US20130167300A1

US20130167300A1 - System and method for providing spinal alignment in surgical and non-medical environments

Info

Publication number: US20130167300A1
Application number: US13/374,498
Authority: US
Inventors: Jason Hammond
Original assignee: Individual
Current assignee: Individual
Priority date: 2011-12-30
Filing date: 2011-12-30
Publication date: 2013-07-04

Abstract

The present invention is directed to a mattress system that provides proper spinal alignment when a person is in the lateral decubitis position for long periods of time, such as when a person is undergoing surgical procedures. Thus the present invention is configured to work within the confines of standard surgical tables. By allowing a section of a mattress under the arm and shoulder of the patient to be easily removed, damaging pressures on the patient's shoulder and pressure injuries in the lateral decubitus position are greatly diminished.

Description

BACKGROUND OF THE INVENTION

Proper spinal alignment is important for preventing lower back and neck pain. This is particularly true if one is supine for long periods of time as may occur if a person is suffering from illness or requires surgery. As reported in Kamel et al., the lateral decubitus position and the prone superman position are significantly more likely to cause irritating pressure on the nerves of the upper extremity when compared with other positions. See I R Kamel et al. The Use Of Somatosensory Evoked Potentials To Determine The Relationship Between Patient Positioning And Impending Upper Extremity Nerve Injury During Spine Surgery: A Retrospective Analysis 102 Anesth. Analg. 1538-1542 (2006). The lateral decubitus position is commonly used for hip replacement surgery, hip and pelvis fracture surgery, shoulder and hip arthroscopy, thoracotomy, splenectomy, neurosurgery and kidney surgery. This position often leads to post-operative maladies for anesthetized patients from general discomfort to the more serious pressure lesions, nerve injury, visual loss, rhabdomylysis and others. Anesthetized patients are at particular risk for pressure sore formation during operative procedures. A study in 1996 identified that 12% of all anesthetized patients suffered from pressure sores. See, C. A. Pearce, Interoperative Pressure Sore Prevention, 6 J. Theatre Nurs. at 31 (1996). The risks of pressure sore formation are a result of the type of mattress used, the patient's own weight, any pressure or motion exerted by the surgeon, and any intraoperative positioning device.
Current practices to prevent shoulder, nerve, and pressure injuries in the lateral decubitus position include elevating the chest, in order to relieve pressure on the down or dependent shoulder. Current devices that are used for this purpose are Lactated ringer's IV bags, viscoelastic gel chest rolls, or a pneumatic patient positioner. Each of these devices has drawbacks. All of these devices do not allow proper spinal alignment of the patient during preoperative preparation, the procedure, and subsequent recovery. By raising the chest, the spine is moved from a position parallel to the table to an upward slope with the upper spine at a higher level than the lower spine. Depending on the patients underlying spinal condition and the length of the case this can cause discomfort of the lower back and neck post-operatively.
Each of these devices decreases the pressure on the shoulder by creating increased pressure at the site of placement of the device. This in addition to friction from movement during the case can create a pressure lesion on the skin at the chest wall.
Additionally, these devices are prone to positioning error, particularly when time elements and care-giver experience are at play. For example, to decrease the risk of nerve compromise, the chest roll must be placed at the level of the chest wall and not the axilla. Thus, these devices may shift during surgery and, therefore, not function as intended.
Similarly, IV bags have been associated with severe pressure ulcerations on the dependent opposite thorax, (Knee Surg Sports Traumatol Arthrosc. 2007 December; 15(12):1489-93). Pneumatic patient positioners are single use per patient and may be prohibitively expensive to many hospitals and surgery centers. Additionally, each of these devices have questionable efficacy for the morbidly obese patient.
A regular operating room table mattress has the following dimensions Head—10 inches by 20 inches by 2.5 inches; Body—41 inches by 20 inches by 2.5 inches; Leg—24 inches by 20 inches by 2.5 inches. Many hospitals then place a viscoelastic gel pad on top of the mattress to further decrease the risk of pressure sores. A disposable mattress cover is then placed over the mattress and changed between patients. The mattress cover does not provide the patient with proper orthopaedic support in the lateral decubitus position and does not facilitate ease of patient positioning nor does it provide ease of removal when necessary.
U.S. Pat. Nos. 7,698,766 and 7,536,741 to Schultz, issued May 26, 2009, discloses a multisectional mattress system that allows for a person in a side-laying position to have proper spinal alignment. However these references do not disclose ease of patient positioning in surgical. environments. U.S. Pat. No. 6,681,426 to Heimbrock et al, issued Jan. 27, 2004 discloses a multi-section mattress for stretchers. However '426 requires use of its mattress in conjunction with its frame system. U.S. Pat. No. 6,182,316 to Thomas et al., issued Feb. 6, 2001, disclose a complex, multisectional surface pad for surgical tables that provides heat transfer to the patient. U.S. Pat. No. 5,247,714 to Lipps, issued Sep. 28, 1993, discloses a multisectional mattress with a removable shoulder/head pad. U.S. Pat. No. 7,571,504 to Kuo, issued Aug. 11, 2009 discloses a multi-cushioned pad, where each cushion attached via hook and loop fastening means. U.S. Pat. No. 7,415,738 to Weedling et al, issued Aug. 26, 2008 disclose a patient transfer pad having looped portions. U.S. Pat. No. 5,860,174 to Failor discloses a patient transfer assembly having loop portions attached via hook and loop fastening means. While these references provide a field of the invention, they do not provide the system or ease of patient torso alignment or ease of addition or removal of the pad as per the present invention, discussed below.

