Patient positioning support structure with coordinated continuous nonsegmented articulation, rotation and lift, and locking fail-safe device

1 . An apparatus for supporting and positioning a patient during a medical procedure, comprising:

a) a patient support subassembly having a centrally located pair of spaced apart hinges adapted to a break upwardly and downwardly;

b) a chest slide adapted to translate along a length of the patient support subassembly; and

c) a linkage linking the hinges with the chest slide, such that breaking of the hinges is linked with translation of the chest slide.

2 . The apparatus according to claim 1 , wherein:

a) when the hinges break upwardly, the linkage causes the chest slide to translate toward the hinges; and

b) when the hinges break downwardly, the linkage causes the chest slide to translate away from the hinges.

3 . An apparatus for supporting and positioning a patient during a medical procedure, the apparatus comprising:

a) a hinge subassembly joining a head portion of an open frame with a foot portion of the frame, the hinge subassembly being located near the middle of a patient supported on the frame and being adapted to controllably angulate in both upward and downward directions and also to return to a non-angled position; and

b) a hinge driver subassembly cooperating with the hinge subassembly, the hinge driver subassembly being translated in a cephalad direction when the hinge subassembly angles downwardly and also being translated in a caudad direction when the hinge subassembly angles upwardly, so as to position the patient in a plurality of prone and non-prone positions.

4 . The assembly according to claim 3 , wherein

a) the hinge driver subassembly is selectively lockable.

5 . The assembly according to claim 4 , wherein

a) the hinge driver subassembly includes a fail-safe locking structure adapted for locking the frame in the event of a catastrophic failure of the apparatus.

6 . The assembly according to claim 3 , further comprising

a) a torso trolley subassembly associated with the frame head portion and adapted for supporting and translating the torso of the patient along a length of the frame head portion in the cephalad and caudad directions and cooperating with the hinge subassembly and hinge driver subassembly to translate the torso in a cephalad direction when the hinge angles downwardly and also to translated the torso in a caudad direction when the hinge angles upwardly.

7 . The assembly according to claim 3 , further comprising

a) a translation compensation subassembly located inside of the frame foot portion and cooperating with the hinge subassembly and the hinge driver subassembly to translate the foot portion in a cephalad direction when the hinge subassembly angles either upwardly or downwardly and also to translate the foot portion in a caudad direction when the hinge subassembly moves toward the non-angled position.

8 . The assembly according to claim 3 , further comprising

a) a pair of space apart head and foot primary motorized vertical end elevators joined with outward ends of the frame head and foot portions; and

b) an infinitely adjustable secondary motorized vertical end elevator adapted for better alignment and orientation of the frame so as to allow additional lowering of the outer end of the frame foot portion beyond an amount of lowering provided by the primary elevators.

9 . The apparatus of claim 3 , wherein

a) the hinge subassembly includes a maximum upward angulation of between about 40° and about 45°.

10 . The apparatus of claim 3 , wherein

a) the hinge subassembly includes a maximum downward angulation of about 30°.

11 . The apparatus of claim 3 , wherein

a) the hinge subassembly includes a total range of motion of about 75°.

12 . An apparatus for supporting a patient during a medical procedure, the apparatus comprising:

a) an open frame having a single breaking location around the middle of a patient positioned on the frame, the frame being outwardly connected to and supported between spaced apart head and foot primary motorized vertical end elevators; and

b) an additional motorized vertical end elevator adapted for infinite adjustability to better align and orient the frame so as to allow for additional vertical adjustability of a frame outer end beyond an amount provided by the primary elevators; wherein

c) the frame can controllably break and bend, upwardly and downwardly, and is adapted to manipulate the patient in a plurality of selectively lockable prone and non-prone positions in cooperation with a frame translation compensation mechanism located in-between the primary end elevators and the frame, while also cooperating with the primary and secondary motorized end elevators to move the patient vertically while the patient is positioned on the frame.

13 . The apparatus according to claim 12 , wherein

a) the translation compensation mechanism cooperatively moves an outer end of the frame away from the respectively connected end elevator in response to upward or downward bending of the frame at the frame breaking location; and

b) the translation compensation mechanism cooperatively moves the outer end of the frame toward the respectively connected end elevator in response to unbending of the frame at the frame breaking location, so as to move the patient between at least two of the prone and non-prone positions.

