Orthopaedic Apparatus For Traction Of The Spinal Column

Abstract

A truss for placing the spine under traction has a pelvic girdle and an upwardly extending tractor structure at the top of which is connected a head-supporting structure. The lower part of the tractor structure has two diverging curved arms which extend from the patient's back around to the sides of the girdle, where they are pivoted to the girdle. This allows the patient to bend forward. Pneumatic cushions on the support for the head are inflated to adjust the traction force finely. Spring means in the tractor structure act as shock absorbers. Other articulated joints allow the patient to nod and turn his head.

Description

This invention relates to orthopedic apparatus for traction of the spinal column of a patient, useful in all cases in which ambulatory traction of the spine is prescribed, such as in the treatment of cyphosis, cyphoscoliosis, rarefying or condensing osteitis and sequela thereof, somatic and disk arthrosic processes, diskpathy, specific and inflammatory processes of the spine, fractures, dislocations and the like.

The invention refers particularly to orthopedic apparatus for such purposes comprising a pelvic girdle shaped anatomically to fit the patient and adapted to rest on the body projections of the pelvis, a tractor structure having shaped upright members extending up the back of the patient and projecting forward in cantilever fashion to each side of the patient's neck, a head-supporting structure adapted to engage the chin and occipital head regions of the patient, and means to tension the tractor structure by reaction on the pelvic girdle.

Apparatuses of this type have been proposed in which the tractor structure is connected adjustably to the rear of the pelvic girdle, while the head-supporting structure is connected to the tractor structure by means permitting tilting or rotation of the head.

Such apparatuses are far more comfortable than traditional braces which have forward supports extending down the patient's chest. However, they oblige the patient to keep the upper part of his torso rigid and do not permit him to bend forward.

The invention sets out to improve known apparatus of the above-mentioned type to increase its comfort to the patient and to allow him an increased freedom of movement; and in particular to allow the patient to bend forward without there being any change in the traction force exerted on the spine.

Broadly, the invention provides an apparatus in which a tractor structure extends generally up the patient's back and is connected between a pelvic girdle and a head-supporting structure, the tractor structure including a lower portion having two symmetrical arms which are articulated to the sides of the pelvic girdle for oscillating movement about a horizontal axis passing through the patient's spinal region to permit the patient to bend forward without altering the traction force exerted on his spine.

Other objects and features of the invention will be clear from the following description of an embodiment thereof, reference being made to the accompanying drawings, in which:

FIG. 1 is a perspective view of an orthopedic apparatus;

FIG. 2 is a simplified view in plan of a pelvic girdle used in the apparatus of FIG. 1;

FIG. 3 is a fragmentary transverse sectioned view on an enlarged scale along the line III--III in FIG. 1, illustrating a detail of that Figure;

FIG. 4 is a fragmentary longitudinal section on an enlarged scale along the line IV--IV in FIG. 1; and

FIG. 5 is another longitudinal section on an enlarged scale along the line V--V in FIG. 4.

The apparatus shown in the drawings comprises a pelvic girdle 1 formed by a truss anatomically shaped to fit closely on the patient's pelvis, and comprises a tractor structure, the lower portion 30 of which has two symmetrical diverging arms 31 which embrace the pelvic truss and are secured thereto by means of an articulated connection allowing their relative pivotal movement along a horizontal axis to permit the patient to bend forward.

For this purpose each arm 31 has its end portion bent towards the girdle and comprising a pivot portion 32 followed by an enlarged head. The pivot portion 32 formed on the end portion of each arm 31 extends through one of a plurality of parallel slots 33 extending in the direction of the height of the girdle 1, cut in a shaped bracket 34 fastened to the girdle. The width of the slots 33 is smaller than the diameter of the enlarged head of the pivot portion 32, but each slot is enlarged at its end facing the upper edge of the girdle to allow mounting of the pivots 34 arranged at diametrically opposite zones of the outer surface of the girdle 1. The two arms 31 bend rearwardly and upwardly and are connected at their upper ends to a body formed of a pair of parallel plates 36, 36' and having two tubular guides 35 arranged parallel to each other in a substantially vertical direction. The guides 35 and connected to each other by a lower cross-bar 37. The plate 36' faces towards the back of the patient and as best seen in FIG. 4, is provided with a yielding cushion 38 to support the patient's back.

