Design and Development of a Traction Device for Semi-Automated Closed Cervical Spine Reduction Procedures

De Villiers, Tertius

Design and Development of a Traction Device for Semi-Automated Closed Cervical Spine Reduction Procedures

Master Thesis

2021

Abstract

Cervical facet dislocations are traumatic injuries which can cause severe compression to the spinal cord. This can lead to extreme adverse outcomes such as full body paralysis or loss of life. Treatment involves a closed reduction (CR) of the dislocated cervical facet joints and alignment of the spinal canal as the first step. This is the most rapid mechanism of decompressing the spinal cord and improving the neurological outcomes. This kind of injury is infrequent, with many clinicians seldom becoming well practiced in CRs, but when they do occur, these injuries require immediate urgent treatment. In addition to this, the existing equipment can be awkward to use and lacks an intuitive framework for operation. This led to the development of the collaTract, a device taking the form of a single item of equipment, able to guide a user through the performance of a CR procedure while avoiding cumbersome and heavy equipment. It is wedge shaped, with an articulating arm, connecting to a patient's skull via commonly used traction callipers. It was designed to apply force to, and alter the angle of the patient's neck allowing it to perform all operations required for a CR. The device was tested for functionality on a single cadaver, after which, a usability study was performed with ten clinicians of varying skill and experience comparing the traditional equipment of weights and a pulley to the collaTract. The device was able to perform all operations involved in a CR including, at any point, returning the neck to a neutral angle and removing the applied tension as would be the case when aborting a procedure. After the usability test, the participants rated the device excellent from a usability standpoint. Of the returned feedback all participants rated the collaTract easier to use than the current equipment and they viewed the collaTract as an improvement over the current equipment. It is important to state that the cadavers in this study had intact cervical spines with no dislocation; therefore, future studies must look into validating the collaTract device with real world spine dislocation models. In conclusion, the collaTract device can perform the functions necessary for a closed cervical reduction procedure. The device was rated by ten different clinicians of varying skill levels as excellent in terms of its usability and can be seen as a new state of the art device in treatment of cervical spine dislocations.

Keywords

Biomedical Engineering

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