Dual modality prone spine patient support apparatuses

Abstract

A patient support apparatus for spine surgery includes first and second lift columns. A patient support frame extends between the first and second lift columns. The patient support frame has a first section to support a torso of a patient and a beam that extends from the first section. The beam is coupled to a foot end region of the first section about midway between opposite sides of the first section. A first set of leg supports are located adjacent a first side of the beam and a second set of leg supports are located adjacent a second side of the beam. The first and second sets of leg supports are independently movable relative to the beam and relative to the first section to support the legs of the patient in a plurality of positions.

Claims

1. A patient support apparatus for spine surgery, the patient support apparatus comprising a first lift column, a second lift column spaced apart from the first lift column in a longitudinal dimension of the patient support apparatus, a patient support frame extending longitudinally between the first and second lift columns, the patient support frame comprising a first section to support a torso of a patient, the first section having spaced apart first and second rails extending generally parallel with the longitudinal dimension of the patient support apparatus, the first section having a head end region coupled to the first lift column by a first coupling assembly, the patient support frame having a first beam that extends from the first section and that couples to the second lift column by a second coupling assembly, the first beam being coupled to a foot end region of the first section about midway between opposite sides of the first section, a first set of leg support pads coupled to patient support frame and located on a first side of the first beam, the first set of leg support pads including a first thigh pad and a first ankle pad, and a second set of leg support pads coupled to the patient support frame and located on a second side of the first beam, the second set of leg support pads including a second thigh pad and a second ankle pad.

2. The patient support apparatus of claim 1, the patient support frame further comprising a second beam extending from the second coupling assembly in a cantilevered manner so as to terminate at a free end that is spaced from the first section of the patient support frame, the second beam being situated above the first beam, the first and second ankle pads being supported by the second beam on respective first and second sides thereof.

3. The patient support apparatus of claim 2, wherein the first and second ankle pads extend laterally from respective first and second sides of the second beam and are each supported relative to the second beam in a cantilevered manner.

4. The patient support apparatus of claim 3, wherein the second beam has first and second slots along the first and second sides and wherein the first and second ankle pads each have a respective support rod that extends into the respective first and second slot.

5. The patient support apparatus of claim 3, wherein the first and second ankle pads are each independently adjustable along a length of the second beam.

6. The patient support apparatus of claim 2, wherein, when the patient support frame is in a horizontal position supporting the patient in a prone position, the first beam comprises a first segment that angles downwardly with respect to the foot end region of the first section, a second segment that extends horizontally from a lower end of the first segment, and a third segment that angles upwardly from the second segment to the second coupling assembly.

7. The patient support apparatus of claim 6, wherein the second coupling assembly includes an arced member that supports the foot end regions of the first and second beams, the patient support frame includes a first laterally extending member and a second laterally extending member coupled to the first laterally extending member for pivoting movement about an axis, the first segment of the first beam being coupled to the second laterally extending member, and the foot end regions of the first and second beams traveling along the arced member as the first and second beams pivot with the second laterally extending member about the axis.

8. The patient support apparatus of claim 7, wherein the first and second laterally extending members serve as a hip support for the patient supported by the patient support frame in a prone position.

9. The patient support apparatus of claim 1, further comprising first and second struts coupled to the first section, the first thigh pad and the first ankle pad being coupled to the first strut, the second thigh pad and the second ankle pad being coupled to the second strut, and wherein at least one of the first and second struts includes a first strut portion and a second strut portion that articulates at a joint relative to the first strut portion.

10. The patient support apparatus of claim 9, wherein the first thigh pad is coupled to the first strut portion and the first ankle pad is coupled to the second strut portion.

11. The patient support apparatus of claim 10, further comprising a knee pad coupled to the at least one of the first and second struts adjacent the joint.

12. The patient support apparatus of claim 1, further comprising first and second struts coupled to the first section, the first thigh pad and the first ankle pad being coupled to the first strut, the second thigh pad and the second ankle pad being coupled to the second strut, and wherein at least one of the first and second struts includes a first strut portion and a second strut portion that telescopically extends and retracts relative to the first strut portion.

13. The patient support apparatus of claim 12, wherein the first thigh pad is coupled to the first strut portion and the first ankle pad is coupled to the second strut portion.

14. The patient support apparatus of claim 13, further comprising a knee pad coupled to the at least one of the first and second struts between the respective first and second thigh and first and second ankle pads.

15. The patient support apparatus of claim 1, further comprising a set of torso supports coupled to one of the first and second rails, a pair of lateral supports coupled to the other of the first and second rails, each lateral support of the pair of lateral supports extending upwardly beyond upper surfaces of the torso supports when the patient is supported on the torso supports in a prone position, the lateral supports supporting a side of the patient's torso when the patient support frame is rotated with respect to the first and second lift columns to place the patient in a lateral position.

16. The patient support apparatus of claim 15, wherein the pair of lateral supports each include a first support portion that couples to one of the first and second rails and a second support portion that adjustably moves toward and away from the first support portion to accommodate patients of different sizes.

17. The patient support apparatus of claim 16, wherein each lateral support of the pair of lateral supports includes a bar that telescopically couples the second support portion to the first support portion.

18. The patient support apparatus of claim 16, wherein the first support portion of each lateral support of the pair of lateral supports has a torso supporting surface and wherein the second support portion of each lateral support of the pair of lateral supports extends over the torso supporting surface when the lateral supports extend upwardly such that the first and second support portions are configured to cradle a side of the patient's torso.

19. The patient support apparatus of claim 9, further comprising first and second collars that couple the first and second thigh pads, respectively, to the first and second struts, respectively, each of the first and second collars being movable along a length of the first and second struts, respectively.

20. The patient support apparatus of claim 19, wherein the first and second collars are lockable to the first and second struts, respectively, to prevent movement of the first and second thigh pads relative to the first and second struts, respectively.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) The detailed description particularly refers to the accompanying figures, in which:

(2) FIG. 1 is a perspective view of a first embodiment of a patient support apparatus for supporting a patient during spine surgery showing a base unit (in phantom) having first and second lift columns spaced apart longitudinally with an interconnecting spacer strut and showing a patient supported in a prone position on a patient support frame that has first and second ends coupled to the first and second lift columns by respective first and second coupling assemblies;

(3) FIG. 2 is a perspective view of the patient support frame and coupling assemblies of FIG. 1 showing the coupling assemblies including head end and foot end H-brackets, the patient support frame having a generally rectangular first section with a plurality of torso support pads coupled thereto, the first section being coupled to the head end H-bracket, the patient support frame having a beam extending from a foot end region of the first section and coupling to the foot end H-bracket via an arced member, and first and second sets of leg supports on opposite sides of the beam;

(4) FIG. 3 is a perspective view, similar to FIG. 1, of a second embodiment of a patient support apparatus for supporting a patient during spine surgery showing a patient supported in a prone position atop a patient support frame of the second embodiment;

(5) FIG. 4 is a perspective view of the patient support frame and coupling assemblies of FIG. 3 showing the coupling assemblies including head end and foot end H-brackets, the patient support frame having a generally rectangular first section with a plurality of torso support pads coupled thereto, the first section being coupled to the head end H-bracket, the patient support frame having a 3-segment lower beam extending from a foot end region of the first section toward the foot end H-bracket, a second beam extending in a cantilevered manner from an arced member that is coupled to the foot end H-bracket, first and second ankle supports coupled to the second beam, first and second rods extending between the foot end region of the first section and the ankle supports, and first and second thigh supports coupled to the first and second rods on opposite sides of the beam;

(6) FIG. 5 is a perspective view, similar to FIGS. 1 and 3, of a third embodiment of a patient support apparatus for supporting a patient during spine surgery showing a patient supported in a prone position atop a patient support frame of the third embodiment;

(7) FIG. 6 is a perspective view of the patient support frame and coupling assemblies of FIG. 5 showing the coupling assemblies including head end and foot end H-brackets, the patient support frame having a generally rectangular first section with a plurality of torso support pads coupled thereto, the first section being coupled to the head end H-bracket, the patient support frame having a beam extending from a foot end region of the first section and coupling to the foot end H-bracket via an arced member, and first and second sets of leg supports on opposite sides of the beam;

(8) FIG. 7 is a sectional view taken horizontally through the arced member of FIGS. 5 and 6 showing the arced member having an arced rack with a first set of teeth, a pinion coupled to the foot end of the beam and having a second set of teeth that interface with the first set of teeth, and a handle coupled to the pinion so that the pinion is manually rotatable to move the foot end of the beam along the arced member;