The two pivot portions 32, by means of which the lower portion 30 of the tractor structure is articulated to the pelvic truss 1, are arranged along a horizontal axis A--A corresponding to the axis about which the patient's spine flexes when the patient bends from the waist. The tractor structure can thus oscillate freely about this axis to allow the patient to bend forward without altering the force exerted by the tractor structure on his spine. The alternative slots 33 allow the apparatus to be fitted correctly to different patients.

To the lower portion 30 of the tractor structure is connected an intermediate portion 39 comprising two parallel uprights 40, adapted to bear slidably in the tubular guides 35 of the lower portion 30, such uprights being provided on their mutually facing surfaces with a series of equidistant notches 41, adapted to co-operate with a ratchet-and-pawl-type mechanism having stop teeth 42 fulcrumed to pivots 43 mounted between the two plates 36 and 36'. The teeth 42 are biased outwards by elastic means, comprising in the embodiment illustrated a single leaf spring 44 bent to U-shape, and engage in the notches 41 of the two uprights 40.

This mechanism allows adjustment of the position of the intermediate portion 39 of the tractor structure with respect to the lower portion 30, allowing coarse adjustment of the traction force exerted on the spinal column.

To increase the traction, the intermediate part 39 is pulled upwards relatively to the lower part 30, this movement being permitted by the ratchet action of the teeth 42. To decrease the traction, the free upper ends of the leaf spring 44 are gripped and drawn together to disengage the teeth 42 from the notches 41. The uprights 40 can then be moved downwards, being locked in a new position as soon as the free ends of the spring are released to return the teeth 42 outwards.

To the intermediate portion 39 of the tractor structure is connected an upper portion 47 of the structure, comprising two symmetrical shaped arms 48 whose upper ends 48a project forward in cantilever fashion to both sides of the neck of the patient and carry a supporting structure for the head, as will be described later.

The lower ends of the two arms 48 each have a cylindrical extension 48b engaged slidably in a tubular guide 46 which forms part of the intermediate structure 39 and is carried on an extension of an upright 40. A cross-bar 45 is located immediately below the guides 46.

In the interior of each tubular guide 46 is arranged a relatively stiff spring 49 bearing against a collar 50 on the arm 48 which is slidable in the guide. This construction forms an elastic telescoping connection between the intermediate portion 39 and the upper portion 47 of the tractor structure. The spring has the function of absorbing shocks a jars which the patient is liable to experience when walking or climbing stairs or the like.

The head-supporting structure 10 is connected to the upper ends 48a of the arms 48. Each end 48a has a bracket 8 attached to it, the structure 10 being articulated for movement about a horizontal axis X--X to the brackets 8 by means of screw-threaded pins 9. The structure 10 comprises a shaped plate 11 to support the occipital head zone of the patient, and another shaped plate 12 to support the chin. On the plates 11 and 12 are mounted pneumatic cushions 13 and 14 forming air chambers and being connected by means of tubes 15 and 16 to a sphygmomanometer device by which the air cushions are inflated with air under pressure. This device comprises a ball pump 17 and a pressure gauge 18, and valve means of a known type for closing the air chambers to the atmosphere and releasing air from them. The pump is easily accessible to the patient and is easily manipulated by him.

The chin plate 12 is fixed to the forward ends 10a of two tubular side members, and the occipital plate 11 to the rear ends 10b of the same members. Joint members 10c provided with adjusting screws connect the structure 10 to the brackets 8, the adjusting screws allowing the apparatus to be properly fitted and adjusted on the patient.

The apparatus is fitted by fastening the pelvic girdle 1 and head-supporting structure 10 on him while the tractor structure is slack and the cushions 13 and 14 are uninflated. A preliminary coarse adjustment of the traction force is made by displacing the intermediate portion 39 of the tractor structure relatively to the lower portion 30 in the manner described earlier. Fine adjustment is made by inflating the pneumatic cushions 13 and 14 by means of the pump 17. The springs 49, being stiff, yields only by a negligible extent during adjustment of the traction force.

The axis X--X about which the head-supporting structure can oscillate coincides substantially with the natural axis of nodding movement of the head, so that flexo-extension of the head is permitted to the patient and does not alter the value of the traction force exerted on his spine.