SUMMARY OF THE INVENTION

It is an object of the present invention to provide a mattress system that allows for proper spinal alignment when a person in lateral decubitis position such as when they undergo surgical procedures.
It is yet another object of the present invention to provide a mattress system that is configured to work within the confines of standard surgical tables.
It is yet another object of the present invention to provide a mattress system that includes a removable shoulder pad thereby relieving damaging pressures.
It is yet another object of the present invention to provide a mattress system having a body pad that includes a handle.
These and other objectives are discussed herein below.

DETAILED DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic of the body mattress of the present invention.

FIG. 1 a is schematic of the body mattress of the present invention showing the shoulder pad void.

FIG. 1 b is a schematic of an exemplary permutation of the body mattress of the present invention.

FIG. 1 c is a permutation of the body mattress of the present invention that acts as a standard surgical mattress.

FIG. 2 is a schematic of the bottom attachment means of the body mattress without the shoulder pad

FIG. 2 a is a schematic of the bottom attachment means of the shoulder pad.

DETAILED DESCRIPTION OF THE EMBODIMENTS

The present invention is directed to a mattress system that provides proper spinal alignment when a person is in the lateral decubitis position or long periods of time, such as when a person is undergoing surgical procedures. Thus the present invention is configured to work within the confines of standard surgical tables. By allowing a section of a mattress under the arm and shoulder of the patient to be easily removed, damaging pressures on the patient's shoulder and pressure injuries in the lateral decubitus position are greatly diminished. Furthermore, the present invention allows the patient's spine to remain anatomically straight and provides spinal and orthopaedic support without having to lift the patient to position them upon the surgical table.
Although there are significant variation from patient to patient on height, build and body mass index, the present system overcomes problems associated with finding a “one size fits all” mattress system. The present system accommodates any size adult because it is based on a person's shoulder width (side of neck to tip of shoulder), arm diameter, and shoulder overhang (the distance from the chest wall to the tip of the shoulder).
Additionally, the present invention eliminates slippage and improper positioning by providing the appropriate spinal alignment commensurate with the patient's body and also parallel positioning of the body to the table to efficiently effectuate surgical procedures. The present invention prevents lateral bending of the patient at the waist. Furthermore, the present invention eliminates shoulder crush of the downside shoulder, a particularly problematic issue for patients with broad shoulders. Finally, the present invention prevents shoulder injuries on the side adjacent to the surgical table aggravated by having the patient's shoulder in a stationary position for an extended period of time.
As shown in FIG. 1, the present invention is a body mattress B having a head portion 1 having a dimension D₁, a shoulder portion 2 having a dimension D₂, a torso/upper body portion 3, having a dimension D₃and a leg/lower body portion 4 having a dimension D₄, so that the total of the of body mattress B is capable of fitting standard surgery tables T, as shown in FIG. 1.
Head portion 1 includes a upper portion 1 a that is positioned on a lower portion 1 b such that the portions are securely held when together. However, upper portion 1 a is separable from lower portion 1 b for purposes described herein below. Similarly, shoulder portion/pad 2 includes an upper portion 2 a that is positioned on a lower portion 2 b, such that the portions are securely held, when together. However, upper portion 2 a is separable from lower portion 2 b for purposes described herein below. Additionally, shoulder portion 2 may be removed entirely, to eliminate slippage and improper positioning by providing the appropriate spinal alignment commensurate with the patient's body and also parallel positioning of the body to the table T to efficiently effectuate surgical procedures. The shoulder pad 2 incorporates a pull out feature having a detachable strap handle 2′. Preferably the strap handle 2 c includes a hook and loop fastener means such as Velcro®. However, other strap configurations, including non-removable leather straps, are also within the scope of the present invention.
Also as shown in FIG. 1, the dimensions D₃of the body pad 3 upper pad portion are such that the body mattress B has a uniform dimension across the head portion 1, the shoulder portion 2, the body portion 3 and the lower body portion 4, when all of the portions are utilized. This dimensional continuity provide proper support and body alignment that alleviates shoulder stress and proper orthopaedic support.
Additionally, as shown in FIG. 1, the lower body portion 4 also includes a upper portion 4 a and a lower portion 4 b that such that the portions are securely held when together. However, upper portion 4 a is separable from lower portion 4 b for specific surgical procedures while providing support and body alignment that alleviates shoulder stress and further provides proper orthopaedic support.
In a preferred embodiment, the dimensions D₁of the head portion 1 and the dimensions D₂of the shoulder pad 2 are each 10 inches by 20 inches by 6 inches where upper portion 1 a and 2 a each have a thickness of 2 inches and lower portion 1 b and 2 b each have a thickness of 4 inches. As is understood by one of ordinary skill, other dimensions for the head portion 1 and the shoulder pad 2, that perform in a manner discussed herein, are within the scope of the present invention. The dimensions D₃of the body pad 3 are 31 inches by 20 inches by 6 inches. The dimensions D₄of the lower body/leg portion 4 are 20 inches by 20 inches by 6 inches, where upper portion 4 a has a thickness of 2 inches and the lower portion 4 b has a thickness of 4 inches. As is understood by one of ordinary skill, other dimensions for the head portion 1, the shoulder portion 2, the body portion 3, and the lower body portion 4 are within the scope of the present invention. In accordance with the present invention, the permutation and combination of the upper and lower portions 1 a and 1 b of the head portion 1, the upper and lower portions 2 a and 2 b of the shoulder portion 2, the body portion 3 and the upper and lower portions 4 a and 4 b of the lower body portion 4 may be altered as needed for specific surgical use or to accommodate individual patient needs. Additionally, the body mattress B may be customized with slots (not shown) to allow for Xray cassettes to be inserted between B and the table T.