14 . The apparatus according to claim 12 , wherein:

a) the translation compensation mechanism is located within the frame.

15 . The apparatus according to claim 12 , further comprising:

a) an angulation subassembly including a pivot associated with the frame breaking location and a driver; wherein

b) downward bending of the frame breaking location translates the driver away from the frame and upward bending of the frame translates the driver toward the frame breaking location, so as to manipulate a patient supported on the frame in a plurality of prone and non-prone positions.

16 . The apparatus according to claim 15 , further comprising:

a) a chest slide associated with a head end of the frame and tethered to the pivot; wherein

b) upward bending of the frame translates the chest slide toward the pivot and downward bending of the frame translates the chest slide away from the pivot, so as to manipulate the patient in the plurality of prone and non-prone positions.

17 . The apparatus according to claim 15 , further comprising:

a) a fail-safe mechanism adapted to substantially lock the frame in the event of a catastrophic failure of the apparatus.

18 . The apparatus of claim 15 , wherein

a) the pivot includes a maximum upward bending position of between about 40° and about 45°.

19 . The apparatus of claim 15 , wherein

a) the pivot includes a maximum downward bending position of about 30°.

20 . The apparatus of claim 15 , wherein

a) the pivot includes a total range of motion of about 75°.

21 . An apparatus for moving a patient between at least two of a plurality of selectively lockable prone and non-prone positions, the patient being supported on a frame connected outwardly to and supported between a pair of opposed primary vertical end elevators adapted to raise and lower a connected end of the frame, the frame including head and foot portions, the apparatus comprising:

a) a continuously adjustable angulation subassembly with a central pivot and located around a middle of the patient, the angulation subassembly being adapted to controllably break and angle the frame both upwardly and downwardly and to de-angle the frame to a position wherein the frame head and foot portions are located within a single plane, wherein at least a portion of the angulation subassembly is translated in a cephalad direction when the angulation subassembly angles the frame downwardly and also is translated in a caudad direction when the angulation subassembly angles the frame upwardly;

b) a chest slide subassembly supported by a head end of the frame and cooperating with the angulation subassembly to translate a torso of the patient in response to manipulation of the patient between at least two of a plurality of selectively lockable prone and non-prone positions; and

c) a linkage tether connecting the angulation subassembly with the chest slide subassembly; wherein

d) upward breaking of the angulation subassembly translates the chest slide toward the central pivot, and downward breaking of the angulation subassembly translates the chest slide away from the central pivot.

22 . The apparatus according to claim 21 , further comprising:

a) an infinitely adjustable secondary vertical end elevator connected to and located between a primary vertical end elevator and a respective frame outer end, and adapted for lowering the respective frame outer end an additional distance beyond a distance of lowering provided by the respective primary vertical end elevator.

23 . The apparatus according to claim 21 , further comprising:

a) a fail-safe apparatus adapted to lock the frame in the event of a catastrophic failure of the apparatus.

24 . The apparatus according to claim 21 , further comprising:

a) a frame translation compensation mechanism is located within the frame and adapted to translate the frame foot portion away from a connected end elevator in response to upward or downward angling of the frame and to translate the frame foot portion toward the connected end elevator in response to de-angling the frame.

25 . The apparatus of claim 21 , wherein

a) the central pivot includes a maximum upward breaking position of between about 40° and about 45°.

26 . The apparatus of claim 21 , wherein

a) the central pivot includes a maximum downward breaking position of about 30°.

27 . The apparatus of claim 21 , wherein

a) the central pivot includes a total range of motion of about 75°.

28 . The apparatus of claim 21 , wherein the chest slide subassembly includes

a) a bracket slidingly engaging the frame and attached to the linkage tether; and

b) a sliding chest support releasably engaging the bracket and supported by the frame.

29 . The apparatus of claim 28 , wherein:

a) the sliding chest support is an imaging table top.

