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Title:
SPINE MOBILIZATION SYSTEM
Document Type and Number:
WIPO Patent Application WO/2017/066074
Kind Code:
A1
Abstract:
A spine mobilization apparatus having embodiments configured to support a spine segment to allow posteroanterior or rotational mobilization of one or more vertebra of the spine.

Inventors:
JOHNSON SCOTT A (US)
Application Number:
PCT/US2016/055744
Publication Date:
April 20, 2017
Filing Date:
October 06, 2016
Export Citation:
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Assignee:
INNOVATIVE HEALTH CREATIONS LLC (US)
International Classes:
A61F5/01; A61H1/02; A61H7/00; A61H37/00; A61H99/00
Foreign References:
DE202008002878U12008-08-21
Other References:
"Wrought Iron Hardware", 2 December 2014 (2014-12-02), Retrieved from the Internet [retrieved on 20161204]
"American Sign Language Manual Alphabet Desktop Wallpaper", 1 July 2006 (2006-07-01), Retrieved from the Internet [retrieved on 20161206]
Attorney, Agent or Firm:
MILES, Craig, R. (US)
Download PDF:
Claims:
VI. CLAIMS

1. A spinal support apparatus, comprising: a first lateral spinal support portion; a second lateral spinal support portion, said first and second spinal support portions joined by a medial recessed portion, said medial recessed portion configured to receive a plurality of spinous processes of a segment of the spine with said first lateral spinal support portion and said second lateral spinal support portion each configured to support one of two transverse processes projecting from each vertebrae on opposite sides of each corresponding spinous process of said segment of said spine. 2. The spinal support apparatus of claim 1 , wherein said medial recessed portion comprises a recess base joining a pair of ascending recess sidewalls which correspondingly join said first lateral spinal support portion and said second lateral spinal support portion.

3. The spinal support apparatus of claim 2, wherein said recess base has a recess base height lesser than a lateral spinal support height of said first lateral spinal support portion and said second lateral spinal support portion.

4. The spinal support apparatus of claim 2, further comprising an axial spinal support member projecting from said first lateral spinal support which crosses a longitudinal axis of said medial recessed portion.

5. The spinal support apparatus of claim 4, wherein said axial spinal support member elevation at said longitudinal axis of said medial recessed portion of about said recess base elevation.

6. The spinal support apparatus of claim 4, where said first and second lateral spinal supports terminate coextensively at lateral spinal support first ends and lateral spinal support second ends. 7. The spinal support apparatus of claim 4, where said first and second lateral spinal supports terminate coextensively at lateral spinal support first ends and have offset lateral spinal support second ends, said first lateral spinal support extending a distance beyond said second lateral spinal support at said lateral spinal support second ends.

8. The spinal support apparatus of claim 7, further comprising a lateral spinal support member projecting from said first lateral spinal support and extending adjacent said lateral support second end of said second lateral spinal support.

9. The spinal support apparatus of claim 8, further comprising a lateral spinal support member height adjacent said lateral spinal support second end of said second lateral spinal support of about said recess base height.

10. The spinal support apparatus of claim 4, wherein said first lateral spinal support portion has a configuration shaped like a hypothenar eminence and a thenar eminence between an ulnar border and a radial border of said hand.

1 1. The spinal support apparatus of claim 10, wherein said first lateral spinal support face corresponds to said palmer surface of said hypothenar eminence and said thenar eminence.

12. The spinal support apparatus of claim 1 1 , wherein said second lateral spinal support portion has a configuration shaped like four fingers of a hand curled to contact each corresponding fingertip with said palmer surface of said hand to dispose a dorsal surface of a middle phalanx of each of said four fingers over said palmer surface of said hand.

13. The spinal support apparatus of claim 12, wherein said second lateral spinal support face corresponds to said dorsal surface of said middle phalanx of each of said four fingers over said palmer surface of said hand.

14. The spinal support apparatus of claim 13, wherein said medial recessed portion has a configuration shaped like the dorsal surface of each distal phalanx of each of said four fingers of said hand curled to contact each corresponding fingertip with said palmer surface of said hand, said palmer surface extending upwardly from the intersection of distal phalanx of each of said four fingers contacting said palmer surface toward said hypothenar eminence and said thenar eminence of said hand.