(9) FIG. 8 is a perspective view, similar to FIGS. 1, 3 and 5, of a fourth embodiment of a patient support apparatus for supporting a patient during spine surgery showing a patient supported in a prone position atop a patient support frame of the fourth embodiment;

(10) FIG. 9 is a perspective view of the patient support frame and coupling assemblies of FIG. 8 showing the coupling assemblies including head end and foot end H-brackets, grip handles coupled to upper legs of each of the H-brackets, the grip handles being grippable to manually rotate the patient support frame relative to the first and second lift columns, the patient support frame having a generally rectangular first section with a plurality of torso support pads coupled thereto, the first section being coupled to lower legs of the head end H-bracket, the patient support frame having a multi-segment beam extending from a foot end region of the first section and coupling to lower legs of the foot end H-bracket, an arced member that is coupled to the foot end region of the beam, first and second rods extending from the arced member toward the first section, first and second ankle supports coupled to the first and second rods, respectively, and first and second thigh supports coupled to the foot end of the first section;

(11) FIG. 10 is a side elevation view of the patient support frame of FIGS. 8 and 9;

(12) FIG. 11A is a top plan view showing a hip support pivoted to a first orientation relative to an underlying lateral frame member of the first section of the patient support frame, the pivoting movement being constrained by interaction between a pair of posts that are received in arced slots formed at the opposite end regions of the hip support;

(13) FIG. 11B is a top plan view, similar to FIG. 11A, showing the hip support pivoted to a second orientation relative to the underlying lateral frame member of the first section of the patient support frame;

(14) FIG. 12 is a perspective view, similar to FIGS. 1, 3, 5 and 8, of a fifth embodiment of a patient support apparatus for supporting a patient during spine surgery showing a patient supported in a prone position atop a patient support frame of the fifth embodiment;

(15) FIG. 13 is a perspective view of the patient support frame and coupling assemblies of FIG. 12 showing the coupling assemblies including head end and foot end H-brackets, the patient support frame having a generally rectangular first section, the first section being coupled to lower legs of the head end H-bracket, the patient support frame having a beam extending from a foot end region of the first section and coupling to the foot end H-bracket via an arced member, first and second thigh supports and first and second shin supports on opposite sides of the beam, a pad support beam extending between upper legs of the H-brackets, and a set of lateral pads, each lateral pad including a first portion coupled to the first section of the patient support frame and extending toward the pad support beam, each lateral pad including a second portion coupled to the pad support beam and extending toward the patient support frame;

(16) FIG. 14 is a perspective view of a sixth embodiment of a patient support apparatus for supporting a patient during spine surgery showing a base unit having first and second lift columns spaced apart longitudinally with an interconnecting spacer strut, a patient support frame having first and second ends coupled to the first and second lift columns by respective first and second coupling assemblies, the patient support frame having a first section configured to support a torso of a patient, a 3-segment first beam that extends from the first section and that couples to the second lift column by the second coupling assembly, an arced member coupled to a foot end region of the first beam, a second beam situated above the first beam, the second beam including a first end coupled to the first section and a second end that is supported by the arced member, and first and second sets of leg supports on opposite sides of the second beam;

(17) FIG. 15 is another perspective view of the patient support apparatus of FIG. 14 showing the opposite side of the sixth embodiment of the patient support apparatus as compared to the side shown in FIG. 14;

(18) FIG. 16 is a perspective view of the sixth embodiment of the patient support apparatus, similar to FIG. 15, showing a patient supported by the patient support frame in a prone position;

(19) FIG. 17 is a perspective view of the sixth embodiment of the patient support apparatus, similar to FIG. 16, showing the patient support frame rotated from the FIG. 16 orientation by about 90 relative to the first and second lift columns so that the patient is supported by the patient support frame in a lateral position; and

(20) FIG. 18 is a perspective view of the sixth embodiment of the patient support apparatus, similar to FIG. 17, showing the second beam and the first and second sets of leg supports carried by the second beam rotated relative to the first section of the patient support frame so that the second end of the second beam is moved to a lower end of the arced member.

DETAILED DESCRIPTION

(21) The present disclosure includes various embodiments of a patient support apparatus that is used for spine surgery. Each embodiment includes a base unit 20 having a first lift column 22 situated at a head end 24 of the respective patient support apparatus, a second lift column 26 situated at a foot end 28 of the respective patient support apparatus, and an interconnecting strut 30 that extends between the first and second lift columns 22, 26 in substantially parallel relation with a longitudinal dimension of the respective patient support apparatus as shown in FIGS. 1, 3, 5, 8, 12, and 14-18 (in phantom in FIGS. 1, 3, 5, 8 and 12). As used in this description, the phrase head end 24 will be used to denote the end of any referred-to object that is positioned to lie nearest the head end 24 of base unit 20 and the phrase foot end 28 will be used to denote the end of any referred-to object that is positioned to lie nearest the foot end 28 of base unit 20. Each column 22, 26 includes a carriage 32, a substantially vertical first tubular segment 34 extending upwardly from the carriage 32, and a substantially vertical second tubular segment 36 that extends and retracts relative to the first tubular segment 34. Each of the carriages 32 extend generally parallel with a lateral dimension of the respective patient support apparatus and each carriage 32 is supported with respect to an underlying floor by a pair of casters 38.

(22) Strut 30 assures that columns 22, 26 are spaced apart longitudinally by the proper amount for use during surgery when a respective patient support frame is attached. In the illustrative embodiments, strut 30 includes a first segment 40 and a second segment 42. In some embodiments, segments 40, 42 are coupled together for telescopic movement and in other embodiments, segments 40, 42 are coupled together for pivoting movement. In either case, segments 40, 42 are movable relative to each other, such as by telescoping or folding, to permit columns 22, 26 to move closer together for compact storage when the respective patient support apparatus is not in use and the respective patient support frame is detached from the columns 22, 26. In other embodiments, strut 30 is a single segment that does not telescope, fold, or otherwise move to permit the spacing between columns 22, 26 to be altered.

(23) Other aspects of base unit 20 are shown and described in U.S. Patent Application Publication No. 2013/0269710 A1 which is hereby expressly incorporated by reference herein to the extent not inconsistent with the present disclosure which shall control as to any inconsistencies. In some embodiments, base unit 20 comprises a model number A-71100 Allen Advance Table available from Allen Medical Systems, Inc. of Batesville, Ind. However, it is within the scope of this disclosure for the patient support frames disclosed herein to be configured for use with dual column surgical tables of other types including various versions of so-called Jackson tables, such as the Jackson 5803 table, and those available from Mizuho OSI, Inc., such as the proAXIS Spinal Surgery Table and the Modular Table System (MTS) base, for example.

(24) Referring now to FIGS. 1 and 2, a first embodiment of a patient support apparatus 100 for supporting a patient during spine surgery includes base unit 20 and a patient support frame 102 that has its head and foot ends 24, 28 coupled to the first and second lift columns 22, 26 by respective first and second coupling assemblies 104, 106. In the illustrative example, coupling assemblies 104, 106 each include H-brackets which, in turn, each include a central bar 108, a pair of lower legs 107 extending downwardly from opposite ends of bar 108 when patient support frame 102 is oriented to support the patient in a prone position, and a pair of upper legs 109 extending upwardly from opposite ends of bar 108 when patient support frame 102 is oriented to support the patient in the prone position. In some embodiments, legs 107, 109 are detachable from central bar 108 in the manner shown and described in U.S. Patent Application Publication No. 2013/0269710 A1 which is already incorporated by reference herein.

(25) Patient support frame 102 includes a first section 110 which is generally rectangular in shape as shown best in FIG. 2. First section 110 is sized to support a patient's torso and includes first and second side rails 112, 114, a head end rail 116, and a foot end rail 118. Rails 112, 114 extend longitudinally between the opposite ends of respective rails 116, 118 and thus, are parallel with the longitudinal dimension of patient support apparatus 100. In the illustrative example, frame 102 has a pair of rounded corner couplers 115 that interconnect the head end 24 of rails 112, 114 to respective ends of rail 116. Rails 112, 114, 116, 118 are sometimes referred to herein as frame members 112, 114, 116, 118.

(26) A bar 120 projects from a central region of frame member 116 toward the head end 24 of apparatus 100. A coupling tube 122 is appended to the head end 24 of bar 120 and extends laterally with respect to apparatus 100 between lower legs 107 of coupling assembly 104. A pin (not shown) extends through tube 122 such that opposite ends of the pin are received in apertures 124 of legs 107 to couple the head end 24 of first section 110 to coupling assembly 104 in a manner that is shown and described in U.S. Patent Application Publication No. 2013/0269710 A1, for example. Legs 107, 109 each have a series of apertures 124 therealong to provide a plurality of mounting locations for patient support frame 102 and other styles of table tops (not shown).