In accordance with a preferred embodiment of the present invention, the fastening means 2′ may be a strap having a length of 20 inches and a width of 1 inch. Approximately 6 inches of the fastening means 2′ is secured to the middle portion of the shoulder pad 2 and the remaining portion of the fastening means 2′ is attached and/or removable fastened to lower portion 2 b. The fastening means 2′ is preferably sewn into the middle two thirds of the shoulder pad 2 and the remaining 14 inches are attached to the lower body portion 2 b. A belt loop (not shown) may also be sewn into the fastening means 2′ to increase stability. Furthermore, at least one additional fastening loop (not shown) may be attached to the lower body portion 2 b adjacent to the shoulder pad 2. Belt loops (not shown) and fastening loops (not shown) facilitate ease of addition or removal of the shoulder pad 2 without disturbing the patient. As will be understood by one of ordinary skill, the combination of fastening means 2′, a belt loop and fastening loops may be utilized on one or both sides of the shoulder pad 2 and body pad 3. In a preferred embodiment, fastening means 2′ begins 4 inches from the end on the 10″×6″ side of the pad 2. The belt loop is sewn into pad 2 1 inch before the fastening means 2′ begins. At the same level on the 4″ lower body mattress 4, 14 inches of fastening loops are sewn adjacent to the shoulder pad 2. Preferably the loops are configured from hook and loop fastening systems such as soft Velcro®. Alternatively snaps may be used. In another preferred embodiment, loops (not shown) may be pre-sewn into shoulder pad 2 in the same position as loops to allow for ease of removal of shoulder pad 2.
In a preferred embodiment, as shown in FIG. 1 a, the shoulder portion 2 has been removed to create a void V that allows the arms of the patient to be placed within the void V for appropriate spinal alignment commensurate with the patient's body and also parallel positioning of the body to the table to efficiently effectuate surgical procedures. An exemplary permutation is shown in FIG. 1 b, where lower portion 1 b is utilized with the body portion 3 and the lower body portion 4.
In yet another preferred embodiment, body portion 3 may include an upper portion and lower portion (not shown). As shown in FIG. 1 c, upper portion 1 a, upper shoulder portion 2 a, and lower torso portion 4 a may be used with a body portion 3′, having a thickness that is uniform with that of upper portion 1 a, 2 a and 4 a may be utilized such that the body mattress B may be used directly on a surgical table T, shown in FIG. 1 when a complete mattress B is unneeded or undesirable. Here, body portion 3′ may have a preferred dimension of 31 inches by 20 inches by 2 inches. As shown in FIG. 2, upper portion 1 a and lower portion 1 b of the head portion 1, body portion 3 and 3′, and the upper portion 4 a and the lower portion 4 b of lower body/leg portion 4 includes a bottom surface 1 c, 3 c/3′c and 4 c having an attachments means 1 d, 3 d and 4 d that allows the body mattress B to be attached to the surgical table T of FIG. 1. When shoulder portion 2 is utilized, it too, includes a bottom surface 2 c having an attachment means 2 d, as shown in FIG. 2 a. Preferred fastening means include, but are not limited, to Velcro® or snaps.
Materials that may be utilized for the body mattress B include but are not limited to any high-density foam based product that sustains long procedures or may be formed of a cost effective foam based product that provides the same functions for shorter procedures. Materials that may be utilized include high-density polyurethane foam, memory foam, latex-free and anti-microbial AktonA® polymer and high-density foam, Akton® viscoelastic polymer, high-density poly foam, T-Foam® Cushion (temper foam).
In use, shoulder pad 2 may be disengaged from body pad 3 by disengaging fastening means and folding pad 2 over on to itself, pulled through the loop, where the fastening means 2′ is then attached to loops to thereby form a handle, shown as 2′ in FIG. 1. The shoulder pad 2 may thus be easily pulled out from under the patient relieving the shoulder pressure after the patient is positioned in the lateral decubitus position. This will allow the shoulder and the arm to rest freely in the void. The pad is most easily pulled out from behind the patient, out of the way of arm boards (not shown).
Although the present invention is designed for the lateral decubitus position, the body mattress B may be used with the patient in any position. Additionally, the mattress B can replace standard mattresses. Furthermore, the present invention may be utilized for intra-operative conversion, i.e. from the lateral to supine without requiring reinsertion of shoulder pad 2. Although there is a void created under the upper back of the patient by removal of shoulder pad 2, this is inconsequential because the weight of the patient is supported by the body pad 3. Furthermore the present invention may be utilized for intra-operative conversion, i.e., from the lateral to supine without requiring reinsertion of the shoulder pad 2.
The present invention may easily be modified to fit upon a Jackson Table or other flat radiolucent operating room tables. It is within the scope of the present invention to incorporate a securing means (not shown) on the head portion 1 for holding the head in a restraining position. It is also within the scope of the present invention to incorporate a second securing means (not shown) on the body pad 3 to hold the body in a restraining position. Additionally, the present invention is useful for chiropractic and massage tables.
It is also within the scope of the present invention to provide a fold in a bedcover, such that it covers the length of the shoulder pad 2, which will allow the cover to easily fall into the cavity once the shoulder pad 2 is removed. A standard armboard gel pad overlay may then placed in the void between the table T and the down side arm of the patient protecting any pressure points. Additionally, the gel pad may be modified for easy insertion and removal. Any gel pad overlay that lies on top of a standard body mattress can be utilized such that pressure point protection is provided. Alternatively gel pads may be customized for specific utilities for the void created when the shoulder pad is removed.
The present invention is also safer for teaching and performing procedures that enter the spinal canal in the lateral decubitus position by anesthesia staff and other health care providers. These procedures include but are not limited to lumbar and thoracic epidural blocks and lumber punctures. Unlike current methods, the spine is anatomically straight with the present invention as it prevents lateral bending at the waist thereby making it easier to palpate landmarks for ease of entering the spinal canal at the appropriate level.
It is also within the scope of the present invention to configure the lower body portion 4 to be configured to include a removable hip holder (not shown) that provides a mechanism for surgeons who prefer a bean bag or hip holder device to hold a patient in the lateral decubitus position. Additionally, if a table top spacer for x-rays is placed on the table T, the spacer is removed to allow the hip holder to reach a table clamp of the table T which assists the patient to remain on their side for the entirety of a medical procedure.

