Tzeng Yuan-Sheng, Chen Shyi-Gen, Chen Tim-Mo
Division of Plastic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Ann Plast Surg. 2012 Dec;69(6):672-4. doi: 10.1097/SAP.0b013e3182742743.
Herniations of the cervical disk in plastic surgeons are far more common in practice than the paucity of reported cases would indicate. A likely explanation may be the peculiar, nonergonomic positions that plastic surgeons must hold during surgery while wearing a headlight and loupes. From January 2003 to December 2006, at Tri-Service General Hospital, Taiwan, 4 plastic surgeons experienced herniations of the cervical disk. Magnetic resonance imaging study indicated there was disk herniation or bulging with spinal cord impingement. Two plastic surgeons received cervical diskectomy, corpectomy with strut reconstruction using titanium cages. These 2 surgeons were symptom-free 2 years after their operations. The other 2 plastic surgeons were under conservative physical therapy with persistent symptoms. The clinical evidence indicated that cervical disk herniation is an occupational hazard in plastic surgeons. To prevent prolonged hyperflexion and twisting of the neck, we proposed wearing a cervical brace during surgery for the plastic surgeons at Tri-Service-General Hospital since January 2008. No more plastic surgeons have experienced herniation of the cervical disk since then. The results indicated that wearing a cervical brace may be an effective measure to protect plastic surgeons from cervical disk disease.
在整形外科医生中，颈椎间盘突出症在实际工作中远比所报道病例的稀少情况更为常见。一个可能的解释是，整形外科医生在手术过程中佩戴头灯和放大镜时必须保持的特殊、不符合人体工程学的姿势。2003年1月至2006年12月期间，在台湾三军总医院，有4名整形外科医生出现了颈椎间盘突出症。磁共振成像研究表明存在椎间盘突出或膨出并伴有脊髓受压。两名整形外科医生接受了颈椎间盘切除术、椎体次全切除并用钛笼进行支撑重建。这两名医生术后两年无症状。另外两名整形外科医生接受保守物理治疗但症状持续。临床证据表明颈椎间盘突出症是整形外科医生的职业危害。为防止颈部长期过度前屈和扭转，自2008年1月起，我们建议三军总医院的整形外科医生在手术期间佩戴颈托。从那时起，没有更多的整形外科医生出现颈椎间盘突出症。结果表明，佩戴颈托可能是保护整形外科医生免受颈椎间盘疾病困扰的有效措施。