(27) A set of torso supports 126 are coupled to rails 112, 114 and a head support 128 is coupled to a cross member 130 that extends between rails 112, 114 as shown in FIG. 2. Two of torso supports 126 are coupled to rail 112 and two are coupled to rail 114. A pair of lateral supports 132 are coupled to rail 114 adjacent to respective torso supports 126. Lateral supports 132 extend upwardly beyond the upper surfaces of torso supports 126 when patient support frame 102 is oriented in a manner to support a patient in a prone position a shown in FIG. 1. Torso supports 126 and lateral supports 132 each have rail clamps 134 that releasably attach the supports 126, 132 to rails 112, 114. Thus, supports 126, 132 are repositionable along rails 112, 114 and the lateral supports 132 can be detached from rail 114 and attached to rail 112, if desired. Examples of suitable rail clamps 134 are shown and described in U.S. Patent Application Publication No. 2013/0269710 A1 and in U.S. Pat. No. 7,520,007 which is hereby incorporated by reference herein to the extent not inconsistent with the present disclosure which shall control as to any inconsistencies.

(28) Bars 108 of coupling assemblies 104, 106 are attached to pivot shafts (not shown) that extend substantially horizontally from the upper end regions of tubular segments 36 of lift columns 22, 26. The pivot shafts are rotatable to permit the coupling assemblies 104, 106 and patient support frame 102 to rotate relative to base unit 20. The axes of rotation of the pivot shafts extend substantially parallel with the longitudinal dimension of apparatus 100. In FIG. 1, a patient is shown supported on patient support frame 102 in a prone position with the lateral supports 132 extending upwardly along the left side of the patient's torso. When patient support frame 102 and coupling assemblies 104, 106 are rotated by about 90 in the counterclockwise direction as determined by looking at apparatus 100 from the foot end 28, the patient moves from the prone position to a lateral position and the lateral supports 132 become positioned beneath the patient. Thus, when frame 102 is oriented to support the patient in the prone position, the weight of the patient's torso bears primarily on torso supports 126 and when the frame 102 is oriented to support the patient in the lateral position, the weight of the patient's torso bears primarily on the lateral supports 126 although, some of the patient's weight bears on the torso supports 126 that are adjacent the lateral supports 132 in the illustrative example.

(29) In FIG. 1, an arm board 135 is shown supporting the patient's right arm. However, it should be understood that a second arm board 135 is provided for supporting the patient's left arm but that second arm board 135 cannot be seen in FIG. 1. The arm boards 135 are omitted in FIG. 2. Arm boards 135 coupled to rails 112, 114 with rail clamps that are substantially the same as the rail clamps described above in connection with supports 126, 132.

(30) A hip support 136 is mounted to frame member 118 for pivoting movement about an axis 138 that is located about midway between the opposite ends of support 136. Torso supports 126, head support 128, lateral supports 132, and hip support 136 are padded supports in some embodiments. The padding includes, for example, one or more layers of foam, gel, or air bladders. These one or more padding layers are encased within a cover of each of supports 126, 128, 132, 136 in some embodiments. Optionally, head support 128 does not have a cover but is an exposed layer of foam in some embodiments. Head support 128 comprises a foam ring that is somewhat oval in shape in the illustrative example. In some embodiments, one or more of supports 126, 128, 132, 136 include a generally rigid panel either inside the covering or beneath or beside the covering as the case may be and depending upon the orientation of frame 102 relative to base unit 20.

(31) Patient support frame 102 includes a beam 140 that extends from rail 118 of first section 110 and that is coupled to and supported with respect to second coupling assembly 106 as shown in FIG. 2. Beam 140 is coupled to foot end 28 of first section 110 about midway between opposite sides of first section 110. In some embodiments, beam 140 is coupled to rail 118 for pivoting movement about axis 138. In some such embodiments, head end 24 of beam 140 is located beneath rail 118 and is mounted on a lower end of a pivot shaft that has hip support 136 coupled to an upper end of the pivot shaft. Thus, the pivot shaft extends through an aperture in rail 118. If desired, hip support 136 and beam 140 are both keyed to the pivot shaft to rotate together relative to first section 110 about axis 138. In other embodiments, beam 140 and hip support 136 rotate independently about axis 138.

(32) Patient support apparatus 100 includes a first set of leg supports 142 located adjacent a first side of beam 140 and a second set of leg supports 144 located adjacent a second side of beam 140. First set and second set of leg supports 142, 144 are movable relative to beam 140 and relative to first section 110 of the patient support frame 102 to support first and second legs of the patient in a plurality of positions. The first set of leg supports 142 are movable independently of the second set of leg supports 144 so that the patient's right and left legs can be placed in different positions. Leg supports 142, 144 each include a thigh support 146 pivotably coupled to foot end 28 of rail 118 of first section 110 of patient support frame 102 and an ankle support 148 slidably coupled to beam 140.

(33) In the illustrative embodiment, each thigh support 146 includes a curved thigh cradle 147 and each ankle support 148 is generally cylindrical. In some embodiments, one or more of cradles 147 of thigh supports 146 and ankles supports 148 are padded in the manner discussed above. In the illustrative example, each thigh support 146 includes a support rod 150 having its head end 24 coupled to the foot end 28 of first section 110 for pivoting movement about a first axis 152 that is oriented in substantially perpendicular relation with the longitudinal dimension of apparatus 100. Each thigh support 146 includes a second rod 154 that extends and retracts relative to the first rod 150 along a second axis 156 that is substantially perpendicular to the first axis 152 as indicated by double headed straight arrow 158 in FIGS. 1 and 2. The thigh support cradle 147 is coupled to the second rod and is rotatable about the second axis 156 as indicated by double headed curved arrow 160 in FIGS. 1 and 2. Rods 150 are attached to T-shaped couplers 162 that are mounted to rail 118 for pivoting movement about axis 152.

(34) Each ankle support 148 extends laterally from beam 140 and is supported relative to beam 140 in a cantilevered manner. Opposite sidewalls 164 of beam 140 are formed to include slots 166. Ankle supports 148 have rods (not shown) that extend through slots 166 so that ends of the rods are situated in an interior region of beam 140. A knob 168 is provided at the end of each of the rods of ankle supports 148 and is rotated to tighten and loosen the rod (depending upon the direction of rotation of knob 168) relative to beam 140. Thus, in some embodiments, a receiving block or nut inside the interior region of beam 140 receives a threaded end of the rod that extends through each ankle support from the respective knob 168. When knob 168 is tightened the respective side wall 164 of beam becomes clamped between the block or nut and the end surface of the respective ankle support 148 that is adjacent the side wall 164. Each ankle support 148 includes a strap 170 to retain a patient's leg on the respective ankle support 148 as shown in FIG. 1. Similar straps are provided on thigh supports 146 in some embodiments. Additional straps are also used around the patient's torso and arms in some embodiments.

(35) Second coupling assembly 106 includes an arced member 172 that supports foot end 28 of beam 140. The foot end 28 of beam 140 travels along the arced member as beam 140 pivots about axis 138. In the illustrative embodiment, arced member 172 includes an arced track 174 and foot end 28 of beam 140 is received within the arced track 174. It will be appreciated that the curvature of the arced track 174 is centered on pivot axis 138 in some embodiments. In alternative embodiments, beam 140 is pivotable relative to first section 110 of frame 102 about a second axis that is spaced from and parallel with axis 138. In such embodiments, the curvature of track 174 is centered on the second axis. A releasable clamp or other suitable lock 176 is provided to lock the beam 140 in place relative to arced member 172 once beam 140 is moved to a desired position.

(36) In the illustrative example, arced member 172 is attached directly to a front surface of legs 107 of second coupling assembly 106 such as by welding, for example. In other embodiments, member 172 includes a bar and tube arrangement similar to bar 120 and tube 122 located at the head end of frame 102 for coupling to legs 107 of coupling assembly 106 with a pin that extends through the tube and through apertures 124 of the associated legs 107.

(37) Referring now to FIGS. 3 and 4, a second embodiment of a patient support apparatus 200 for supporting a patient during spine surgery includes base unit 20 and a patient support frame 202 that has its head and foot ends 24, 28 coupled to the first and second lift columns 22, 26 by coupling assemblies 104, 106 that include H-brackets having respective bars 108, lower legs 107, and upper legs 109. Because coupling assemblies 104, 106 of frame 202 are substantially the same as coupling assemblies 104, 106 of frame 102, the same reference numbers are used and the discussion above is equally applicable to coupling assemblies 104, 106 of frame 202. Furthermore, in the description of apparatus 200 that follows, other components of apparatus 200 that are substantially the same as components of apparatus 100 are denoted with like reference numerals and the description of these various components above in connection with apparatus 100 is equally applicable to apparatus 200.