30 . An apparatus for supporting a patient during a medical procedure, the apparatus comprising:

a) a breaking patient support subassembly including a head portion and a foot portion joined at a central pivot point;

b) an angulation subassembly including:

i) a pair of opposed hinges, each hinge having first and second knuckles with inboard ends pivotably joined by an upper axle located at the pivot point;

ii) a pair of opposed angulation wedges, each angulation wedge including upper and lower sides, and front and rear ends;

iii) a pair of upper guide members, each of the upper guide members slidably engaging the upper side of one of the angulation wedges, each of the upper guide members having a first through-bore that pivotably receives an associated upper axle therethrough;

iv) a pair of lower guide members, each lower guide member slidably engaging the lower side of the associated angulation wedge, each lower guide member having a second through-bore that pivotably receives an associated lower axle therethrough; and

v) a pair of V-links having inner and outer ends, the lower axles pivotably joining the inner ends with a respective associated lower guide member, and each of the outer ends being pivotably joined with an outboard end of one of the associated first and second knuckles;

c) a torso trolley slidingly supported by the head portion and joined with the angulation subassembly by a linkage tether, the torso trolley adapted for moving in cephalad and caudad directions with respect to the pivot point in response to upward and downward breaking of the patient support subassembly;

d) a pair of selectively telescoping piers supporting the patient support subassembly, the pair of piers including:

i) a head-end pier joined with the outboard end of the head portion and having an independently and continuously adjustable head-end primary elevator; and

ii) a foot-end pier joined with the outboard end of the foot portion and having independently and continuously adjustable foot-end primary and secondary elevators cooperating with the head-end primary elevator;

e) a rotation subassembly cooperating with the head-end and foot-end piers, the elongate patient support subassembly and the angulation subassembly; and

f) a powered actuator for actuating the angulation subassembly and for telescoping the head-end and foot-end piers, so as to so as to allow the hinges to move through an infinitely adjustable non-segmented plurality of angular orientations at the pivot point while substantially maintaining a selected height of the pivot point relative to a floor supporting the apparatus.

31 . The apparatus according to claim 30 , comprising:

a) a pair of tensioned rear tethers, each tether joining the actuator and an associated angulation wedge, so as to slidingly move the angulation wedges in the cephalad and caudad directions between the associated upper and lower sliding guide members, so as to cause the hinges to break upwardly or downwardly with respect to the floor.

32 . The apparatus according to claim 30 , the torso trolley comprising:

a) a pair of opposed sliding brackets slidably engaging the head portion of the patient support subassembly;

b) a pair of opposed sliding channel members removably received on the patient support subassembly and each of the sliding channel members releasably mating with a sliding bracket; and

c) a chest slide removably and adjustably received on the pair of sliding channel members.

33 . The apparatus according to claim 32 , including:

a) a linkage strut pivotably joining each of the sliding brackets with the front end of an associated angulation wedge.

34 . The apparatus according to claim 32 , wherein:

a) the patient support subassembly includes a frame; and

b) each of the sliding brackets includes an inner surface that defines a trapezoidal cross-section sized and shaped to slidingly mate with the associated frame, wherein the cross-section is taken perpendicular to a longitudinal axis of the frame.

35 . The apparatus according to claim 30 , further comprising a fail-safe subassembly, the fail-safe subassembly including:

a) a toothed rack associated with the upper side of the angulation wedge and extending from about the front end of the angulation wedge to about the rear end thereof;

b) a pawl pivotably linked with each of the upper sliders and including a ratchet tooth for engaging the toothed rack; wherein

c) in the event of a catastrophic failure of the apparatus, the ratchet tooth engages the toothed rack, so as to block downward breaking of the patient support subassembly subsequent to the failure.

36 . The apparatus according to claim 35 , wherein:

a) catastrophic failure includes at least one of mechanical failure and electrical failure.

37 . The apparatus according to claim 30 , wherein:

a) the patient support subassembly includes a frame.

38 . The apparatus according to claim 37 , wherein:

a) the frame includes a trapezoidal cross-section, wherein the cross-section is taken perpendicular to a longitudinal axis thereof.

39 . The apparatus according to claim 30 , the patient support subassembly further comprising:

a) a second patient structure, the second structure being a solid support board.