15. The spinal support apparatus of claim 14, wherein said first lateral spinal support portion having said configuration shaped like said hypothenar eminence and said thenar eminence between an ulnar border and a radial border of said hand and said second lateral spinal support portion having said configuration shaped like said four fingers of a hand curled to contact each corresponding fingertip with said palmer surface of said hand to dispose said dorsal surface of said middle phalanx of each of said four fingers over said palmer surface of said hand each taper axially toward a base of said spinal support apparatus between said radial border and ulnar border. 16. The spinal support apparatus of claim 14, wherein said axial spinal support member has a configuration shaped like a thumb of said hand, said thumb projecting from said thenar eminence at an angle to cross said longitudinal axis defined by said intersection of said distal phalanx of each of said four fingers with said palmer surface of said hand.

17. The spinal support apparatus of claim 7, wherein said first lateral spinal support portion has a configuration shaped like a hypothenar eminence and a thenar eminence between an ulnar border and a radial border of said hand and said second lateral spinal support portion has a configuration shaped like three fingers of a hand curled to contact each corresponding fingertip with said palmer surface of said hand to dispose a dorsal surface of a middle phalanx of each of said three fingers over said palmer surface of said hand between about said ulnar border and said middle finger, said offset lateral spinal support second ends having a configuration in which said radial border of said thenar eminence extends b beyond said dorsal surface of said middle finger.

18. The spinal support apparatus of claim 17, wherein said lateral spinal support member has a configuration shaped like the index finger of a hand projecting outward from said palm adjacent and extending beyond said dorsal surface the proximal phalanx of said curled middle finger.

Description:
SPINE MOBILIZATION SYSTEM

This International Patent Cooperation Treaty Patent Application is a continuation of United States Non-Provisional Patent Application No. 14/880,370, filed October 12, 2015. hereby incorporated by reference herein. I. TECHNICAL FIELD

Generally, a spine mobilization device including first and second lateral spinal support portions joined by a medial recessed portion which defines a medial open space configured to receive a plurality of spinous processes of a segment of the spine with the first and second lateral spinal support portions each supporting one of two transverse processes projecting from each vertebrae on opposite sides of each corresponding spinous process of the segment of the spine and an axial spinal support member projecting from the first lateral spinal support to cross the longitudinal axis of the medial recessed portion.

II. BACKGROUND

The vertebrate spinal column includes a series of vertebrae extending from the skull to the small of the back enclosing the spinal cord and providing support for the thorax and abdomen. Each vertebra is an irregular bone with a complex structure composed of bone and some hyaline cartilage. The proportions of each vertebra can vary according to the location in the spinal column and between individual animals.

The basic structure of a vertebra comprises a vertebra body including a main anterior bony part that consists of the centrum, the ossified posterolateral joints linking the centrum and each half of the neural arch, and part of the neural arch. The upper and lower surfaces of the vertebra body give attachment to the intervertebral discs. The posterior part of a vertebra forms a vertebral arch, consisting of two pedicles, two laminae, and seven processes. The laminae give attachment to the ligamenta flava. There are vertebral notches formed from the shape of the pedicles, which form the intervertebral foramina when the vertebrae articulate. These foramina are the entry and exit conduits for the spinal nerves. The body of the vertebra and the vertebral arch form the vertebral foramen, the larger, central opening that accommodates the spinal canal, which encloses and protects the spinal cord. The spinous process is directed backward and downward from the junction of the laminae, and serves for the attachment of muscles and ligaments. The articular processes, two superior and two inferior, spring from the junctions of the pedicles and laminae. The superior project upward, and their articular surfaces are directed more or less backward; the inferior project downward, and their surfaces look more or less forward. The transverse processes, two in number, project one at either side from the point where the lamina joins the pedicle, between the superior and inferior articular processes.

They serve for the attachment of muscles and ligaments. Vertebrae articulate with each other to give strength and flexibility to the spinal column, and the shape at their back and front aspects determines the range of movement. Spinal manipulative therapy is a "hands-on" treatment of the spine in which the therapist moves the vertebrae within the physiological range of motion. The therapist may use slow, passive movements, starting with a small range and gradually increasing to a larger range of motion or the therapist may apply specifically directed manual impulse, or thrust, to a joint, at or near the end of the physiological range of motion. Typically, spinal manipulative therapy includes posteroanterior mobilization of the vertebra largely confined to the sagittal plane of the spine and rotational mobilization which involves complex three dimensional movements and loading resulting in axial rotation and movement in other planes. The spinal posture during spinal manipulative therapy can have a significant influence on the movement of the spine. Lee, Raymond Y. W., Kinematics of rotational mobilization of the lumbar spine, Clinical Biomechanics 16 (2001 ) 481-488. Accordingly, a wide variety of devices are available to assist in fixing the spinal posture during spinal manipulative therapy. As an illustrative example, mobilization wedges may utilized to orient the articular surfaces for passive or active joint mobilization. Typically, a mobilization wedge will have a thick end and a thin end joining two principal flat faces meeting in an acute angle. For spinal mobilization, the wedges often have a cut out disposed axially and medially in one of the two faces. The cut out provides a space in which the spinous process of a vertebral segment can be located while the edges of the cut out which join the flat face block the transverse processes.