(38) Patient support frame 202 includes a first section 210 which is generally rectangular in shape as shown best in FIG. 4. First section 210 is sized to support a patient's torso and includes first and second side rails 212, 214, a head end rail 216, and a foot end rail 218. Rails 212, 214 extend longitudinally between the opposite ends of respective rails 216, 218 and thus, are parallel with the longitudinal dimension of patient support apparatus 200. In the illustrative example, frame 202 has a pair of rounded corner couplers 215 that interconnect the head end 24 of rails 212, 214 to respective ends of rail 216. Rails 212, 214, 216, 218 are sometimes referred to herein as frame members 212, 214, 216, 218. A bar 220 projects from a central region of frame member 216 toward the head end 24 of apparatus 200. A coupling tube 222 is appended to the head end 24 of bar 220 and extends laterally with respect to apparatus 200 between lower legs 107 of coupling assembly 104. A pin (not shown) extends through tube 222 such that opposite ends of the pin are received in apertures 124 of legs 107 to couple the head end 24 of first section 210 to coupling assembly 104 in the same manner as described above in connection with apparatus 100.

(39) In the illustrative embodiment, a pair of torso supports 126 is coupled to rail 212 with rail clamps 134. Of course, torso supports 126 are detachable from rail 212 and are coupleable to rail 214 as desired. A head support 128 is coupled to a pair of curved cross members 230 that extends from respective rails 212, 214 toward the central region of the first section 210 as shown in FIG. 4. Apparatus 200 includes first and second armboards 235 that are coupled to rails 212, 214, respectively. Each arm board 235 includes a forearm supporting portion 280 and a hand supporting portion 282 that is telescopically coupled to portion 280 by a bar 284. Thus, bar 284 extends and retracts relative to portion 280 to adjust the spacing between portions 280, 282, thereby to accommodate patient arms of different sizes, as indicated by double headed arrow 285 in FIG. 4. Each armboard 235 is coupled to a respective rail 212, 214 by an armboard clamp 286 and one or more rods or struts (not shown) extend between each clamp 286 and the respective armboard 235 as is well-known in the art.

(40) A pair of lateral supports 232 are coupled to rail 214 via respective rail clamps 134 and are aligned laterally with the torso supports 126 on rail 212. Lateral supports 232 each include a first support portion 290 and a second support portion 292 that is telescopically coupled to portion 290 by a bar 294. Thus, bar 294 extends and retracts relative to portion 290 to adjust the spacing between portions 290, 292, thereby to accommodate patient torsos of different sizes, as indicated by double headed arrow 295 in FIG. 4. Lateral supports 232 extend upwardly beyond the upper surfaces of torso supports 126 when patient support frame 202 is oriented in a manner to support a patient in a prone position a shown in FIG. 3. Portions 290 of lateral supports 232 each have torso supporting surfaces 297 that underlie the patient's torso when the patient is supported in the prone position by frame 202. Thus, lateral supports 232 are configured to serve a torso supporting function as well. Hence, separate torso supports 126 are not needed on rail 214 in the illustrative example since lateral supports 232 serve this purpose. Lateral supports 232 are configured to cradle a side of the patient's torso when frame 202 is rotated relative to base 20 to support the patient in a lateral position.

(41) First section 210 of frame 202 includes a second frame member or rail 236 that is mounted to frame member 218 for pivoting movement about an axis 238 which is located adjacent the foot end 28 of rail 214. Frame members 218, 236 cooperate to serve as a hip support 218, 236 of frame 202. Torso supports 126, head support 128, lateral supports 232, and hip support 218, 236 are padded supports in some embodiments. Thus, the discussion above regarding the types of suitable padding and optional covers in connection with apparatus 100 is equally applicable to supports 126, 128, 232, 218, 236 of apparatus 200.

(42) Patient support frame 202 includes a first beam 240 that extends from rail 236 of first section 210 and that is coupled to and supported with respect to second coupling assembly 106 as shown in FIG. 4. Beam 240 is coupled to foot end 28 of first section 210 about midway between opposite sides of first section 210. In the illustrative embodiment, beam 240 is coupled to rail 236 with a rigid connection so that beam 240 and rail 236 pivot together about axis 238. Beam 240 is a three-segment beam in the illustrative embodiment. Thus, beam 240 includes first, second, and third segments 241, 243, 245. When frame 202 is oriented to support a patient in a prone position, first segment 241 angles downwardly with respect to the foot end 28 of first section 210, second segment 243 extends horizontally from a lower end of first segment 241, and third segment 245 angles upwardly from the second segment 243 to the second coupling assembly 106.

(43) Frame 202 includes a second beam 247 having its foot end 28 coupled to coupling assembly 106 and terminating at its head end 24 in spaced apart relation with first section 210. In the illustrative example, beam 247 is situated substantially vertically above beam 240 and head end of 24 of beam 247 is located above second segment 243 of beam 240. The upper end of third segment 245 of beam 240 is rigidly attached to an undersurface of beam 247, such as by welding, for example. Thus, beam 247 extends from coupling assembly 106 in a cantilevered manner.

(44) Patient support apparatus 200 includes a first leg support strut 250 coupled to the foot end 28 of rail 236 of first section 210 adjacent a first side of beam 240 and a second leg support strut 251 coupled to foot end 28 of rail 236 of first section 210 adjacent a second side of beam 210 opposite to the first side. A first set of leg support pads 242 are coupled to first leg support strut 250 and a second set of leg support pads 244 are coupled to the second leg support strut 251. The first and second sets of leg support pads 242, 244 each include a thigh pad 246, an ankle pad 248, and a knee pad 249. Pads 246, 248 underlie the patient's thighs and ankles, respectively, and knee pads 249 are situated along the insides of the patient's knees to prevent them from buckling inwardly toward each other when frame 202 is oriented to support the patient in the prone position.

(45) Struts 250, 251 and first and second sets of leg supports 242, 244 are movable relative to beam 240 and relative to first section 210 of the patient support frame 202 to support first and second legs of the patient in a plurality of positions. The first set of leg supports 242 are movable independently of the second set of leg supports 244 so that the patient's right and left legs can be placed in different positions. In the illustrative example, struts 250, 251 are cylindrical bars or tubes and thigh support pads 246 couple to struts 250, 251 with respective lockable collars 254. Thus, thigh support pads 246 are movable along the length of struts 250, 251 between the head end 24 of struts 250, 251 and the respective knee pads 249 as indicated by double headed arrow 258 in FIG. 4 when the respective locking collar 254 is unlocked. Each thigh support pad 246 is also rotatable about the respective strut 250, 251 when the associated locking collar 254 is unlocked.

(46) In the illustrative embodiment, each thigh support pad 246 is shaped as a curved thigh cradle and each ankle support 248 is generally cylindrical. In the illustrative example, each strut 250, 251 has a head end portion 253 coupled to the foot end 28 of first section 110 for pivoting movement about a first axis 252 that is oriented in substantially perpendicular relation with the longitudinal dimension of apparatus 200. Also in the illustrative example, each strut 250, 251 includes a foot end portion 255 that extends and retracts relative to the head end portion 253. The thigh support pads 246 and knee pads 249 are coupled to the head end portions 253 of respective struts 250, 251. Portions 253 are attached to tubular couplers 262 that are mounted to rail 236 for pivoting movement about axis 252.

(47) Each ankle support 248 extends laterally from beam 247 and is supported relative to beam 247 in a cantilevered manner. Opposite sidewalls 264 of beam 247 are formed to include slots 266. Ankle supports 248 have rods (not shown) that extend through slots 266 so that ends of the rods are situated in an interior region of beam 247. A knob 268 is provided at the end of each of the rods of ankle supports 248 and is rotated to tighten and loosen the rod (depending upon the direction of rotation of knob 268) relative to beam 247. Thus, ankle pads 248 are locked and released for repositioning along beam 247 in the same manner as described in connection with ankle supports 148 relative to beam 140. Each ankle pad 248 includes a strap 270 to retain a patient's leg on the respective ankle pad 248 as shown in FIG. 3. Similar straps 271 are provided on thigh pads 246 as also shown in FIG. 3. Additional straps are also used around the patient's torso and arms in some embodiments.