40 . The apparatus according to claim 30 , the patient support subassembly further comprising:

a) a second patient structure, the second structure being an imaging table.

41 . The apparatus according to claim 30 , wherein:

a) each angulation wedge includes at least one of an upper locking slot and a lower locking slot, wherein

b) each of the locking slots extends between the front and rear ends thereof; and

c) each of the locking slots being sized and shaped to slidingly receive therein a complementary mating guide key therein.

42 . The apparatus according to claim 41 , wherein:

a) each of the upper guide members includes an upper guide key sized and shaped to slidingly mate with an associated upper locking slot, so as to slidingly guide the associated upper guide member along the upper side of the associated angulation wedge; and

b) each of the lower guide members includes a lower guide key sized and shaped to slidingly mate with an associated lower locking slot, so as to slidingly guide the associated lower guide member along the lower side of the associated angulation wedge.

43 . The apparatus according to claim 42 , wherein:

a) each of the upper and lower locking slots includes a trapezoidal cross-section, wherein the cross-section is taken perpendicular to a longitudinal axis thereof.

44 . The apparatus of claim 30 , wherein the plurality of angular orientations includes a maximum upward breaking position of about 40° to about 45°.

45 . The apparatus of claim 30 , wherein the plurality of angular orientations includes a maximum downward breaking position of about 30°.

46 . The apparatus of claim 30 , wherein the plurality of angular orientations includes a total range of motion of about 75°.

47 . The apparatus of claim 30 , wherein:

a) the apparatus comprises a base; and

b) a portion of an outboard end of the foot portion is lowered below a portion of the base, when the foot-end primary and secondary elevators are maximally lowered.

48 . The apparatus according to claim 30 , wherein:

a) the rotation subassembly being adapted to rotate the patient support subassembly relative to a longitudinal axis thereof a distance selected from the group consisting of at least about ±5°, at least about ±10°, at least about ±15°, at least about ±20°, at least about ±25°, and at least about ±30°.

49 . An apparatus for supporting and positioning a patient during a medical procedure, the apparatus comprising:

a) a pair of spaced opposed hinge subassemblies joining a head portion of an open frame with a foot portion of a frame, the hinge subassemblies being located about the middle of a patient supported on the frame and being adapted to controllably angle in both upwardly and downwardly directions and also to return to a non-angled position; and

b) a hinge driver subassembly cooperating with the hinge subassemblies, the hinge driver subassembly being translated in a cephalad direction when the hinge subassemblies angle downwardly and also being translated in a caudad direction when the hinge subassemblies angle upwardly, so as to manipulate a patient supported on the frame in a plurality of prone and non-prone positions.

50 . An apparatus for supporting and positioning a patient during a medical procedure, comprising:

a) a prone patient support structure suspended above a floor and adapted for selectively and reversibly flexing and articulating the spine of a patient supported thereon while maintaining the spine at selected height;

b) a pair of first vertical translation subassemblies held in fixed spaced opposed relation to one another; each of the first vertical translation subassemblies including a pitch axis and being reversibly joined with an outboard end of the prone patient support structure so as to allow for reversible rotational movement of the respective outboard end about the respective pitch axis.

51 . The apparatus according to claim 1 , wherein:

a) the spaced apart hinges are gearless.

52 . The apparatus according to claim 1 , wherein:

a) each of the spaced apart hinges includes a cam.

53 . The apparatus according to claim 1 , wherein:

a) each of the spaced apart hinges includes a push-pull control rod.

54 . The apparatus according to claim 1 , wherein:

a) each of the spaced apart hinges includes an angulation wedge actuated by a push-pull control rod.

55 . The apparatus according to claim 3 , wherein:

a) the spaced apart hinges are gearless.

56 . The apparatus according to claim 3 , wherein:

a) the hinge driver subassembly includes a cam.

57 . The apparatus according to claim 3 , wherein:

a) the hinge driver subassembly includes a push-pull control rod.

58 . The apparatus according to claim 3 , wherein:

a) each of the spaced apart hinges includes an angulation wedge actuated by a push-pull control rod.

59 . The assembly according to claim 7 , wherein:

a) the translation compensation subassembly includes a sliding inner translation bar that is coplanar with the portion of the frame surrounding the inner translation bar.