The structure of conventional mobilization wedges may introduce shortfalls and risks in spinal manipulative therapy. A first aspect can be that the height of the thick end joining the two principal faces of the mobilization wedge may allow excessive posteroanterior mobilization of the vertebra in the sagittal plane between supported and unsupported spinal segments. A second aspect can be that that the flat face of the wedge extending outward on opposite sides of the cut out terminates axially at the thick end of the wedge. Thus, in an adjoining pair of vertebrae disposed proximate the thick end of the wedge, a first vertebrae supported by the wedge can have both transverse processes supported by the flat face on either side of the cut out while the second vertebrae unsupported by the wedge can have neither transverse process supported by the face on either side of the wedge. Accordingly, the rotational movement of the unsupported vertebrae can be in either direction about the axis of the spinal column when the therapy is directed only in one direction about the axis of the spinal column. A third aspect can be that the wedge may not include any supporting member which extends outward axially or laterally from the thick end of the wedge.

III. DISCLOSURE OF THE INVENTION

A broad object of particular embodiments of the invention can be to provide a spine mobilization apparatus including first and second lateral spinal support portions joined by a medial recessed portion which defines a medial open space configured to receive a plurality of spinous processes of a segment of the spine with the first and second lateral spinal support portions each supporting one of two transverse processes projecting from each vertebrae on opposite sides of each corresponding spinous process of the segment of the spine and including an axial spinal support member projecting from the first lateral spinal support to cross the longitudinal axis of said medial recessed portion providing the advantage of supporting the portion of the spinal column that extends beyond the end of the first and second lateral support segments to reduce or avoid excessive posteroanterior mobilization of a vertebra in the sagittal plane between supported and unsupported spinal segments. Another broad object of particular embodiments of the invention can be to provide a spine mobilization apparatus including first and second lateral spinal support portions joined by a medial recessed portion which defines a medial open space configured to receive a plurality of spinous processes of a segment of the spine with the first and second lateral spinal support portions each supporting one of two transverse processes projecting from each vertebrae on opposite sides of each corresponding spinous process of the segment of the spine and in which the lateral spinal support first ends terminate at about the same location along the longitudinal axis defined by the medial recessed portion and in which the lateral spinal support second ends termination in offset relationship along the longitudinal axis defined by the medial recessed portion providing the advantage of supporting one of the pair of transverse processes of vertebrae with the longer one of the first or second lateral support portions and providing lesser support of the other one of the pair of transverse processes of the vertebrae with the shorter one of the first or second lateral support portions to increase the likelihood, induce, direct or control rotation or three dimensional movement of a vertebrae or spinal segment in a clockwise or counter clockwise direction depending on whether the offset of the lateral spinal support second ends occurs in the first lateral support portion (the second lateral support portion second end extends beyond the first lateral support portion second end) or in the second lateral support portion (the first lateral support portion second end extends beyond the second lateral support portion second end). A broad object of particular embodiments of the invention can be to provide a spine mobilization apparatus including first and second lateral spinal support portions joined by a medial recessed portion which defines a medial open space configured to receive a plurality of spinous processes of a segment of the spine with the first and second lateral spinal support portions having offset lateral support second ends and including an lateral spinal support member which projects laterally outward from the extending lateral spinal support portion and disposed adjacent to the offset lateral spinal support second end and extending a distance beyond the lateral side of the offset spinal support second end providing the advantage of supporting the vertebrae that rotates in the direction of the offset lateral support second end to reduce or avoid excessive rotational or three dimensional mobilization of a vertebra or spinal segment in a clockwise or a counterclockwise direction.

Another broad object of particular embodiments of the invention can be to provide a spine mobilization apparatus in both left handed or right handed configurations which provide non-superimposable mirror images of each other to provide embodiments of the spine mobilization apparatus which induce similar forces but on opposite sides of a vertebrae or spinal segment.

Another broad object of particular embodiments of the invention can be to provide a spine mobilization apparatus in left handed and right handed embodiments having certain components shaped like the human hand to afford the advantage of ready determination of the position of a vertebrae or the spine segment in relation to the mobilization apparatus to result in an pre-determined amount or direction of mobilization of a vertebrae or a spine segment.

Naturally, further objects of the invention are disclosed throughout other areas of the specification, drawings, photographs, and claims.