(48) Portions 255 of struts 250, 251 are coupled to respective ankle pads 248. Thus, as ankle pads 248 are repositioned relative to beam 247, the associated portions 255 either telescope or articulate or both relative to the respective portions 253 of struts 250, 251. Thus, a joint 257 that is flexible and that telescopes relative to portion 253 is provided at the interface between portions 253, 255 of respective struts 250, 251.

(49) Second coupling assembly 106 of apparatus 200 includes an arced member 272 that supports foot end 28 of beam 247. The foot end 28 of beam 247 travels along the arced member 272 as beams 240, 247 pivot about axis 238. Rail 236 is configured so that when oriented in parallel relation with rail 218, a gap exists therebetween so that rail 236 is able to pivot from the parallel orientation toward rail 218 to close the gap. Of course, rail 236 is able to pivot in the opposite direction relative to rail 218 to widen the gap. In the illustrative embodiment, arced member 272 includes an arced track 274 and foot end 28 of beam 247 is received within the arced track 274. It will be appreciated that the curvature of the arced track 274 is centered on pivot axis 238. A releasable clamp or other suitable lock 276 is provided to lock the beam 247 in place relative to arced member 272 once beam 247 is moved to a desired position. Because beam 240 is rigidly attached to beam 247, movement of beam 247 along track 274 about axis 238 also moves beam 240 and rail 236 about axis 238. Furthermore, the struts 250, 251 and accompanying sets of leg supports 242, 244 also move about axis 238 because these are attached to rail 236.

(50) In the illustrative example, arced member 272 has a coupling tube 277 that is situated between legs 107 of second coupling assembly 106 and a pin (not shown) extends through coupling tube 277 and through apertures 124 of the associated legs 107 to couple arced member 272 to legs 107. Also, in the illustrative FIG. 4 example, a handle 279 is provided at each end of arced member 272. Handles 279 are grippable by a user to assist in rotating frame 202 relative to base unit 20 thereby to move the patient from the prone position to the lateral position. Similar handles 281 are coupled to first section 210 of frame 202 to assist with rotation of frame 202 relative to base unit 20.

(51) Referring now to FIGS. 5-7, a third embodiment of a patient support apparatus 300 for supporting a patient during spine surgery includes base unit 20 and a patient support frame 302 that has its head and foot ends 24, 28 coupled to the first and second lift columns 22, 26 by coupling assemblies 104, 106 that include H-brackets having respective bars 108, lower legs 107, and upper legs 109. Thus, coupling assemblies 104, 106 of frame 302 are substantially the same as coupling assemblies 104, 106 of the previously described embodiments. Similarly, in the description of apparatus 300 that follows, other components of apparatus 300 that are substantially the same as components of apparatus 100 or apparatus 200 are denoted with like reference numerals and the description of these various components above in connection with apparatuses 100, 200 is equally applicable to apparatus 300.

(52) Patient support frame 302 includes a first section 310 which is generally rectangular in shape as shown best in FIG. 6. First section 310 of apparatus 300 is substantially similar to first section 210 of apparatus 200. Thus, the 200-series reference numbers are used for first section 310 and the description of the various 200-series components is not repeated. Furthermore, torso supports 126 and associated clamps 134 are mounted on rail 212 of first section 310 of apparatus and so the 100-series reference numbers are used for these and the description is not repeated.

(53) Head support 328 has an overall U-shape (i.e., when viewed from above, for example) and its cross section is also U-shaped. A pair of support flanges 329 couple head support 328 to frame member 216 for lateral movement along frame members 216. Thus, head support 328 is movable and lockable by suitable locks (not shown) in a plurality of positions between rails 212, 214. Apparatus 300 includes first and second armboards 335 that are coupled to rails 212, 214, respectively. Each armboard 335 is shaped as a curved arm cradle. Straps 337 are provided to secure the patient's arms to the respective armboards 335.

(54) A pair of lateral supports 332 are coupled to rail 214 via respective rail clamps 134 and are aligned laterally with the torso supports 126 on rail 212. Lateral supports 332 each include a first support portion 390 and a second support portion 392 that is coupled to portion 390 by an L-shaped bar 394. Thus, the L-shape of bar 394 permits portions 392 to extend and retract relative to portion 390 in two dimensions, one of which corresponds to double headed arrow 295 (see FIG. 4) and the other of which corresponds to double headed arrow 395 in FIG. 6, to adjust the spacing between portions 390, 392, thereby to accommodate patient torsos of different sizes. In some embodiments, suitable locks are provided to lock and release movement of portions 392 and bars 394 relative to respective portions 390 and to lock and release movement of portions 392 relative to respective bars 394.

(55) Lateral supports 332 extend upwardly beyond the upper surfaces of torso supports 126 when patient support frame 302 is oriented in a manner to support a patient in a prone position as shown in FIG. 5. Portions 390 of lateral supports 232 each have torso supporting surfaces that underlie the patient's torso when the patient is supported in the prone position by frame 302. Thus, lateral supports 332 are configured to serve a torso supporting function as well. Hence, separate torso supports 126 are not needed on rail 214 in the illustrative example since lateral supports 332 serve this purpose. Lateral supports 332 are configured to cradle a side of the patient's torso when frame 302 is rotated relative to base 20 to support the patient in a lateral position.

(56) Patient support frame 302 includes a beam 340 that extends from rail 236 of first section 310 and that is coupled to and supported with respect to second coupling assembly 106 as shown in FIG. 6. Beam 340 is coupled to foot end 28 of first section 310 about midway between opposite sides of first section 310. In the illustrative embodiment, beam 340 is coupled to rail 236 with a rigid connection so that beam 340 and rail 236 pivot together about axis 238.

(57) A first set of leg supports 342 is located on a first side of beam 340 and a second set of leg supports 344 is located on a second side of beam 340 opposite of the first side. The first and second leg supports 342, 344 each include a thigh support 346 having its head end 24 coupled to rail 236 for pivoting movement about an axis 352 as indicated by double headed curved arrow 358. Axis 352 is perpendicular to the longitudinal dimension of apparatus 300 when rail 236 is oriented parallel with rail 218. First and second leg supports 343, 344 also include ankle supports 148, knobs 168, and straps 170 that are substantially the same as these same components of apparatus 100. Thus, the descriptions of these components is not repeated. FIG. 6 does, however, have a pair of double headed arrows 369 to indicate the adjustability of ankle supports 148 along beam 340.

(58) First and second sets of leg supports 342, 344 are movable relative to beam 340 and relative to first section 310 of the patient support frame 302 to support first and second legs of the patient in a plurality of positions. The first set of leg supports 342 are movable independently of the second set of leg supports 344 so that the patient's right and left legs can be placed in different positions. In the illustrative embodiment, each thigh support 346 is shaped as a flat panel. A strap 347 is provided with each thigh support 346 to secure a patient's thigh to the respective thigh support 346.

(59) Second coupling assembly 106 of apparatus 300 includes an arced member 372 that supports foot end 28 of beam 340. The foot end 28 of beam 340 travels along the arced member 372 as beam 340 and rail 236 pivot about axis 238. In the illustrative embodiment, arced member 372 includes an arced track 374 and an arced rack 376 having a first set of gear teeth 378. A pinion 380 is mounted to the foot end region of beam 340 and a portion of pinion 380 is received within the arced track 274. Pinion 380 has a second set of teeth 382 that interface with the first set of teeth 380 of curved rack 376. The pinion 380 is rotatable to move the foot end 28 of beam 340 along the arced member 372 as indicated by doubled headed curved arrow 384 in FIGS. 6 and 7. A handle 386 is coupled to the pinion 380 and is manually movable to rotate pinion 380, as indicated by double headed curved arrow 388 in FIGS. 6 and 7, thereby to move the foot end 28 of beam 340 along the arced member 372. It will be appreciated that the curvature of the arced track 374 and arced rack 376 is centered on pivot axis 238 in apparatus 300. Alternative embodiments, such as in apparatus 100, included curved rack 376 and an associated pinion 380 and handle 386 with the center of curvature of the curved rack 376 in such an embodiment being centered on axis 138.

(60) Referring now to FIGS. 8-10, a fourth embodiment of a patient support apparatus 400 for supporting a patient during spine surgery includes base unit 20 and a patient support frame 402 that has its head and foot ends 24, 28 coupled to the first and second lift columns 22, 26 by coupling assemblies 104, 106 that include H-brackets having respective bars 108, lower legs 107, and upper legs 109. Thus, coupling assemblies 104, 106 of frame 402 are substantially the same as coupling assemblies 104, 106 of the previously described embodiments. Similarly, in the description of apparatus 400 that follows, other components of apparatus 400 that are substantially the same as components of any of apparatuses 100, 200, 300 are denoted with like reference numerals and the description of these various components above in connection with apparatuses 100, 200, 300 is equally applicable to apparatus 400.

