Wunderlich M, Jacob R, Stelzig Y, Rüther T, Leyk D
Institut für Physiologie und Anatomie, Deutsche Sporthochschule Köln, Am Sportpark Müngersdorf 6, 50933, Köln, Deutschland.
HNO. 2010 Aug;58(8):791-8. doi: 10.1007/s00106-010-2091-0.
Back pain is a common cause of sick leave in industrialized countries. Performing surgery is often associated with considerable cervical spine disorders. However, only a few studies have examined to what extent working posture or individual surgical techniques can be seen as stress indicators.
Posture and movement of the spine and trunk were assessed by means of a newly developed analysis system (3-D-SMG). The individual-case study was carried out during six sinus operations using varying techniques (microscope, endoscope or headlamp only).
Spine and trunk deviation from neutral position (upright standing) was strongest in the sagittal plane. Awkward distortions were primarily observed in the cervical and lumbar spine. The analysis of work characteristics revealed static postures in 65-90% of sinus operations. Isometric positions were mainly related to microscopic surgery.
The data from this explorative individual-case study indicate that prevalence and magnitude of forced isometric and awkward postures are strongly associated with work-related spinal stress in sinus surgery. The new measurement device enables not only the recommendation of individual preventive strategies but also the objective evaluation of ergonomics.
在工业化国家，背痛是病假的常见原因。进行手术通常与相当多的颈椎疾病相关。然而，只有少数研究探讨了工作姿势或个体手术技术在多大程度上可被视为压力指标。
通过新开发的分析系统（3-D-SMG）评估脊柱和躯干的姿势及运动。在六次鼻窦手术中采用不同技术（仅显微镜、内窥镜或头灯）进行个案研究。
脊柱和躯干偏离中立位置（直立站立）在矢状面最为明显。主要在颈椎和腰椎观察到别扭的扭曲。对工作特征的分析显示，65%至90%的鼻窦手术存在静态姿势。等长姿势主要与显微手术相关。
这项探索性个案研究的数据表明，强制等长姿势和别扭姿势的发生率及程度与鼻窦手术中与工作相关的脊柱压力密切相关。这种新的测量设备不仅能够推荐个体预防策略，还能对人体工程学进行客观评估。
