A Complex Spinal Surgery Lifting System for Prone Positioning

Spinal surgery is one of the fastest-growing surgical procedures and improving prone position is always a big challenge, specifically for patients with advanced deformity. Current spinal surgery tables (e.g. Allen Table, Hillrom LTD, Newbury, Berks, UK) can meet the simple positioning requirement, but they lack the necessary flexibility and customisation to adequately address the needs of patients with more complex requirements, such as patients with advanced deformities. This study identified the clinical challenge of prone positioning through a literature review and focus group with six professionals (one clinical engineer, two spinal anaesthetists and three mechanical engineers) and proposes a solution to address the problem. A two-stage study was conducted. A detailed design specification of the smart lifting system was developed based on the literature review and focus group results, which includes four categories, ‘Hardware’, ‘Software’, ‘Safety’ and ‘User’s preference’ requirements in the first stage. The second stage is the design and evaluation of the smart lifting system. According to the design requirements, a smart lifting system is designed for spinal surgery with 170 kg loading capability and 250 mm lifting height. Multiple iterations of focus groups involving professionals were undertaken to assess the smart lifting system, and it successfully satisfies all identified design requirements. This study proposes a potential solution that can be used to address the difficulty of positioning patients with advanced deformities and reduce the need to use manual handling of patients during surgery.