(61) Apparatus 400 has a grip handle 405 coupled to each pair of legs 109 of coupling assemblies 104, 106. Grip handles 405 are gripped by a user to assist in rotating patient support frame 402 relative to base unit 20. Patient support frame 402 includes a first section 410 which is generally rectangular in shape as shown best in FIG. 9. First section 410 of apparatus 400 is substantially similar to first section 110 of apparatus 100. Thus, the 100-series reference numbers are used for first section 410 and the description of the various 100-series components is not repeated. Furthermore, torso supports 126 and associated clamps 134 are mounted on rail 112 of first section 410 of apparatus 400 and so the 100-series reference numbers are used for these and the description is not repeated.

(62) Head support 128 is coupled to frame member 116 by a rod 127 and a V-shaped tubular member 129 as shown in FIG. 9. Rod 127 angles downwardly from foot end 28 of head support 128 and toward head end 24 of apparatus 400. A first segment of V-shaped tubular 129 member receives an end of rod 127 and a second segment of V-shaped tubular member 129 is appended to the undersurface of frame member 116. Apparatus 400 includes first and second armboards 435 that are coupled to rails 112, 114, respectively, by respective armboard clamps 286. A rod or strut 287 extends from each clamp 286 to the respective armboard 435. Each armboard 435 is shaped as a curved arm cradle. Straps 437 are provided to secure the patient's arms to the respective armboards 435.

(63) A pair of lateral supports 432 are coupled to rail 114 via respective rail clamps 134 and are aligned laterally with the torso supports 126 on rail 112. Lateral supports 432 each include a first support portion 490 and a second support portion 492 that is coupled to portion 490 by an upside down L-shaped bar 494 that extends around the top and back of portion 492 and has a lower end that is received in an upper end of a tubular member 495 (see FIG. 10) situated at the back of portion 490. Thus, the receipt of bar 494 in member 495 permits adjustment of the spacing between portions 490, 492 as indicated by double headed arrow 295, thereby to accommodate patient torsos of different sizes. In some embodiments, suitable locks are provided to lock and release movement bar 494 and the corresponding portion 492 relative to tubular member 495 and the corresponding portions 490.

(64) Lateral supports 432 extend upwardly beyond the upper surfaces of torso supports 126 when patient support frame 402 is oriented in a manner to support a patient in a prone position as shown in FIG. 8. Portions 490 of lateral supports 432 each have torso supporting surfaces that underlie the patient's torso when the patient is supported in the prone position by frame 402. Thus, lateral supports 432 are configured to serve a torso supporting function as well. Hence, separate torso supports 126 are not needed on rail 114 in the illustrative example since lateral supports 432 serve this purpose. Lateral supports 432 are configured to cradle a side of the patient's torso when frame 402 is rotated relative to base unit 20 to support the patient in the lateral position.

(65) First section 410 of frame 402 includes a frame member or rail 418 extending laterally between the foot ends 28 of rails 112, 114 as shown in FIG. 9. Frame 402 includes a hip support 436 situated atop frame member 418. In some embodiments, hip support 436 is padded as discussed above in connection with hip support 118. Hip support 436 has arced slots 437 at its opposite ends and frame member 418 has arced slots 419 at its opposite ends as shown in FIGS. 11A and 11B. Pins 439 extend through slots 419, 437 and interaction between pins 439 and slots 419, 437 guide the manner in which hip support 436 is pivotable relative to the underlying frame member 418.

(66) The radii of curvature of each slot 419, 437 is smaller than the distance defined between the two pins 439. Thus, pins 439 are movable within the slots 419, 437. This is apparent by comparing FIG. 11A, in which the pin 439 at the top set of slots 419, 437 is generally centered between the ends of the respective slots 419, 437, with FIG. 11B, in which the pin 439 at the top set of slots 419, 437 is adjacent one of the ends of the respective slots 419, 437 and, in particular in FIG. 11B, pin 439 at the top of the drawing is adjacent the left end of slot 419 and is adjacent the right end of slot 437. The opposite positioning of pin 439 at the bottom set of slots 419, 437 can also be seen in FIGS. 11A and 11B. That is, by comparing FIG. 11B, in which the pin 439 at the bottom set of slots 419, 437 is generally centered between the ends of the respective slots 419, 437, with FIG. 11A, in which the pin 439 at the bottom set of slots 419, 437 is adjacent one of the ends of the respective slots 419, 437 and, in particular in FIG. 11A, pin 439 at the bottom of the drawing is adjacent the left end of slot 419 and is adjacent the right end of slot 437. This type of pivotable coupling between hip support 436 and frame member 418 is referred to as a squirkle pivot according to this disclosure. Pins 439 have bent upper regions to provide handles 441 (see FIG. 9) that are used to manipulate the position of pins 439 within slots 419, 437 by a user.

(67) Patient support frame 402 includes a beam 440 that extends from rail 418 of first section 410 and that is coupled to and supported with respect to second coupling assembly 106 as shown in FIG. 9. Beam 440 is coupled to foot end 28 of first section 410 about midway between opposite sides of first section 410. In the illustrative embodiment, beam 340 is coupled to rail 418 with a rigid connection so that beam 440 does not pivot with respect to first section 410. Beam 440 is a multi-segment beam that includes 1.sup.st through 7.sup.th segments 481, 482, 483, 484, 485, 486, 487 as shown best in FIG. 10.

(68) When frame 402 is oriented to support the patient in the prone position, segment 481 extends horizontally from first section 410, second segment 482 angles downwardly from the foot end 28 of first segment 481 toward foot end 28 of apparatus 400, third segment 483 extends horizontally from the lower end of segment 482 toward foot end 28 of apparatus 400, fourth segment 484 angles upwardly from the foot end 28 of segment 483, fifth segment 485 extends horizontally from foot end 28 of segment 484 toward foot end 28 of apparatus 400, sixth segment 486 is shaped as a small step to interconnect segments 485, 487 and segment 487 extends horizontally from foot end 28 of segment 486 toward the foot end 28 of apparatus 40.

(69) A coupling tube 477 is appended to the foot end 28 of segment 487 of beam 440 as shown in FIGS. 9 and 10. Tube 477 extends laterally with respect to apparatus 400 between lower legs 107 of coupling assembly 106 and a pin (not shown) extends through tube 477 and respective apertures 124 of legs 107 that are aligned with tube 477 to couple beam 440 to coupling assembly 106.

(70) A first set of leg supports 442 is located on a first side of beam 440 and a second set of leg supports 444 is located on a second side of beam 440 opposite of the first side. The first and second leg supports 442, 444 each include a thigh support 446 and an ankle support 448. An arced rail 472 is supported on segment 472 of beam 440. The central region of arced rail 472 is affixed to beam 440 so that portions of rail 472 are positioned on opposite sides of beam 440. Apparatus 400 has first and second rods 474, 476 that are coupled to arced rail 472 by rail clamps 473. Ankle supports 448 are coupled to the respective first and second rods 474, 476. Clamps 473 are lockable and releasable, such as by turning a knobs 475 that are located at distal ends of rods 474, 476. When clamps 473 are released, the clamps 473 and respective rods 474, 476 and ankle supports 448 are movable along arced rail 472. In some embodiments, rods 474, 476 have one or more degrees of freedom of movement with respect to clamps 473, such as being able to be pivotably raised and lowered with respect to the associated clamp 473 when released.

(71) In some embodiments, each of the ankle supports 448 include a first portion 447 that is configured to engage a patient's shin and a second portion 449 that is configured to engage a top of the patient's foot. The first and second portions 447, 449 of each of the ankle supports 448 each have a concave patient-engaging surface in the illustrative embodiment. Each ankle support 448 is repositionable along the respective first and second rod 474, 476 as indicated by double headed arrow 451 in FIG. 9. Ankle supports 448 each have a collar 452 that mounts the ankle support on the respective rod 474, 476. In some embodiments, a suitable lock, such as a threaded bolt and knob, is provided to lock and release collar 452 with respect to the corresponding rod 474, 476 thereby to lock and release the associated ankle support 448 with respect to the corresponding rod 474, 476.