Between the upper portion 47 of the tractor structure and the head-supporting structure 10 there might also be interposed means (not illustrated) to allow the patient to turn his head about a vertical axis, and so increasing his freedom of movement still further.

Because of the features described above, and in particular the novel articulation of the tractor structure to the pelvic girdle and the use of an elastic tractor structure, the comfort of the apparatus is enhanced and it may be worn for long periods of treatment. Since the pump 17 is readily accessible to the patient, he is able to adjustments of the traction force himself, without being reliant on others.

Claims

What I claim is:

1. Orthopedic apparatus for traction of the spinal column of a patient, the apparatus comprising in combination a pelvic girdle shaped anatomically to bear on the body projections of the patient's pelvis; a tractor structure adapted to extend generally up the patient's back and connected to the pelvic girdle, the tractor structure having an upper portion with arms which extend forward in cantilever fashion to each side of the patient's neck; a head-supporting structure connected to the forwardly extending arms and adapted to engage the patient in the chin and the occipital head zones, the head-supporting structure being connected to the tractor structure for oscillating movement about an axis permitting nodding movement of the patient's head; coarse adjusting means associated with the tractor structure for exerting traction force on the patient's spine; pneumatic cushions mounted on the head-supporting structure to bear on the patient's chin and occipital head regions; and means to inflate the pneumatic cushions to provide fine adjustment of the traction force, the tractor structure including a lower portion comprising two symmetrical arms that are positioned to diverge from the back of the patient and are pivotally connected to the pelvic girdle substantially at opposite midpoints of the sides of the girdle for oscillating movement about a substantially horizontal axis passing through the spinal region of the patient, thereby allowing the patient to bend forward without there being any alteration in the traction force exerted on the spine.

2. The apparatus of claim 1 including elastic shock-absorbing means provided in the tractor structure.

3. The apparatus of claim 2 in which the tractor structure includes an intermediate portion positioned to extend centrally up the patient's back and adjustably connected to the lower portion to vary the length of the tractor structure and so effect coarse adjustment of the traction force, the upper portion of the tractor structure being telescopically connected to the intermediate portion, spring means being included in the telescopic connection to provide shock-absorbing action.

4. The apparatus of claim 1 in which the arms of the lower portion of the tractor structure which are articulated to the pelvic girdle have pins at their ends and the pelvic girdle has brackets on its external side surfaces formed with slots which receive such pins.

5. The apparatus of claim 1 in which the lower portion of the tractor structure includes a body positioned to be centrally disposed on the patient's back from which the arms project divergingly to engage the pelvic girdle, the body having a cushioned surface to bear on the patient's back.

6. Orthopedic apparatus for traction of the spinal column of a patient, the apparatus comprising in combination a pelvic girdle shaped anatomically to bear on the body projections of the pateint's pelvis; a tractor structure adapted to extend generally up the patient's back and connected to the pelvic girdle, the tractor structure having an upper portion with arms which extend forward in cantilever fashion to each side of the patient's neck; a head-supporting structure connected to the forwardly extending arms and adapted to engage the patient in the chin and the occipital head zones, the head-supporting structure being connected to the tractor structure for oscillating movement about an axis permitting nodding movement of the patient's head; coarse adjusting means associated with the tractor structure for exerting traction force on the patient's spine; pneumatic cushions mounted on the head-supporting structure to bear on the patient's chin and occipital head regions; and means to inflate the pneumatic cushions to provide fine adjustment of the traction force, the tractor structure including a lower portion comprising two symmetrical arms that are positioned to diverge from the back of the patient and are pivotally connected to the pelvic girdle at points on the sides of the girdle for oscillating movement about a substantially horizontal axis passing through the spinal region of the patient, thereby allowing the patient to bend forward without there being any alteration in the traction force exerted on the spine, said tractor structure also including an intermediate portion positioned to extend centrally up the patient's back and adjustably connected to the lower portion to vary the length of the tractor structure and so effect coarse adjustment of the traction force, the lower portion including guide means in which the intermediate portion is slidable, and spring-biased tooth means adapted to engage in notch means in the intermediate portion to lock the intermediate portion releasably to the lower portion.