60 . The apparatus according to claim 12 , wherein:

a) the spaced apart hinges are gearless.

61 . The apparatus according to claim 12 , wherein:

a) the hinge driver subassembly includes a cam.

62 . The apparatus according to claim 12 , wherein:

a) the hinge driver subassembly includes a push-pull control rod.

63 . The apparatus according to claim 12 , wherein:

a) each of the spaced apart hinges includes an angulation wedge actuated by a push-pull control rod.

64 . The assembly according to claim 13 , wherein:

a) the translation compensation subassembly includes a sliding inner translation bar that is coplanar with the portion of the frame surrounding the inner translation bar.

65 . The apparatus according to claim 21 , wherein:

a) the spaced apart hinges are gearless.

66 . The apparatus according to claim 21 , wherein:

a) the hinge driver subassembly includes a cam.

67 . The apparatus according to claim 21 , wherein:

a) the hinge driver subassembly includes a push-pull control rod.

68 . The apparatus according to claim 21 , wherein:

a) each of the spaced apart hinges includes an angulation wedge actuated by a push-pull control rod.

69 . The assembly according to claim 24 , wherein:

a) the translation compensation subassembly includes a sliding inner translation bar that is coplanar with the portion of the frame surrounding the inner translation bar.

70 . The apparatus according to claim 30 , wherein:

a) the spaced apart hinges are gearless.

71 . The apparatus according to claim 30 , wherein:

a) the hinge driver subassembly includes a cam.

72 . The apparatus according to claim 30 , wherein:

a) the hinge driver subassembly includes a push-pull control rod.

73 . The apparatus according to claim 30 , wherein:

a) each of the spaced apart hinges includes an angulation wedge actuated by a push-pull control rod.

74 . The assembly according to claim 30 , further comprising:

a) a translation compensation subassembly with a sliding inner translation bar that is coplanar with a portion of the frame surrounding the inner translation bar.

75 . The apparatus according to claim 49 , wherein:

a) the hinge subassemblies are gearless.

76 . The apparatus according to claim 49 , wherein:

a) the hinge driver subassembly includes a cam.

77 . The apparatus according to claim 49 , wherein:

a) each of the hinge driver subassemblies includes a rotatable elongate member.

78 . The apparatus according to claim 49 , wherein:

a) each of the hinge subassemblies includes an angulation wedge actuated by a push-pull control rod.

79 . The assembly according to claim 49 , further comprising:

a) a translation compensation subassembly with a sliding inner translation bar that is coplanar with a portion of the frame surrounding the inner translation bar.

80 . The apparatus according to claim 1 , wherein:

a) when the hinges break upwardly, movement of the linkage in one direction causes the chest slide to translate in the same direction.

81 . An apparatus for supporting a patient during a medical procedure, the apparatus comprising:

a) an open frame having a single breaking location around the middle of a patient positioned on the frame, the frame being outwardly connected to and supported between spaced apart head and foot primary motorized vertical end elevators; and

b) an additional motorized vertical end elevator adapted for infinite adjustability to better align and orient the frame so as to allow for additional vertical adjustability of a frame outer end beyond an amount provided by the primary elevators; wherein

c) the frame can controllably break and bend, upwardly and downwardly, and is adapted to manipulate the patient in a plurality of selectively lockable prone and non-prone positions in cooperation with a frame translation compensation mechanism located within an end of the frame, while also cooperating with the primary and secondary motorized end elevators to move the patient vertically while the patient is positioned on the frame.

82 . An apparatus for supporting and positioning a patient during a medical procedure, comprising:

a) a prone patient support structure suspended above a floor and adapted for selectively and reversibly flexing and articulating the spine of a patient supported thereon while maintaining the spine at selected height above a floor; and

b) the patient support structure including head and foot end sections forming a frame with outer and inner ends, the inner ends being connected at a pair of hinges and the outer ends being connected to first and second vertical translation subassemblies; wherein

c) the first and second vertical translation subassemblies are held in fixed spaced opposed relation to one another; each of the vertical translation subassemblies including pitch and yaw axes about which the outer ends of the prone patient support structure are rotatable.