(72) In the illustrative embodiment, thigh supports 446 are configured as U-shaped leg cradles having respective U-shaped thigh support surfaces. Also in the illustrative example, thigh supports 446 each may have a notch 445 configured to receive a patient's knee cap. Patient support frame 402 has a first cylindrical bar 462 mounted to foot end 28 of first section 410 adjacent a first side of the beam 440 and a second cylindrical bar 463 mounted to foot end 28 of first section 410 adjacent a second side of beam 440. Clamps 464 are coupled to bars 462, 463 and rods 466 extend from each clamp 464. Thigh supports 446 are mounted on respective rods 466. Clamps 464 lock and release rods 466 and thigh supports 446 with respect to the corresponding bars 462, 463. Clamps 464 each have a release trigger 467 that is squeezed or otherwise moved to release the respective clamp 464 from clamping onto the corresponding bar 462, 463 so that the associated rod 466 and thigh support 446 are rotatable about the corresponding bar 462, 463.

(73) In the illustrative embodiment, thigh supports 446 are mounted to respective rods 466 with collars 468. Release handles 469 are coupled to each collar 468 as shown in FIG. 9 with respect to one of the collars 468. Handles 469 are movable to lock and release the respective collar 468, and therefore, the associated thigh support 446 with respect to the corresponding rod 466. When handles 469 release collars 468, the thigh support 446 is movable along rod 466 as indicated by double headed arrow 470 shown in FIG. 9.

(74) Referring now to FIGS. 12 and 13, a fifth embodiment of a patient support apparatus 500 for supporting a patient during spine surgery includes base unit 20 and a patient support frame 502 that has its head and foot ends 24, 28 coupled to the first and second lift columns 22, 26 by coupling assemblies 104, 106 that each include H-brackets having respective bars 108, lower legs 107, and upper legs 109. Thus, coupling assemblies 104, 106 of frame 502 are substantially the same as coupling assemblies 104, 106 of the previously described embodiments. Similarly, in the description of apparatus 500 that follows, other components of apparatus 500 that are substantially the same as components of any of apparatuses 100, 200, 300, 400 are denoted with like reference numerals and the description of these various components above in connection with apparatuses 100, 200, 300, 400 is equally applicable to apparatus 500. For example, patient support frame 502 includes a first section 510, torso supports 126, head support 128, armboards 435, and hip support 436 that are substantially the same as those of first section 410 of frame 402. Thus, the same reference numbers used for these components and related components of frame 402 are used for frame 502 and the description above these components is equally applicable.

(75) Apparatus 500 includes a pad support beam 512 extending between the first and second coupling assemblies 104, 106 in spaced apart relation with the patient support frame 502 as shown in FIGS. 12 and 13. Pad support beam 512 includes an elongated main beam portion 514 that is situated vertically above rail 114 of first section 510 of patient support frame 502 when frame 502 is oriented to support a patient in a prone position. Pad support beam has a first offset beam portion 513 appended to head end 24 of the elongated main beam portion 514 and a second offset beam portion 515 appended to foot end 28 of the elongated main beam portion 514. First offset beam portion 513 is mounted to first coupling assembly 104 by a coupling tube 517 that is situated between legs 109 of assembly 104. Similarly, second offset beam portion 515 is mounted to second coupling assembly 106 by a coupling tube 519 that is situated between legs 109 of assembly 106. Pins extend through respective tubes 517, 519 and through apertures 124 of respective legs. Head end 24 of offset beam portion 513 is affixed to tube 517 and foot end 28 of offset beam portion 515 is affixed to tube 519.

(76) Apparatus 500 includes a set of lateral pads 532. Each lateral pad 532 includes a first portion 590 coupled to rail 114 of first section 510 of frame 502 by a respective rail clamp 134. Each lateral pad 532 also includes a second portion 592 coupled to portion 514 of pad support beam 512 by a respective beam clamp 534. First portion 590 of each lateral pad 532 extends upwardly toward pad support beam 512 and second portion 592 of each lateral pads 532 extends downwardly toward first portion 510 of patient support frame 502 when frame 502 is oriented to support a patient in the prone position as shown in FIGS. 12 and 13.

(77) First portion 590 of each lateral pad 532 includes a first cutout 516 and a first protrusion 518. Second portion 592 of each lateral pad 532 includes a second cutout 520 and a second protrusion 522. First protrusion 518 of each lateral pad 532 extends into a space defined by an associated second cutout 520 and second protrusion 522 of each lateral pad extends into a space defined by the first cutout 516. Portions 590, 592 of lateral pads 532 are configured so that, when patient support frame 502 is oriented to support a patient in a prone position, second portion 592 of each lateral pad 532 includes a downwardly facing edge that is spaced from a complimentarily shaped upwardly facing edge of the associated first portion 590. In the illustrative example, the upwardly facing edge of each portion 590 and the downwardly facing edge of each portion 592 are generally S-shaped.

(78) Patient support frame 502 includes a beam 540 that extends from foot end 28 of first section 510. Head end 24 of beam 540 is coupled to frame member 418 of first section 510 of frame 502 about midway between the opposite sides of first section 510 for pivoting movement about an axis (not shown) that is substantially vertical when frame 502 is oriented to support a patient in the prone position. Coupling assembly 106 includes an arced member 573 that guides and supports an arced member 573 that is coupled to a foot end 28 of beam 540. Arced member 572 is coupled to assembly 106 by a coupling tube 574 that is situated between legs 107 of assembly 106. A pin extends through tube 574 and apertures 124 of legs 107.

(79) Apparatus 500 includes a pair of thigh supports 546 with each thigh support 546 being coupled to a respective side of beam 540 by a respective pivot tube assembly 545. Apparatus 500 also includes a pair of shin supports 548 with each shin support 548 being coupled to a respective of beam 540 by a respective pivot tube assembly 547. In the illustrative embodiment, thigh supports 546 and shin supports 548 each comprises a generally square-shaped flat panel. Optionally, thigh supports 546 and shin supports 546 are padded. Pivot tube assemblies 545 are located at head end 24 of the respective thigh support 546 and pivot tube assemblies 547 are located at foot end 28 of the respective shin support 548.

(80) Each pivot tube assembly 545, 547 includes a handle 549 that is rotated to lock and release the respective tube assembly 545, 547. When pivot tube assemblies 545, 547 are released or unlocked, the respective thigh and shin supports 546, 548 are pivotable about respective axes that are substantially perpendicular to a longitudinal dimension of beam 540. In some embodiments, when pivot tube assemblies 547 are released, the positions of shin supports 548 along beam 540 are individually adjustable. Thus, in the illustrative example, one of shin supports 548 is closer to head end 24 of apparatus 500 than the other. When pivot tube assemblies 545, 547 are locked, the positions of thigh supports 546 and shin supports 548 are fixed relative to beam 540.

(81) In the illustrative embodiment, apparatus 500 includes a resilient knee sleeve 560 that is mounted on beam 540 for linear movement along beam 500. In use, sleeve 560 is positioned to protect a patient's knees from contacting beam 540. In some embodiments, sleeve 560 is a tubular element that totally surrounds beam 540. In other embodiments, a slit or channel is provided at the bottom of sleeve 560 so that sleeve 560 can be slipped onto and off of beam 540. As shown in FIG. 12, thigh straps 552 are provided to secure the patient's thighs to thigh supports 546 and calf straps 554 are provide to secure the patient's lower legs to shin support 548.

(82) Referring now to FIGS. 14-18, a sixth embodiment of a patient support apparatus 600 for supporting a patient during spine surgery includes base unit 20 and a patient support frame 602 that has its head and foot ends 24, 28 coupled to the first and second lift columns 22, 26 by coupling assemblies 104, 106. Assemblies 104, 106 are substantially the same as assemblies 104, 106 except that assemblies 104, 106 include curved connector bars 605 extending between the ends of respective pairs of legs 107, 109 that are distal from the associated bar 108. Bars 605 serve as handles that are gripped by a user when rotating frame 602 relative to base unit 20.

(83) Frame 602 includes a first section 610 which is generally rectangular in shape. First section 610 is sized to support a patient's torso and includes first and second side rails 612, 614, a head end rail 616, and a foot end rail 618. Rails 612, 614 extend longitudinally between the opposite ends of respective rails 616, 618 and thus, are parallel with the longitudinal dimension of patient support apparatus 600. Rails 612, 614, 616, 618 are sometimes referred to herein as frame members 612, 614, 616, 618.

(84) A coupling tube 622 and coupling pin 625 is used to couple head end 24 of frame 602 to legs 107 of coupling assembly 104 a coupling tube 623 and coupling pin 627 is used to couple foot end 28 of frame 602 to legs 107 of coupling assembly 106. Pins 625, 627 extend through respective tubes 622, 624 such that opposite ends of pins 625, 627 are received in apertures 124 of legs 107. Tube 622 and associated pin 625 are shown best in FIG. 14. Tube 623 and associated pin 627 are shown best in FIG. 17.