IV. BRIEF DESCRIPTION OF THE DRAWINGS Figure 1 is a perspective view of an embodiment of the inventive spine mobilization apparatus.

Figure 2 is a top plan view of an embodiment of the inventive spine mobilization apparatus shown in Figure 1.

Figure 3 is a bottom plan view of an embodiment of the inventive spine mobilization apparatus shown in Figure 1.

Figure 4 is a first side view of an embodiment of the inventive spine mobilization apparatus shown in Figure 1. Figure 5 is a second side view of an embodiment of the inventive spine mobilization apparatus shown in Figure 1.

Figure 6 is a first end view of an embodiment of the inventive spine mobilization apparatus shown in Figure 1. Figure 7 is a second end view of an embodiment of the inventive spine mobilization apparatus shown in Figure 1.

Figure 8 is a perspective view of an embodiment of the inventive spine mobilization apparatus.

Figure 9 is a top plan view of the embodiment of the inventive spine mobilization device shown in Figure 8.

Figure 10 is a bottom plan view of the embodiment of the inventive spine mobilization device shown in Figure 8.

Figure 1 1 is a first side view of an embodiment of the inventive spine mobilization apparatus shown in Figure 8. Figure 12 is a second side view of an embodiment of the inventive spine mobilization apparatus shown in Figure 8.

Figure 13 is a first end view of an embodiment of the inventive spine mobilization apparatus shown in Figure 8.

Figure 14 is a second end view of an embodiment of the inventive spine mobilization apparatus shown in Figure 8.

Figure 15 is an illustration identifying certain creases, segments, and parts of the human hand.

Figure 16A is a perspective view of a left handed embodiment of the inventive spine mobilization apparatus having particular elements shaped like the human hand. Figure 16B is a perspective view of a right handed embodiment of the inventive spine mobilization apparatus having particular elements shaped like the human hand.

Figure 17 is a top plan view of a left handed embodiment of the inventive spine mobilization apparatus shown in Figure 16A.

Figure 18 is a bottom plan view of a left handed embodiment of the inventive spine mobilization apparatus shown in Figure 16A. Figure 19 is a first side view of a left handed embodiment of the inventive spine mobilization apparatus shown in Figure 16A.

Figure 20 is a second side view of a left handed embodiment of the inventive spine mobilization apparatus shown in Figure 16A.

Figure 21 is a first end view of a left handed embodiment of the inventive spine mobilization apparatus shown in Figure 16A.

Figure 22 is a second end view of a left handed embodiment of the inventive spine mobilization apparatus shown in Figure 16A.

Figure 23A is a perspective view of a left handed embodiment of the inventive spine mobilization apparatus having particular elements shaped like the human hand.

Figure 23B is a perspective view of a right handed embodiment of the inventive spine mobilization apparatus having particular elements shaped like the human hand.

Figure 24 is a top plan view of a left handed embodiment of the inventive spine mobilization apparatus shown in Figure 23A.

Figure 25 is a bottom plan view of a left handed embodiment of the inventive spine mobilization apparatus shown in Figure 23A.

Figure 26 is a first side view of a left handed embodiment of the inventive spine mobilization apparatus shown in Figure 23A.

Figure 27 is a second side view of a left handed embodiment of the inventive spine mobilization apparatus shown in Figure 23 A.

Figure 28 is a first end view of a left handed embodiment of the inventive spine mobilization apparatus shown in Figure 23A.

Figure 29 is a second end view of a left handed embodiment of the inventive spine mobilization apparatus shown in Figure 23A.

Figure 30 is an illustration of a method of using the left handed embodiment of the inventive spine mobilization apparatus shown in Figure 16A.

Figure 31 is an illustration of a method of using the left handed embodiment of the inventive spine mobilization apparatus shown in Figure 23A.

Figure 32 is an illustration of a method of using the right handed embodiment of the inventive spine mobilization apparatus shown in Figure 23 B. V. MODE(S) FOR CARRYING OUT THE INVENTION

