have approximately the same height in  FIG. 42 , which is greater than the heights thereof in either of  FIGS. 40 and 41 . Although the patient support arm  600  is depicted  FIGS. 40-42 , the patient support arm  600 A can be used similarly. 
     The patient support arm  600 , as depicted in  FIGS. 39 and 40-42 , includes a base portion  602 , a post portion  604 , an arm portion  606 , and a pad portion  608 . The base portion  602  is supported by and moveable along the translating beam  404 . The base portion  602  can be fixedly supported by the translating beam  404  at various increments along the translating beam  404  affording adjustment therealong. The post portion  604  includes a first portion  610  attached to the base portion  602 , and a second portion  612  capable of telescoping movement inwardly and outwardly with respect to the first portion  610 . The base portion  602  can be configured to afford telescoping movement thereof via controlled automation or manual operation. The second portion  612  includes an end portion  614 , and the arm portion  606  is rotatably attached to the end portion  614 . The arm portion  606  includes a first end portion  620  and a second end portion  622 . The first end portion  620  is rotatably attached to the end portion  614 , and the second end portion  622  supports the pad portion  608  thereon. The pad portion  608  can be contacted to various portions of the patient P, and such contact facilitates support of these portions of patient P by the patient support arm  600 . To position the pad portion  608  into contact with the patient P, the base portion  602  can be moved along the translating beam  404 , the second portion  612  can be moved inwardly and outwardly with respect to the first portion  610 , and the arm portion  606  can be rotated relative to the end portion  614  of the second portion  612 . 
     Like the patient support arm  600 , the patient support art  600 A, as depicted in  FIG. 39A , includes the post portion  604 , the arm portion  606 , and the pad portion  608  that can be used similarly. However, rather than including the base portion  602 , the components of the patient support arm  600 A can be attached to the linear movement mechanism  630 . The linear movement mechanism  630  can employ an electrical motor  632  or a hand crank (not shown), a transmission portion  634 , a truck portion  636 , and a track  638 . As depicted in  FIG. 39A , the track  638  is provided on the translating beam  404 , the truck portion  636  is moveable along the track  638 , and the transmission portion  434  can be driven by the electrical servomotor  632  or hand crank to actuate movement of the truck portion  636  along the track  638 . The transmission can include gear(s) or wheel(s) for contacting the track  638  to drive movement of the truck portion  636  along the track  638 . As such, operation of the electrical servomotor  632  or the hand crank can move the truck portion  636  between the first terminal linear position and the second terminal linear position by driving the transmission portion  634 . Furthermore, the truck portion  636  can include an attachment surface  640  for fixedly supporting the base portion  602  of the patient support arm  600 A thereon. Thus, using the linear movement of the truck portion  636 , the patient support arm  600 A can be moved along the translating beam  404  from at least adjacent one end to at least adjacent the other end thereof. 
     Using the electrical servomotor  632 , the movement of the truck portion  636  and hence, the patient support arm  600 A can be automated. Thus, like movement of at least the translating beam  404 , the linkage  406 , and the telescoping linkage, controlled automation can allow the movement of the patient support arm  600 A to be controlled by an operator such as a surgeon and/or a surgical assistant. The controlled automation can be either manually or programmably effectuated using various controllers and controls (not shown). As such, the patient support arm  600 A can be positioned and repositioned relative to the translating beam  404  and the patient P during surgery. 
     While the patient support arms  600  and  600 A in preferred embodiments thereof are used in association with the translating beam  404 , it is appreciated that the patient support arms  600  and  600 A described herein also have applicability with surgical frames without a translating beam. The patient support arms  600  and  600 A in other embodiments may be supportively and moveably attached to a lower beam, even if the lower beam does not have translating capabilities. In yet other alternative embodiments, the patient support arms  600  and  600 A have applicability with surgical frames with or without a lower beam by being supportively and moveably attached to another portion of the surgical frames permitting the patient support arms  600  and  600 A to moveably support a patient before, after, and during rotation of the patient. 
     Other embodiments of the invention will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the invention being indicated by the following claims.