(85) A set of torso supports 626 are coupled to rails 612, 614 and a head support 628 is coupled to a cross member 630 that extends between rails 612, 614 as shown in FIG. 2. Cross member 630 is adjustable along rails 612, 614 in the longitudinal dimension of apparatus 600 when a knob 631 is loosened. In the illustrative example, two of torso supports 626 are coupled to rail 612 and two are coupled to rail 614. Two of the torso support 626 are situated above frame member 618 and serve as hip supports. A pair of lateral supports 632 are coupled to rail 614 adjacent to and laterally outboard of respective torso supports 626. Lateral supports 632 extend upwardly beyond the upper surfaces of torso supports 626 when patient support frame 602 is oriented in a manner to support a patient in a prone position as shown in FIGS. 14-16.

(86) In the illustrative example, the torso supports 626 above frame member 618 and the lateral support 632 adjacent frame member 618 are fixed at those locations relative to first section 610 of frame 602. The other pair of torso supports 626 and lateral support 632 are coupled to a sleeve 633 that is adjustable along the respective rail 612, 614 in the longitudinal dimension of apparatus 600 when an associated knob 635 is loosened. Also, when knob 635 is loosened by a greater extent, the associated lateral support 632 is able to be detached from the respective sleeve 633 and moved to the sleeve 633 on the opposite side of apparatus 600.

(87) Each lateral support 632 includes a bar 690, a panel 692, and a pad 694. Panels 692 are generally rigid and are generally L-shaped so as to curve around the patient's body. Pads 694 fit into the L-shape of the panel and have generally concave inner surfaces 691 for engaging the patient's torso. The lateral support 632 closer to head end 24 of apparatus 600 is a bit wider in the longitudinal dimension of apparatus 600 and has an arm-receiving recess 693 to engage the patient's arm in circumstances in which the patient's arm is placed adjacent their side.

(88) Bar 690 of the wider lateral support 632 is retained in sleeve 633 by a threaded shaft of knob 695 that extends through an aperture or slot provided at the lower end of the bar 690. The threaded shaft of knob 635 extends through bar 690 and sleeve 633 so that its tip engages the respective rail 612, 614 when the knob is tightened, thereby to lock sleeve 633 and the associated torso support 626 and lateral support 632 in place relative to section 610 of frame 602. In the case of the other sleeve 633, the threaded shaft of the associated knob 635 extends only through sleeve 633 to engage the associated rail 612, 614 because there is no lateral support 632 present.

(89) Coupling blocks 695 are provided at the ends of frame member 618 on the opposite sides of frame 602 and each block has a slot 697 (see FIG. 14) that is configured for receipt of bar 690 of an associated lateral support 632 (see FIG. 15). In some embodiments, a press fit between each block 695 and the associated bar 690 retains lateral supports 632 in place relative to first section 610 of frame 602. In other embodiments, a knob similar to knobs 631, 635 is provided adjacent to each block 695 to loosen and tighten relative to bar 690 to lock and release the associated lateral support relative to block 695. Each lateral support 632 includes a knob 637 that is loosened to permit adjustment of the position of the associated panel 692 and pad 694 relative to bar 690 and that is tightened to lock the associated panel 692 and pad 694 in place relative to bar 690. In this way, lateral supports 632 are adjustable to accommodate patient's having torsos of different sizes.

(90) Apparatus 600 has a pair of armboards 675 for supporting the patient's left and right arms. Armboards 675 each include a lower forearm portion 676, an upper forearm portion 677, a hand supporting portion 678, and a pair of straps 679 to secure the patient's arm between respective lower and upper forearm portions 676, 677. Arm boards 675 are coupled to respective rails 612, 614 with respective rail clamps 680 and struts 682 that extend between clamps 680 and lower forearm portion 676. Each rail clamp 680 includes a knob 683 that is used to loosen and tighten the respective clamp 680 relative to rails 612, 614 as the case may be. When knob 683 is loosened, a position of armboard 675 along the respective rail 612, 614 is adjustable and when knob 683 is tightened, armboard 675 are secured in place on the respective rail 612, 614.

(91) Patient support frame 602 includes a first beam 640 that is rigidly coupled at its head end 24 to rail 618 of first section 610 and that is coupled to and supported with respect to second coupling assembly 106 as shown in FIGS. 14-18. Beam 640 is coupled to foot end 28 of first section 610 about midway between opposite sides of first section 610. Beam 640 has first, second and third segments 635, 637, 639 as shown in FIGS. 14-16. When frame 602 is oriented to support a patient in a prone position, segment 635 angles downwardly from rail 618, segment 637 extends substantially horizontally from the lower end of segment 635, and segment 639 extends upwardly from foot end 28 of segment 635. The upper end or foot end 28 of segment 635 is coupled to legs 107 of coupling assembly 106 by tube 623.

(92) An arced member 672 is coupled to the foot end region 28 of beam 640. Handles 673 are provided at the ends of arced member 672 for gripping by a user when rotating frame 602 relative to base unit 20. Frame 602 includes a second beam 650 that has its head end 24 pivotably coupled to the first section 610 and its foot end 28 supported by arced member 672. Beam 650 is being coupled to rail 618 of the first section 610 about midway between opposite sides of the first section 610. In the illustrative embodiment, beam 650 is situated substantially vertically above beam 640 when beam 650 is oriented parallel with the longitudinal dimension of apparatus 600 and frame 602 is oriented to support the patient in the prone position.

(93) Beam 650 is pivotable relative to rail 618 and foot end 28 of beam 650 moves along arced member 672 as beam 650 pivots. As shown in FIGS. 17 and 18, arced member 672 has a series of apertures 671. A T-shaped pull pin 669 is provided for locking and releasing foot end 28 of beam 650 relative to arced track 672. Pin 669 is inserted through a desired one of apertures 671 and through a hole provided at the foot end 28 of beam 650 to lock beam 650 in place relative to arced member 672. To pivot beam 650 along member 672, pin 669 is detached from member 672.

(94) Patient support apparatus 600 includes a first set of leg supports 642 located adjacent a first side of beam 640 and a second set of leg supports 644 located adjacent a second side of beam 640. First set and second set of leg supports 1642, 1644 are movable relative to beam 640 and relative to first section 610 of the patient support frame 602 to support first and second legs of the patient in a plurality of positions. The first set of leg supports 642 are movable independently of the second set of leg supports 644 so that the patient's right and left legs can be placed in different positions. Leg supports 642, 644 each include a thigh support 646 and an ankle support 648.

(95) In some embodiments, thigh supports 646 are pivotably coupled to second beam 650 and ankle supports 648 are slidably coupled to second beam 650. Each thigh support 646 includes an L-shaped pad 645 having a bottom portion 647 and an inner thigh engaging portion 649 that extends upwardly from the bottom portion 647 when patient support frame 602 is oriented to support the patient in a prone position. In the illustrative embodiment, each thigh support 646 includes an outer thigh engaging portion 651 coupled to a respective bottom portion 647. Outer thigh engaging portions 651 are each adjustable relative to the respective L-shaped pad 645 by loosening a knob 653 which allows repositioning of portion 651 along a corresponding bar 655 to accommodate patient legs of different sizes.

(96) In the illustrative embodiment, ankle supports 648 each include a generally cylindrically shaped pad with a concave outer surface. Straps 711 are provided on each ankle support 648 to secure a patient's leg to the respective ankle support. Frame 602 includes first and second tubes 712, 714 mounted on beam 650 and slidable relative to beam 650 when a respective knob 716 (see FIGS. 17 and 18) is loosened for repositioning therealong. Thigh supports 646 are pivotably coupled to opposite sides of tube 712. Ankle supports 648 extend laterally from tube 714 and are supported relative to tube 714 in a cantilevered manner. Ankle supports 648 are slidably repositionable with respect to tube 714 when a knob 718 is loosened.

(97) In use, each of apparatuses 100, 200, 300, 400, 500, 600 are configured for use during complex prone surgeries and lateral (MIS) approaches. Apparatuses 100, 200, 300, 400, 500, 600 each have the ability to hold the patient in the prone position and the respective leg supports are rotatable about the patient's sacrum to correct scoliotic curvature for corrective surgery. Each of apparatuses 100, 200, 300, 400, 500, 600 have respective frames 102, 202, 302, 402, 502, 602 with the ability to rotate by about 90 with respect to the associated base unit 20 (see FIG. 17 with regard to apparatus 600) and to drop the patient's leg to expose the L4-L5 disk space (see FIG. 18 with regard to apparatus 600).

(98) Although certain illustrative embodiments have been described in detail above, many embodiments, variations and modifications are possible that are still within the scope and spirit of this disclosure as described herein and as defined in the following claims.