Now referring primarily to Figures 1 through 14, particular embodiments of the inventive spinal support apparatus (1 ) include a first lateral spinal support portion (2) and a second lateral support portion (3) joined by a medial recessed portion (4). The first and second lateral support portions (2)(3) and the medial recessed portion (4) can, but need not necessarily, share a flat coextensive base (5) which allows the spinal support apparatus (1 ) to be positioned on a substantially flat support surface (6) such as a mobilization table (7)(as shown in the examples of Figures 30-33). Each of the first and second lateral support portions (2)(3) have opposite lateral spinal support first and second ends (7a)(7b)(8a)(8b) each extending upwardly from the base (5) to correspondingly join first and second lateral spinal support faces (9)(10). The lateral spinal support first ends (7a)(7b) and the lateral spinal support second ends (8a)(8b) can, but need not necessarily have, substantially the same lateral spinal support first and second end heights (1 la)(l lb) disposing each of the first and second lateral spinal support faces (9)( 10) in substantially axial horizontal relation to the base (5) As shown in the example of Figures 1 through 7, particular embodiments can have lateral spinal support first ends (7a)(7b) of lesser lateral spinal support first end heights (1 1 a) than the lateral spinal support second end heights (l ib) relative to the base (5). As to these embodiments, the first and second spinal support faces (9)(10) can taper axially toward the base (5) from the lateral spinal support second ends (8a)(8b) to the lateral spinal support first ends (7a)(7b)(as shown in the examples of Figures 4-5 and 1 1 -12).

The medial recessed portion (4) can be configured to include a recess base (12) joining a pair of ascending recess sidewalls (13)(14) which correspondingly join the first lateral spinal support face (9) and the second lateral spinal support face (10). The medial recessed portion (4) can be configured to dispose the recess base (12) at a recess base elevation ( 15) lesser than either of the a first lateral spinal support elevation (16) of the first lateral spinal support face (9) and a second lateral support elevation (17) of the second lateral spinal support face (10) to provide a medial portion open space (18) of sufficient volume to receive a plurality of spinous processes ( 19) of a spine segment (20) when the first lateral spinal support portion (2) and the second lateral spinal support portion (3) are each correspondingly supporting one of two transverse processes (21)(22) projecting from each vertebrae (23) on opposite sides of each corresponding one of the plurality of spinous processes (19) of the spine segment (20) (as shown in the example of Figure 30).

The first lateral spinal support portion (2) and a second lateral support portion (3) can correspondingly include a first lateral side (24) and a second lateral side (25) extending upwardly from the base (5) to correspondingly join the first and second lateral spinal support faces (9)(10). The first lateral side (24) and the second lateral side (25) can correspondingly have a similar first and second lateral side height (26)(27) which disposes each of the first and second lateral spinal support faces (9)(1 0) in substantially lateral horizontal relation to the base (5).

Again referring primarily to Figures 1 through 14, particular embodiments can, but need not necessarily, include an axial spinal support member (28) which projects outward from the first lateral spinal support second end (8a)(or from both the first and second lateral spinal support second ends (8a)(8b)) to cross the longitudinal axis (29) of the medial recessed portion (4). Without reducing the breadth of the forgoing, as to particular embodiments, the axial spinal support member (28) can share the flat coextensive base (5) and include an axial spinal support member first side (30) opposite an axial spinal support member second side (31 ) each extending upwardly from the base (5) to join an axial spinal support member face (32) having an axial spinal support member elevation (33) at the longitudinal axis (29) of about the same height as the recess base elevation (15). The axial spinal support member (28) can provide support to a portion of the spine segment (20) extending beyond the lateral spinal support second ends (8a)(8b).

Now referring primarily to Figures 1 through 7, as to particular embodiments, the first and second lateral spinal support portions (2)(3) can, but not necessarily, terminate substantially coextensively (neither being substantially longer than the other) at each of a lateral spinal support first ends (7a)(7b) and lateral spinal support second ends (8a)(8b) such that neither of the first or second lateral support portions (2)(3) have a corresponding lateral spinal support first end (7a)(7b) or lateral spinal support second end (8a)(8b) that is substantially offset a distance beyond the other. Now referring primarily to Figures 8 through 14, as to particular embodiments, the first and second lateral spinal support portions (2)(3) can, but need not necessarily, have either lateral spinal support first ends (7a)(7b) or lateral spinal support second ends (8a)(8b) that terminate substantially coextensively as above described while the opposite corresponding lateral spinal support first ends (7a)(7b) or lateral spinal support second ends (8a)(8b) are axially offset in relation to one another.

Now referring primarily to Figures 8 through 14, particular embodiments of the spinal support apparatus (1 ) which include lateral spinal support first ends (7a)(7b) which terminate substantially coextensively, as above described, while the lateral spinal support second ends (8a)(8b) are axially offset in relation to one another can, but need not necessarily, include the axial spinal support member (28), as above described, and can but need not necessarily include, a lateral spinal support member (34) which projects laterally outward from the first lateral spinal support portion (2) adjacent to the second lateral spinal support second end (8b) and extending a distance beyond second lateral side (25) of the second spinal support portion (3). The lateral spinal support member (34) can have a first and second lateral spinal support member sides (35)(36) which extend from the base (5) to join a lateral spinal support member face (37) having a lateral spinal support member height (38) adjacent the second lateral spinal support second end (8b) at about the recess base elevation (15). The overall length of the lateral spinal support member (24) can be of a greater or lesser length depending on the application.

