Beds – Support means for discrete portion of user – useable with bed... – For head or neck
Reexamination Certificate
2001-03-05
2004-02-03
Shackelford, Heather (Department: 3673)
Beds
Support means for discrete portion of user, useable with bed...
For head or neck
C005S622000, C005S640000
Reexamination Certificate
active
06684428
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates to a head-clamping device for surgical purposes, specifically for intra-operatively fixing the patient's head in any anatomically possible position, the center of rotation of the head clamp being in the cervical vertebral region of the patient.
BACKGROUND OF THE INVENTION
Precise operations on the brain, particularly in neurosurgery, require that the head of the anesthetized patient should not move. This is achieved by a head-clamping device attached to the operating table.
A head clamp in which the head is clamped between three steel arbors is known from U.S. Pat. No. 3,099,441. The points of these arbors are pressed into the skull by an adjustable force. The arbors are arranged on two diametrically opposed arms. One arm is provided with an axially adjustable clamp for one arbor and the other arm is provided with a clamp with two arbors which is also axially adjustable but is centrally pivoting.
These head clamps have proved their worth in practice for decades to fix the head in the desired, anatomically exact position. It is, however, extremely difficult and troublesome to change the position of the head with the known head clamps during the operation. But such a position change becomes increasingly necessary in minimally invasive operations to make the surgical region accessible and visible.
It is another disadvantage that the design requires the division of the known number of three arbors into 1+2 and that additionally the two arbors which are arranged together in a common, usually rotating clamp are not axially adjustable, i.e. neither the distance between the two points nor their angle of inclination can be adjusted. It is another disadvantage that particular bulky components of the head clamp are placed under the head of the lying patient and thus interfere with the legs of the sitting surgeon or of an assistant joining him from the side.
With the strongly increasing endoscopy in neurosurgery, the intra-operative position change has gained further importance. For operations using an endoscope, a much smaller opening in the skull is sufficient, facilitating the postoperative restoration of a patient's health. In endoscopic and endoscope-aided microneurosurgical operations, it is extremely essential to be able to slightly change the position of the clamped head during the operation. This should be possible in a simple, rapid, stepless and ergonomic way.
A device for head surgeries comprising a spreading device is known from DE 28 09 645 A1. A head clamp allowing a simple fixation of the head is known from DE-PS 86665.
A clamping joint for medical devices and apparatuses which can also be used for head clamps is known from DE 198 54 347 A1.
A clamping device for medical instruments which comprises a flexible link arm is described in DE-UM 75 24 814. A surgical head clamp comprising a frame is known from U.S. Pat. No. 4,169,478. EP 0 938 873 A2 describes a stereotactic positioning device for a patient to be irradiated.
SUMMARY OF THE INVENTION
FIGS. 10A-10D
illustrate the different movement directions of the head at the upper end of the human vertebral column.
FIG. 10A
shows the flexion and extension (YES movement) of the head in which the head is inclined vertically to the front and back.
FIG. 10B
shows the transverse inclination or lateral tilt of the head to the left and right.
FIG. 10C
shows the side-to-side movement of the head (NO movement).
FIG. 10D
shows the point of intersection of the vertical and horizontal median lines in the head joint.
It appears from
FIGS. 10A-10D
that a head clamp adjusted to the anatomical conditions should take account of the three degrees of freedom shown in
FIGS. 10A-10C
, whereas according to
FIG. 10D
the center of rotation of the head clamp should be in the cervical vertebral region of the patient, i.e. near the two upper vertebrae (atlas and epistropheus).
Therefore, an efficient head clamp to be used in neuroendoscopy and endoscope-aided microneurosurgery should meet the following requirements. It should be possible to clamp the head in any anatomically possible initial position and to move it by means of the head clamp in the three directions illustrated in
FIGS. 10A-10C
. It should be possible to perform these movements simply and without any operative trouble. These movements should be steplessly variable and rapidly fixable in any position. The center of rotation of the three movements should be in the two upper cervical vertebrae. Moreover, the center of rotation of the head clamp should be also on the median lines of said cervical vertebrae of the patient. The space below the head of the lying patient should be free of hindering mechanisms.
It is, therefore, the problem of the invention to provide a head-clamping device for surgical purposes which meets the above-mentioned requirements and, in addition, allows a division of the at least two arbors into 1+1, i.e. allows at least two clamps with one arbor each, the two or even three clamps being steplessly adjustable to each other in such a way that the point of intersection of the extended lines of the three arbors is always on the vertical median line of the upper cervical vertebrae.
This problem is solved according to the invention by a head-clamping device according to claim 1. The frame can be pivoted on an axis (x) which represents the tilting movement sideways which is shown in FIG.
10
B. The profile pivoting on an axis (y) allows the flexion and extension of the head (YES movement) shown in FIG.
10
A. Finally, the mating profile pivoting on an axis (z) allows the side-to-side movement (NO movement) of the head shown in FIG.
10
C.
It is preferred that the profile and the mating profile are curved in the shape of a circular segment throughout. This prevents the central point from shifting when the mating profile is pivoted on the profile.
Preferably, a headrest is attachable to the mating profile. This allows an additional supporting of the head if two clamping arbors are used.
The head clamps can be attached to the mating profile in any position. This allows the free adjustment and re-arresting of the clamp points.
The pivoting movements on the axes (x, y, z) can be performed steplessly and can be fixed in any position or they have a self-locking design. This allows the universal use and easy repositioning of the head-clamping device.
Preferably, the axes (x, y, z) are perpendicular to each other so that any position of the head can be adjusted with three independent degrees of freedom within the limits of the head inclination angle.
REFERENCES:
patent: 3099441 (1963-07-01), Rles
patent: 3853861 (1974-12-01), Garbrecht
patent: 4108426 (1978-08-01), Lindstroem et al.
patent: 4169478 (1979-10-01), Hickman
patent: 5269034 (1993-12-01), Day et al.
patent: 5276927 (1994-01-01), Day
patent: 5537704 (1996-07-01), Dinkler
patent: 6381783 (2002-05-01), Reinhardt et al.
patent: PS86665 (1895-06-01), None
patent: UM7524814 (1975-08-01), None
patent: 2809645 (1978-11-01), None
patent: 1984347 (1999-06-01), None
patent: 0938873 (1999-09-01), None
Grotenhuis J. André
Von Zeppelin Kurt Dieter
Zegers Theo J. J.
Friedman Mark M.
Lagman Frederick Lyndon
Shackelford Heather
Theo J.J Zegers
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