Claims

What is claimed is:

1. A mattress system for preventing damaging pressures on the patient's shoulder and pressure injuries in the lateral decubitus position, comprising:

a body mattress having a head pad, a shoulder pad, an upper body pad and a lower body pad wherein said shoulder pad is removably connected to said body pad;

said head pad comprising an upper pad portion and a lower pad portion;

said shoulder pad comprising an upper and a lower pad portion;

said lower body pad comprising an upper and lower pad portion

wherein each of said shoulder pad and said body pad having a width, length and depth such that said shoulder pad and said body pad provide proper support and body alignment so as to prevent said damaging pressures and proper orthopaedic support.

2. A mattress system as recited in claim 1 wherein said shoulder pad further comprises a detachable strap handle.

3. A mattress system as recited in claim 2 wherein said lower portion of said head, shoulder, and lower body portions and said body portion are attached to a surgical table by a removable fastening means.

4. A mattress system as recited in claim 3 wherein said detachable strap handle and said fastening means comprise a hook and loop system.

5. A system as recited in claim 4 wherein said body pad further comprises a first loop and at least one second loop such that said shoulder pad is constructed so as to fold over on to itself and disengage from said body pad and said fastening means and further constructed so as to pull through said first loop;

said fastening means are constructed so as to attach to said at least one second loop so as to form a handle;

said first loop further constructed so as to be positioned away from said at least one second loop to prevent contact with said body pad;

said shoulder pad further constructed so as to be removed thereby providing ease of shoulder pressure.