Accordingly, particular embodiments, can have lateral spinal support first ends (7a)(7b) or lateral spinal support second ends (8a)(8b) axially offset in relation to one another exclusive of the an axial spinal support member (28) and a lateral spinal support member (34), or inclusive of one or the other of the axial spinal support member (28) and the lateral spinal support member (34), or inclusive of both the axial spinal support member (28) and the lateral spinal support member (34).

Now referring primarily to Figures 16 through 29 and referring to Figure 15, particular embodiments of the spinal support apparatus (1) above described can, but need not necessarily, have various elements shaped as portions of a human hand (39)(particular creases, segments and portions of the human hand (39) shown in the example of Figure 15). The first lateral spinal support portion (2), can but need not necessarily, have a configuration shaped like a portion of a palmer surface (40) of the human hand (39) including the hypothenar eminence (41) and a thenar eminence (42) disposed between an ulnar border (43) and a radial border (44) of the human hand (39) to correspond to or provide the first lateral spinal support face (9). The second lateral spinal support portion (3), can but need not necessarily, have a configuration shaped like the four fingers (45)(46)(47)(48)(index finger (45), middle finger (46), ring finger (47), and little finger (48)) of the human hand (39) curled to contact each corresponding fingertip (49) with the palmer surface (40) of the human hand (39) (as shown in the example of Figures 16A and 16B) at about the proximal palmer crease (50) to dispose the dorsal surface (51)(opposite the palmer surface (40)) of the middle phalanx (52) of each four fingers (45)(46)(47)(48) over the palmer surface (40) to correspond to or provide the second lateral spinal support face (10) of the spinal support apparatus (1). The medial recessed portion (4) can, but need not necessarily, be configured like the dorsal surface (51) of each distal phalanx (53) of each of the four fingers (45)(46)(47)(48) extending downwardly to join the palmer surface (40) of the human hand (39) and the palmer surface (40) extending upwardly from the distal phalanx (53) of each of the four fingers (45)(46)(47)(48) joining the palmer surface (40) toward the thenar eminence (42). The recess base (12) correspondingly disposed along the longitudinal axis (29) defined by the intersection of the distal phalanx (53) of each of the four fingers (45)(46)(47)(48) with the palmer surface (40). The axial spinal support member (28) which projects outward from the first lateral spinal support second end (8a) to cross the longitudinal axis (29) of the medial recessed portion (4), can but need not necessarily, have a configuration shaped like the thumb (54) of the human hand (39) extending outwardly from the thenar eminence (42) at an angle which crosses the longitudinal axis (29) defined by the intersection of the distal phalanx (53) of each of the four fingers (45)(46)(47)(48) with the palmer surface (40). The dorsal surface (51) of the hand opposite the palmer surface (40) corresponds to or provides the flat coextensive base (5) of the spinal mobilization apparatus ( 1 ). The first and second lateral sides (24)(25) extending upward from the coextensive base (5) can, but need not necessarily, be correspondingly shaped like the dorsal surface (51) of the proximal phalanx (55) of each of the four fingers (45)(46)(47)(48) and the portion of the hypothenar eminence (41 ) and thenar eminence (42) upwardly extending from the wrist (56).

Again referring primarily to Figures 16 through 29, as to particular embodiments, the first lateral spinal support portion (2) having a configuration shaped like a portion of a palmer surface (40) of the human hand (39) including the hypothenar eminence (41 ) and a thenar eminence (42) can correspond to the first lateral spinal support face (9) having substantially the same height between the ulnar border (43) of the human hand (39)(corresponding to the first lateral spinal support first end (7a)) and the radial border (44) of the human hand (39)(corresponding to the first lateral spinal support second end (8a)).

Similarly, the second lateral spinal support portion (3) having a configuration shaped like the four fingers (45)(46)(47)(48) (index finger (45), middle finger (46), ring finger (47). and little finger (48)) of the human hand curled to contact each fingertip (49) with the palmer surface (40) of the human hand (39) disposing the dorsal surface (51 ) of the middle phalanx (52) over the palmer surface (40) can provide the second lateral spinal support face ( 10) having substantially the same height between the ulnar border (43) and radial border (44) of the human hand (39).

The lateral spinal support first ends (7a)(7b) can correspond to the ulnar border (43) and the lateral spinal support second ends (8a)(8b) can be disposed at the radial border (44) can, but need not necessarily be, substantially the same height disposing each of the first lateral support face (9) afforded by the hypothenar eminence (41) and a thenar eminence (42) and second lateral spinal support face (10) afforded by the dorsal surface (51 ) of the middle phalanx (52) of the four fingers (45)(46)(47)(48) in substantially horizontal relation to the base (5) at the about the same height.

As to particular embodiments, the first lateral spinal support portion (2) having a configuration shaped like a portion of a palmer surface (40) of the human hand (39) including the hypothenar eminence (41 ) and a thenar eminence (42) and the second spinal support portion (3) afforded by the dorsal surface (51 ) of the middle phalanx (52) of the four fingers

(45) (46)(47)(48) can provide first and second lateral spinal support faces (9)( 10) which taper axially toward the base (5) between the radial border (44) of the human hand (39)(corresponding to the first lateral spinal support first end (7a)) and the ulnar border (43) of the human hand (39)(corresponding to the first lateral spinal support second end (8a)).

As to particular embodiments, the second lateral spinal support portion (3), can but need not necessarily, have a configuration shaped like the three fingers (46)(46)(48)(middle finger

(46) , ring finger (47), and little finger (48)) curled to contact each fingertip (49) with the palmer surface (40) of the human hand (39) (as shown in the example of Figures 23A and 23B at about the proximal palmer crease (50)) to dispose the dorsal surface (51 ) of the each middle phalanx (52) over the palmer surface (40) to correspond to or provide the second lateral spinal support face (3) of the spinal support apparatus (1 ). The lateral spinal support member (34) can be configured as the index finger (45) projecting outward from the palm (57) adjacent the curled middle finger (46) and extending beyond the dorsal surface (51 ) of the proximal phalanx (55).

Now referring generally to Figures 1 through 29, each of the various embodiments whether or not configured or shaped like the human hand (39) can be achieved as a chiral object or have left handedness (58) or right handedness (59).

Now referring primarily to Figures 30 through 32, methods of using embodiments of the spine mobilization apparatus ( 1 ) are shown. As to the embodiment of Figure 30, a patient (60) can lie supine face upward to position a spinal segment (20) with the plurality of spinous processes (19) of a spine segment (20) within the medial portion open space (18) with the first and second lateral spinal support portions (2)(3) each supporting one of two transverse processes (21 )(22) projecting from each vertebrae (23) on opposite sides of each corresponding spinous process (19) of spine segment (20).

Now referring primarily to Figure 30, as to certain embodiments of the spine mobilization apparatus (1 ), above described, in which the lateral spinal support first and second ends (7a)(7b)(8a)(8b) are coextensive (are not offset), posteroanterior mobilization of the vertebra (23) (largely confined to the sagittal plane of the spine) can be performed by movement of a pair of vertebrae (23a)(23b) within the physiological range of motion with the second ends (8a)(8b) supporting the first of the pair of vertebrae (23a) proximate the sagital plane between the first vertebrae (23a) and the second vertebrae (23b) of the pair of vertebrae (23a)(23b). The therapist may use slow, passive movements, starting with a small range and gradually increasing to a larger range of motion within the physiological range of motion of the pair of vertebrae (23a)(23b).

Now referring primarily to Figures 31 and 32, as to certain embodiments of the spine mobilization apparatus (1), above described, in which the lateral spinal support first ends (7a)(7b) are coextensive (are not offset), and the lateral spinal support second ends (8a)(8b) are offset, as above described, and can, but need not necessarily, include the lateral spinal support member which projects laterally outward from the first lateral spinal support portion (2) adjacent to the second lateral spinal support second end (8b) and extending a distance beyond the second lateral side (25) of the second spinal support portion (3) can be used to more readily, or efficaciously effect rotational mobilization between a pair of vertebrae (23a)(23b) which involves complex three dimensional movements and loading resulting in axial rotation of at least one of the pair of vertebrae (23a)(23b). In this regard, embodiments of the spinal support apparatus (1) in the left handed configuration can advantage axial rotation in the clockwise direction and embodiments of the spinal support apparatus (1) in the right handed configuration can advantage axial rotation in the counter clockwise direction. As can be easily understood from the foregoing, the basic concepts of the present invention may be embodied in a variety of ways. The invention involves numerous and varied embodiments of a spinal support apparatus (1) and methods for making and using such spinal support apparatus (1 ) including the best mode.

As such, the particular embodiments or elements of the invention disclosed by the description or shown in the figures or tables accompanying this application are not intended to be limiting, but rather exemplary of the numerous and varied embodiments generically encompassed by the invention or equivalents encompassed with respect to any particular element thereof. In addition, the specific description of a single embodiment or element of the invention may not explicitly describe all embodiments or elements possible; many alternatives are implicitly disclosed by the description and figures.

It should be understood that each element of an apparatus or each step of a method may be described by an apparatus term or method term. Such terms can be substituted where desired to make explicit the implicitly broad coverage to which this invention is entitled. As but one example, it should be understood that all steps of a method may be disclosed as an action, a means for taking that action, or as an element which causes that action. Similarly, each element of an apparatus may be disclosed as the physical element or the action which that physical element facilitates. As but one example, the disclosure of a "support" should be understood to encompass disclosure of the act of "supporting" - whether explicitly discussed or not - and, conversely, were there effectively disclosure of the act of "supporting' * , such a disclosure should be understood to encompass disclosure of a "support" and even a "means for supporting." Such alternative terms for each element or step are to be understood to be explicitly included in the description. In addition, as to each term used it should be understood that unless its utilization in this application is inconsistent with such interpretation, common dictionary definitions should be understood to be included in the description for each term as contained in the Random House Webster's Unabridged Dictionary, second edition, each definition hereby incorporated by reference. All numeric values herein are assumed to be modified by the term "about", whether or not explicitly indicated. For the purposes of the present invention, ranges may be expressed as from "about" one particular value to "about" another particular value. When such a range is expressed, another embodiment includes from the one particular value to the other particular value. The recitation of numerical ranges by endpoints includes all the numeric values subsumed within that range. A numerical range of one to five includes for example the numeric values 1 , 1.5, 2, 2.75, 3, 3.80, 4, 5, and so forth. It will be further understood that the endpoints of each of the ranges are significant both in relation to the other endpoint, and independently of the other endpoint. When a value is expressed as an approximation by use of the antecedent "about," it will be understood that the particular value forms another embodiment. The term "about" generally refers to a range of numeric values that one of skill in the art would consider equivalent to the recited numeric value or having the same function or result. Similarly, the antecedent "substantially" means largely, but not wholly, the same form, manner or degree and the particular element will have a range of configurations as a person of ordinary skill in the art would consider as having the same function or result. When a particular element is expressed as an approximation by use of the antecedent "substantially," it will be understood that the particular element forms another embodiment.

Moreover, for the purposes of the present invention, the term "a" or "an" entity refers to one or more of that entity unless otherwise limited. As such, the terms "a" or "an", "one or more" and "at least one" can be used interchangeably herein. Thus, the applicant(s) should be understood to claim at least: i) each of the spinal support apparatuses herein disclosed and described, ii) the related methods disclosed and described, iii) similar, equivalent, and even implicit variations of each of these devices and methods, iv) those alternative embodiments which accomplish each of the functions shown, disclosed, or described, v) those alternative designs and methods which accomplish each of the functions shown as are implicit to accomplish that which is disclosed and described, vi) each feature, component, and step shown as separate and independent inventions, vii) the applications enhanced by the various systems or components disclosed, viii) the resulting products produced by such systems or components, ix) methods and apparatuses substantially as described hereinbefore and with reference to any of the accompanying examples, x) the various combinations and permutations of each of the previous elements disclosed.

The background section of this patent application provides a statement of the field of endeavor to which the invention pertains. This section may also incorporate or contain paraphrasing of certain United States patents, patent applications, publications, or subject matter of the claimed invention useful in relating information, problems, or concerns about the state of technology to which the invention is drawn toward. It is not intended that any United States patent, patent application, publication, statement or other information cited or incorporated herein be interpreted, construed or deemed to be admitted as prior art with respect to the invention. The claims set forth in this specification, if any, are hereby incorporated by reference as part of this description of the invention, and the applicant expressly reserves the right to use all of or a portion of such incorporated content of such claims as additional description to support any of or all of the claims or any element or component thereof, and the applicant further expressly reserves the right to move any portion of or all of the incorporated content of such claims or any element or component thereof from the description into the claims or vice-versa as necessary to define the matter for which protection is sought by this application or by any subsequent application or continuation, division, or continuation-in-part application thereof, or to obtain any benefit of, reduction in fees pursuant to, or to comply with the patent laws, rules, or regulations of any country or treaty, and such content incorporated by reference shall survive during the entire pendency of this application including any subsequent continuation, division, or continuation-in-part application thereof or any reissue or extension thereon.

Additionally, the claims set forth in this specification, if any, are further intended to describe the metes and bounds of a limited number of the preferred embodiments of the invention and are not to be construed as the broadest embodiment of the invention or a complete listing of embodiments of the invention that may be claimed. The applicant does not waive any right to develop further claims based upon the description set forth above as a part of any continuation, division, or continuation-in-part, or similar application.